Epilepsy is a neurological disorder affecting one in twenty-six Americans according to Dr. Joseph Sirvin, MD of the Epilepsy Foundation. There are several types of epileptic seizure you should know about.
According to the Epilepsy Foundation, there are fourteen different types of seizures. You or a loved one may be suffering from epilepsy and not even know it. There have been updates to the names of certain seizures so it’s important for all to know what’s new in epilepsy research. Everyone needs to know the signs of different seizures and what to do when we see a person having a seizure. Epilepsy can be deadly depending on the type of seizure. Epilepsy affects women and men differently, along with affecting races differently.
Here are the different types of epileptic seizure.
1. Focal Aware Seizures
One of the types of epileptic seizure is a focal aware seizure. This type begins in one side of the brain. They are the most common types of seizures in all ages. Anybody can get focal aware seizures, but there is an increased risk for those who have had a stroke, head trauma, a brain tumor or a brain infection. The person is fully awake and aware during a focal aware seizure. These seizures last less than two minutes. Focal aware seizures can be a warning before a stronger seizure, with a loss of consciousness. The person must tell you it’s happening, as mostly you will be unaware.
2. Focal Onset Impaired Awareness Seizures
These are most common in adults. A focal onset impaired awareness seizure begins on one side of the brain. A person will have a change in their level of awareness during some or all of the seizure. This type of seizure most often starts in the temporal or frontal lobe. Seizures that begin in the frontal lobe tend to be shorter han those starting in the temporal lobe.
Focal onset impaired awareness seizures can involve involuntary movements such as bicycle movements of the legs and pelvic thrusting with frontal lobe seizures. The onset of focal onset impaired awareness seizures is that the person suddenly stares blankly and does not respond. This type of seizure lasts thirty seconds to three minutes and the person may not be aware they are having a seizure.
Afterwards, they are tired and confused for fifteen minutes and may not return to normal functioning for hours. Less often people cry, scream, laugh or repeat words. Due to involuntary movements, the person may take off their clothes or do something unsafe.
Treatment available is surgery, dietary therapy, vagus nerve stimulation, and responsive neurostimulation. Some people may outgrow focal onset impaired awareness seizures or have it be controlled with medication.
3. Bilateral Tonic-Clonic Seizures
This type of seizure can be deadly. Bilateral tonic-clonic seizures can happen to anyone who has focal onset seizures and occur in thirty percent of people with focal onset seizures. These seizures start suddenly and movement can be strong or forceful.
They may start with a focal onset aware seizure or an aura such as a smell, feeling of nausea, or change in sensation or movement. The person may turn their eyes or head forcefully. The person is fully awake at this point. The tonic phase starts with the stiffening of the muscles. This is the point where the person is unaware they are having a seizure. At this point, the person may cry or groan. They may bite their tongue or cheek forcefully so there could be blood in the mouth. Breathing can be temporarily impaired.
Next, the clonic phase begins with jerking movements. The person has no control over their body and may urinate and defecate. Consciousness returns slowly. It can take days for a person to recover from a bilateral tonic-clonic seizure. If the seizure lasts more than five minutes you must dial 911.
If the person does not return to normal or another seizure occurs before they return to normal this may be a sign of a medical emergency called status epilepticus and you must dial 911. It ranges widely in how many a person with bilateral tonic-clonic seizures will have on a daily basis.
Some are helped by medication, but medication, unfortunately, does not work for all. If they do begin in one area of the brain surgery or neurostimulation can be an option for treatment. Devices, such as cameras that detect seizures, and diet therapy are also part of the treatment program.
4. Absence Seizures
These last for a short period of time and are noticeable when a person stares into space. This is not the same as daydreaming, as the person will suddenly stop doing something, such as talking about the weather or throwing the ball for their dog to fetch.
Absence seizures used to be called petit mal seizures. An absence seizure begins on both sides of the brain at the same time. There are two types of absence seizures. During an absence seizure, which typically lasts less than ten seconds, the person’s eyes may turn upward and flutter. They may rub their fingers, chew, or smack their lips. Generally, no first aid is needed even though the person will be unaware they had a seizure.
Absence seizures mostly affect children from ages four to fourteen years old, and some people may have hundreds of absence seizures a day. Epilepsy can severely affect the quality of a person’s life.
For seventy percent, the seizures will disappear by the time the child turns eighteen. The chances are much greater of a child outgrowing this type of seizure if the absence seizures began before age nine.
