Seizures are broadly classified in to two – generalized and partial seizures. Those seizures where the patient loses consciousness are termed generalized seizures. In partial seizure there is no loss of consciousness.
Generalized tonic clonic seizure
In a certain type of generalized seizures, convulsions initially produce a stiffening of the entire body, rolling up of the eyes, and cessation of respiration which lasts for a few seconds. This phase is followed by jerking movements of the body parts and chewing movements of the jaws. Frothing from the mouth and incontinence of urine are at times seen during this type of seizures. During this phase which might last for three to five minutes, there is a risk of biting the tongue, or injuring the limbs. After this phase most patients lapses in to a deep sleep which might last for a variable period. On waking up some of them develop vomiting or severe headache. This type of seizure is called generalized tonic clonic epilepsy. (Grand mal epilepsy) The patient all of a sudden notices himself on the ground and concludes that he had a seizure from circumstantial evidences because he had lost consciousness during the entire seizure.
In a generalized seizure termed as absence and which is mostly seen in children, the person suddenly loses consciousness, but doesn’t fall down or develop any motor phenomena. He vacantly stares foreword for a few seconds and abruptly “wakes up”. These type of seizures are likely to be missed totally or are often ignored as inattention because the changes are very subtle.
Simple partial seizure
In certain cases the fits start as a twitching of a body part such as a finger or angle of the mouth. These jerking may remain confined to the site where it has started (Focal motor seizures) or slowly spreads to the adjoining parts and finally becomes a generalized seizure with loss of consciousness (Focal motor seizure with secondary generalization). Sometimes the seizure phenomena may be a paresthesia or peculiar abnormal sensation rather than movement of a body part (Sensory seizure). These sensory seizures can progress to become sensory-motor seizure.
Complex partial seizures
At times the seizure starts as a vague discomfort in the abdomen or an abnormal fearful feeling followed by clouding of consciousness. During this period the person may attempt to walk about or do certain physical activities as if in a dream like state. Chewing movements, lip smacking and fidgeting with clothes are the usual phenomena seen during this phase. However, it is not common for these patients to execute complex and purposeful activities during this period. This type of seizures which were previously called Temporal Lobe Seizures are now termed Complex partial seizure. Some of these episodes may culminate in generalized seizures. This type of seizures are also usually mistaken for behavioral abnormalities or pshychiatric disorders.