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Types of Epileptic Seizures in Children

Seizures are classified in two major categories based on the origin of the abnormal electrical activity in the brain:

  • Primary generalized seizures start with widespread electrical activity on both sides of the brain.
  • Partial (focal) seizures begin with electrical activity confined to one side of the brain.

Within these two categories, there are dozens of types of seizures. Each type is associated with a combination of symptoms. It is important to get an expert medical assessment to determine which type of seizure your child is having and determine the most effective treatment for that specific type of seizure.

Some seizures and epilepsy syndromes cannot be simply classified in these two categories. Sometimes a seizure starts on one side of the brain and spreads to the other side. This is called a secondarily generalized seizure (SGS). Additionally, it is possible to have primary generalized seizures with occasional partial (focal) seizures. This is called symptomatic generalized epilepsy (SGE).

Primary Generalized Seizures

Absence seizures

If your child is experiencing absence seizures, also known as petit mal seizures, he or she may seem to “space out” or stare blankly. It’s possible that your child’s eyes may roll, as well. This type of staring is different from a child mesmerized by the television, for example. It occurs with no apparent reason, and may happen suddenly. If your child has absence seizures, there’s a good chance he or she may lose awareness during the seizure and may not remember it afterward. It’s also possible that your child will have subtle body movement during the seizure -- but not the classic jerking spasms associated with other types of seizures. 

Atonic seizures

Atonic seizures may involve a sudden loss of muscle tone, a head drop, or leg weakening. If your child has an atonic seizure, he or she may suddenly collapse or drop objects. Atonic seizures are also called drop attacksdrop seizures and akinetic epileptic drop attacks

Clonic seizures

Characterized by jerking muscle movements and spasms, clonic seizures involve movements that are most often rhythmic rather than chaotic. The affected muscles are usually in the face, neck or arms. Clonic seizures may last for several minutes. 

Tonic-clonic seizures

Tonic-clonic seizures, also known as grand mal seizures, are characterized by classic symptoms that tend to be most commonly associated with seizures: loss of consciousness, body stiffening, and jerking or shaking movements. Symptoms may also include loss of bladder or bowel control. 

Tonic seizures

Tonic seizures cause the body to stiffen. If your child has a tonic seizure, he or she may fall or collapse. The stiffening most often affects muscles in the back, arm or leg. 

Myoclonic seizures

Characterized by uncontrollable jerking movement, myoclonic seizures most often affect the arms, legs or both. Myoclonic seizures are usually brief, lasting for only a second or two. 

Partial Seizures (Focal Seizures)

Partial seizures, also known as focal seizures, are classified as one of two types:

  • Simple partial seizures, also called simple focal seizures
  • Complex partial seizures, also called psychomotor seizures

Recurrent partial (focal) seizures are sometimes also referred to as one of four classifications based on the area of the brain where seizure activity occurs:

  • Frontal lobe epilepsy
  • Occipital lobe epilepsy
  • Parietal lobe epilepsy
  • Temporal lobe epilepsy

The location of the seizure activity is closely associated with the type of seizures that occur and the severity of the impact on the child. For example, gelastic epilepsy is associated with hypothalamic hamartoma, a benign tumor or lesion located in or near the hypothalamus. With gelastic seizures, most commonly characterized by uncontrollable laughing spells, activity generally occurs around the hypothalamus in the frontal or temporal lobe.

Simple partial seizures (Simple focal seizures)

Some simple partial seizures only include the aura stage, which is the first of three stages often seen with other types of seizures.If your child has a simple partial seizure, he or she will remain aware and conscious, and will likely retain all memory of what happened. The seizure may alter your child’s emotions or alter sensory perception, changing the way things smell, taste, look, feel or sound. He or she may also experience involuntary jerking of an arm, leg or other body part and may experience spontaneous sensory symptoms, like dizziness, tingling or seeing flashing lights.

Complex partial seizures (Psychomotor seizures)

Complex partial seizures alter consciousness or responsiveness. If your child has this type of seizure, he or she may appear to move without purpose or stare into space. Some of the movements often associated with complex partial seizures include abnormal or continuous swallowing, hand rubbing, chewing, or repetitive motion, like walking in a circle or moving the legs as if riding a bicycle.