5. Tonic-Clonic Seizures
These potentially lethal seizures are the same as bilateral tonic-clonic seizures but start only in one part of the brain. These used to be called grand mal seizures. The same seizure patterns happen as those in a bilateral tonic-clonic seizure. If the seizure lasts more than five minutes, another seizure occurs before they return to normal, or the person does not return to normal, dial 911. If tonic-clonic seizures occur in childhood there is a seventy percent chance the child will outgrow them. Medication can help some, along with a responsive stimulator or vagus nerve stimulator.
6. Atonic Seizures
During this seizure, the head may droop forward and the person may drop things. If the person is standing, they will drop to the ground because their muscles suddenly become limp. People with atonic seizures may need to wear a helmet. Atonic seizures are also called drop seizures. These seizures typically last less than fifteen seconds, usually start in childhood and are lifelong. Usually, the person is unaware they are having a seizure and may or may not be confused after the seizure. The person may have one or a cluster of them in a row.
Be sure to check for bumps and bruises and give first aid or call 911 if there are serious injuries, such as if they hit their head when falling. Treatment options are medication, which works for some, dietary therapies, vagus nerve stimulation or split-brain operation, which is a very serious brain operation in which nerves connecting the left and right brain hemispheres are cut apart.
7. Clonic Seizures
This type can start in the motor area of the brain. These are noticeable due to the repeated jerking in one part of the body or face. Clonic seizures affect all ages, including newborns. Medication is the standard treatment.
8. Tonic Seizures
This type of seizure usually lasts less than twenty seconds and normally does not require first aid. A person may fall and this seizure is noticeable by the stiffening of the muscles. Tonic seizures typically occur during sleep and will wake the person up so they may be aware or notice a small change in awareness during the tonic seizure. This type of seizure happens to anyone, although they are more common in people diagnosed with Lennox-Gastaut syndrome.
9. Myoclonic Seizures
There are two types of myoclonic seizures and the latter is tragically lethal. Myoclonic seizures involve brief, shock-like jerks of a muscle or group of muscles. Juvenile myoclonic seizures start anywhere from the beginning of puberty to early adulthood and typically happen to children and young adults with average IQs. Normally, juvenile myoclonic seizures happen right when waking. They affect the neck, shoulder, and upper arms and require medication for life. Progressive myoclonic epilepsy is a combination of myoclonic and tonic-clonic seizures. Treatment is not long lasting and sadly the patient does deteriorate over time.
10. Gelastic and Dacrystic Seizures
These are seizures that affect only children. Since these seizures begin in the hypothalamus they are hard to detect with an EEG test. A gelastic seizure can be noticed when the child has uncontrollable giggling or laughing. They may look like they are smirking.
Do not be deceived, most children do not feel happy or well during a gelastic seizure. A dycristic seizure is when uncontrollable crying occurs. Gelastic seizures happen in an astounding thirty-three percent of children and start typically around ten months old. Typically the child remains awareness. If they were sleeping the seizure will wake them up.
Before the gelastic or dacrystic seizure occurs, the infant or child may stare blankly, have a headache, or have butterflies in their stomach. A child may run to his parent, teacher, or favorite toy for comfort. It’s important to prevent fearful reactions and loud noises as much as possible as these stimuli have been proven to increase the frequency of gelastic and dacrystic seizures.
Unfortunately, seventy-five percent of children with these types of seizures will develop other seizures as they age, sometimes including lethal forms of seizures such as bilateral clonic-tonic seizures. Unfortunately, since they begin in the hypothalamus they are very difficult to diagnose with an EEG, the standard tool for diagnosing epilepsy.
11. Febrile Seizures
These occur in children ages three months to age six when the child has a high fever. Febrile seizures occur in 2% to 5% of children. A febrile seizure can happen out of the blue. Treatment involves medication, such as diastate gel given through the rectum during a febrile seizure. The vast majority of children outgrow febrile seizures after age five.
12. A Refractory Seizure
This refers to any type of seizure that is not controlled with medication. Unfortunately, only one-third of people with epilepsy respond to medication. This is why donations for further research are so vital because epilepsy can be deadly. According to the National Epilepsy Foundation, 3.4 million Americans have epilepsy, and many are undiagnosed. Epilepsy effects races and different demographics in various ways.
Who is affected by seizures?
13. The Transgender Population
Dr. Kristine Ziemba, MD states the transgender population who decide to take hormone treatment drugs, such as to prevent growing breasts, can affect seizure medication. Transgender people with epilepsy must work carefully with their doctors and decide if hormonal drugs are something they really want to take because they can damper the effectiveness of seizure medications.
