Epilepsy is a group of brain disorders that cause seizures, which can start in any part of the brain. Because of this, the symptoms of epilepsy can be very different from person to person. Most people with epilepsy have a similar type of seizure each time, so their symptoms usually don’t change much from one seizure to the next. Some people can have more than one type of seizure. This often leads to a common question for those living with epilepsy and their families: How many types of seizures are there?

There are many different kinds of seizures, but they can be classified into three main types:

• Generalized onset seizures — If you’ve ever asked, “Which type of seizure affects both sides of the brain?” it’s these. They can also lead to loss of consciousness and fatigue afterward.
• Focal onset seizures — These affect only one area of the brain and used to be called partial seizures.
• Unknown onset seizure — These seizures are difficult to classify as either generalized or focal because there isn’t enough information about how they begin.

Sometimes, diagnosing the type of seizure is not straightforward. One MyEpilepsyTeam member shared, “I have grand mals and an unknown seizure that required an EEG while having the seizure to tell what type of seizure it was.” (EEG is short for “electroencephalogram,” a test that measures eletrical activity in the brain.)

The seizure types listed below describe where in the brain the seizure starts, the level of awareness during the seizure, and whether or not the seizure involves movement. The terminology used in this article is based on a new classification system developed in 2017 by the International League Against Epilepsy. You may also see older classification systems when reading about or discussing seizures.

Knowing what type of seizure you have can make it easier to understand your condition and find the right treatment options. One MyEpilepsyTeam member said, “Since there are so many different types of seizures, another person with epilepsy may not know what it feels like having the type of seizures you have.”

Keep reading to learn about some of the different types of seizures you might experience.

1. Generalized Tonic-Clonic Seizures

Generalized tonic-clonic seizures were previously known as grand mal seizures. There are five distinct phases to this type of seizure, although not everyone will experience all five. During the tonic phase, the body, arms, and legs will flex, then straighten, then shake. In the clonic period, contraction (tightening) and relaxation of the muscles follow. The seizure ends with a recovery phase called the postictal period, when a person may feel very tired, have trouble seeing or speaking clearly, and experience headaches or body aches.

Generalized tonic-clonic seizures can sometimes be signaled by an aura, which is a sensation or feeling that happens just before the seizure starts. Sometimes, the aura is a focal onset aware seizure. Tonic-clonic seizures may also cause vomiting and loss of bladder control.

2. Absence Seizures

Absence seizures are another form of generalized seizure, formerly referred to as petit mal seizures. They typically last less than 30 seconds. Absence seizures cause a short period of staring and altered consciousness. Most likely, the person will remain standing or sitting upright. Their eyes may blink rapidly, or their face or mouth may twitch. After the seizure, they may not remember what just happened. Absence seizures may happen multiple times a day.

3. Atonic Seizures

Atonic seizures or akinetic seizures (also called drop attacks) are a type of seizure that can cause a sudden loss of muscle tone. A person may suddenly drop their head or fall from a standing position. During the seizure, the body part will be limp and the onset can be focal or generalized.

4. Myoclonic Seizures

Myoclonic seizures are motor seizures that often occur in clusters. This type of seizure can cause quick, sudden muscle jerks, but these movements are brief and don’t last long. Myoclonic seizures may happen several times a day or many days in a row and can be either focal or generalized.

5. Clonic Seizures

Clonic seizures cause continuous jerking movements and/or rhythmic motions of the arms and legs, sometimes affecting the face and neck. Clonic seizures can happen on both sides of the body.

6. Tonic Seizures

Tonic seizures cause sudden muscle stiffening. Tonic seizures can have a focal or generalized onset. If a tonic seizure affects both legs or occurs when the person is standing, it can cause them to fall.

7. Focal Aware Seizures

Focal aware seizures, previously called simple partial seizures or simple focal seizures, begin in a specific area of the brain. If a person is awake and aware during the seizure, it’s called a focal aware seizure. Symptoms of a focal seizure vary depending on which part of the brain it affects but may include:

• Visual disturbances
• Isolated muscle twitching
• Sweating
• Nausea
• Intense emotions
• Unusual sensations

Focal aware seizures can sometimes precede a tonic-clonic seizure, leading some people to regard them as auras or premonitions of an oncoming generalized seizure. Because there aren’t always many signs of an oncoming seizure, it’s good to know that these can be an indicator.

8. Focal Impaired Awareness Seizures

During focal impaired awareness seizures, formerly referred to as complex partial seizures, a person may be confused, appear awake but be unresponsive, or lose consciousness. Other behaviors during focal impaired awareness seizures may include chewing, gagging, laughing, crying, screaming, or running. These seizures generally last between 30 seconds and one minute. After the seizure, feeling very tired is common.

9. Focal to Bilateral Tonic-Clonic

Previously known as secondary generalized, focal to bilateral tonic-clonic seizures start in one area of the brain and then spread to both sides. At first, a person might show specific signs depending on where the seizure begins, but as it spreads, it can turn into a more widespread, generalized seizure. This change in symptoms is why these seizures can look different as they progress.

What Triggers Seizures?

In some people with epilepsy, certain circumstances can trigger a seizure. Triggers vary from person to person, but the most common are:

• Stress
• Missed doses of medication
• Lack of sleep
• Flashing lights
• Alcohol
• Hormonal changes related to menstruation
• Fever or infection
• Hypoglycemia (low blood sugar)
• Caffeine and other stimulants
• Pain
• Certain medications

Identifying seizure triggers allows a person with epilepsy to avoid theirs and hopefully have fewer seizures. Keeping a seizure diary is a good way to identify triggers. When a seizure occurs, note the date and time, any special situations surrounding the seizure, and how it felt. There are many apps and websites that can help you track seizures and triggers.

What Do Stress Seizures Look Like?

While stress can cause epileptic seizures, some people experience psychogenic nonepileptic seizures when they’re in psychological distress. These look a lot like epileptic seizures but are not caused by electrical impulses or activity in your brain. Instead, the person is unknowingly converting their stress to a physical symptom. A health care provider may need to record the brain’s electrical activity to determine what kind of seizure you’re having.

What Are the Most Common Types of Seizures?

Temporal lobe seizures are the most common type of seizures. These are a kind of focal seizure that affects the temporal lobe. This part of the brain is just inside the temples and contributes to feelings, memories, and understanding of both sound and language.

Work With Your Doctor

With so many types of seizures, understanding what each one looks like can make a big difference in managing epilepsy. Recognizing seizure patterns and triggers can guide better treatment choices and improve daily life. Keeping track of symptoms can also give doctors valuable information to create an effective plan for reducing seizures.

Talk with your doctor about any changes you notice in your seizures, ask if different treatment options might be right for you, or discuss how to adjust your plan to better avoid triggers. Working closely with a health care provider can help you find the best approach for your needs.

Find Your Team

On MyEpilepsyTeam, the social network for people with epilepsy, more than 123,000 members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

What kind of seizures do you or your child have and what are the symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.