14. The Veteran Population
Epilepsy is the most common form of head trauma. Post-traumatic epilepsy or PTE is caused by a traumatic brain injury, TBI.
Three hundred thousand American children have epilepsy. Children with epilepsy are often bullied and socially ostracized. It is extremely important that teachers and parents teach children about epilepsy so that children with epilepsy are understood and befriended.
For women of the childbearing decades, epileptic seizures increase because of the menstruation cycle and pregnancy. Menopause will also affect the number and severity of seizures. Contraception effects the efficacy of seizure medication because of the hormones involved in it.
If you are a man with epilepsy, there is a higher chance your biological children will have it. Men are also more likely than women to keep their epilepsy to themselves. Suicide rates in men with epilepsy are a concern. It’s important to join support groups and talk to others about your epilepsy so they can help you, potentially saving your life. If you are a father who gave away a baby for adoption, and you have epilepsy, it is vital you find the adoptive parents if your child is a minor, or your adopted child if they are an adult, and let them know about your epilepsy because it can run in families. Many people today are using websites such as Family Tree DNA and ancestry.com DNA to connect with biological family.
18. Senior Population
Three hundred thousand seniors in the United States have epilepsy. They have a higher risk of falls, and therefore a higher risk of broken bones. Epilepsy also puts a strain on elderly people’s hearts. Alzheimer's, a pandemic, can trigger the onset of epilepsy.
19. Asian American Population
According to the Epilepsy Foundation, three in two hundred Asian Americans has epilepsy. However, it is recorded that the statistics may be higher because in some Asian cultures epilepsy is a taboo topic, and is seen as a mental illness which carries a great stigma in some cultures. It is important for everybody, Asian American or not, to talk openly about epilepsy and learn this is a potentially serious neurological disorder. The Epilepsy Foundation does not specify if the three in two hundred ratio is primarily for Asian Americans whose ancestors hail from a certain region of Asia.
20. Black American Population
Three hundred seventy-five African Americans have epilepsy. Heartbreakingly, epilepsy is more detrimental to black people. Black Americans are more likely to develop lifelong epilepsy. Black Americans are also more likely to have medical emergency seizures, and they are more likely to die from SUDEP, a sudden death caused by an epileptic seizure. (National Research Council, 2012).
21. Closed Adoptee Population
Currently, approximately seven million Americans are in a closed adoption. Closed adoptees, their children, and grandchildren do not have biological family medical information or updated biological family medical information. In many states, there is no way to update said information and pass it along to the adoptee. Adoption agencies can choose whether or not they want to send along life saving family health history even if the biological parent asks them to which can be read about in "A Hole In My Heart" by Lorraine Dusky, a first mother and writer for the New York Times from Rochester, New York whose adopted out daughter suffered from epilepsy and the adoption agency refused to pass along medical information between the adoptive parents, pediatrician, and Lorraine. Unfortunately, the book has a tragic ending.
Late discovery adoption is also a common problem in the United States. This occurs when an adult learns they are adopted or that one parent is not their biological parent. In 2017 alone, I personally encountered four adults in their fifties and sixties who learned they are adopted. Late discovery adoptees learn that the family health information they gave their doctors is incorrect, along with information passed down to their children and grandchildren. Courts have not unsealed original birth certificates or adoption records for adoptees in life or death situations, such as epilepsy, and because of the discrimination toward adoptees, some have died from otherwise preventable diseases and disorders.
It’s important for first-time parents and biological relatives to reach out to the adopted out family member. Whether you are an adoptee searching or a biological family member searching, a great tool to use to find family are DNA sites such as Family Tree DNA and ancestry.com DNA.
According to registered nurse Patty Osborne Shafer, RN, MN and a first responder training video dated July 1, 2015 from the Epilepsy Foundation of Eastern Pennsylvania the following information is important for all to know:
22. Be Educated and Educate Others to Get past the Fear
It can be scary seeing someone suddenly drop. You need to remain calm in order to help the person.
23. Break the Myths
For example, a person can never swallow their tongue during a seizure.
24. Seizures Are Caused by Abnormal Electrical Activity in the Brain
25. Stress Can Bring on a Seizure, Making the Combat Veteran Population Susceptible
26. Hunger and Dehydration Can Cause a Seizure
27. Flashing Lights Can Cause a Seizure
28. Sleep Deprivation Can Trigger a Seizure
More information can be found at epilepsy.com where donations can be made.