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Types of epileptic seizures and what to do
Epileptic seizures can be divided into two main types: partial seizures and generalised seizures. Seizures
can vary from one person to another and how people are affected and how they recover after seizures
varies.

Partial seizures

In partial seizures the seizure starts in, and affects, just part of one side of the brain. What happens during
the seizure depends on where in the brain the seizure happens and what this part of the brain normally
does.

Simple partial seizures

In a simple partial seizure (SPS) the person is conscious (awake) and aware of what is happening to them.
A SPS could be twitching of one limb or part of a limb, an unusual smell or taste, a strange feeling such
as a ‘rising’ sensation in the stomach or ‘pins and needles’ in part of the body or a sudden intense feeling
of fear or joy.

What to do during the seizure:

        although the person is awake and aware, SPS can feel unsettling so giving gentle reassurance may
        be helpful.

Complex partial seizures

A complex partial seizure (CPS) affects a bigger part of the brain than a SPS. In a CPS the person’s
consciousness is affected and they may be confused. You might notice them wandering around or
behaving strangely and they may not know what they are doing. They may pick objects up for no reason,
fiddle with their clothes or make chewing movements with their mouth. Afterwards, they may need to
sleep or they might be confused for some time. CPS may last from a few seconds to a few minutes.

What to do during the seizure:

        do not restrain them as this may upset or confuse them;
        gently guide them away from any danger (such as walking into the road); and
        speak quietly and calmly so that they are not startled. They may be confused, so if you speak
        loudly or act forcefully this may confuse them more. They may mistake your help for being
        hostile, and be upset or respond in an aggressive way.

After the seizure stops:

        they may feel tired and need to sleep;
        it may help if you remind them where they are because they may be confused and not fully aware
        of their surroundings; and
        stay with them until they have recovered, and can safely return to what they were doing before
        the                                                                                    seizure.
Some people recover quite quickly after their seizure but others may take longer to feel back to
        normal again.

Secondarily generalised seizures

For some people SPS and CPS develop into a generalised seizure (see below). When this happens the
person becomes unconscious and will usually have a tonic clonic seizure.

This is called a secondarily generalised seizure because it starts as a partial seizure and then becomes a
generalised seizure. Some people call their partial seizure an ‘aura’ or ‘warning’ because it warns them
that a generalised seizure may follow.

What to do during the seizure:

        if the person is aware of a warning, they may need help to make themselves safe before the
        generalised seizure starts.

Generalised seizures

Generalised seizures affect btoh sides of the brain. The person becomes unconscious, and afterwards will
not remember what happened during the seizure.

Absences (sometimes called petit mal)

During an absence a person becomes unconscious for a short amount of time, usually a few seconds. They
may look blank and not respond to what is happening around them. For example, if they are walking they
may continue to walk, but will not be aware of what they are doing.

What to do during the seizure:

        stay with the person and, if necessary, gently guide them away from any danger.

Tonic and atonic seizures

In a tonic seizure the person’s muscles suddenly become stiff. If they are standing they often fall
backwards and may injure the back of their head. In an atonic seizure (sometimes called a 'drop attack')
the person’s muscles suddenly relax, and they become floppy. If they are standing they often fall forwards
and may injure their face or head. Both tend to be very brief and happen without warning so you cannot
help during the seizure itself. People usually recover quickly.

What to do after the seizure:

        as the person recovers they may need reassurance. If they have been injured, they may need
        medical help.

Myoclonic seizures

Myoclonic seizures involve the jerking of a limb or part of a limb, and often happen shortly after waking
up from sleep. They are brief and can happen in clusters with many happening close together in time. As
they are so brief, there is nothing that needs to be done to help the person other than making sure they
haven’t hurt themselves.

Tonic clonic (convulsive) seizures (sometimes called grand mal seizures)

During a tonic clonic seizure the person goes stiff, usually falls to the ground and make shakes or makes
jerking movements (convulses). Their breathing can be affected and they may go pale or blue, particularly
around their mouth. They may also bite their tongue. Some people have just clonic (convulsive) seizures.

Although this can be frightening to see, these seizures are not usually a medical emergency. Usually, once
the jerking has stopped, the person recovers and their breathing goes back to normal.

What to do during the seizure:

        try to stay calm;
        check the time to see how long the seizure is going on for (because there may be a risk of status
        epilepticus - see below);
        move objects, such as furniture, away from the person if they might hurt themselves. Only move
        them if they are in a dangerous place; for example, at the top of stairs or in the road;
        put something soft (like a jumper) under their head, or cup their head in your hands, to stop it
        hitting the ground;
        do not restrain them, allow the seizure to happen;
        do not put anything in their mouth - there is no danger of them swallowing their tongue during the
        seizure; and
        try to stop other people from crowding around.

What to do when the jerking (convulsing) has stopped (recovery):

        roll them on to their side into the recovery position;
        wipe away any spit and if their breathing is difficult check their mouth to see that nothing is
        blocking their airway, like food;
        try to minimise any embarrassment. If they have wet themselves deal with this as privately as
        possible; and
        stay with them, giving reassurance, until they have fully recovered.

Some people recover quickly after these seizures but more often the person will be very tired, may want
to sleep and may not feel ‘back to normal’ for several hours or sometimes days.

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4

  • 1. Types of epileptic seizures and what to do Epileptic seizures can be divided into two main types: partial seizures and generalised seizures. Seizures can vary from one person to another and how people are affected and how they recover after seizures varies. Partial seizures In partial seizures the seizure starts in, and affects, just part of one side of the brain. What happens during the seizure depends on where in the brain the seizure happens and what this part of the brain normally does. Simple partial seizures In a simple partial seizure (SPS) the person is conscious (awake) and aware of what is happening to them. A SPS could be twitching of one limb or part of a limb, an unusual smell or taste, a strange feeling such as a ‘rising’ sensation in the stomach or ‘pins and needles’ in part of the body or a sudden intense feeling of fear or joy. What to do during the seizure: although the person is awake and aware, SPS can feel unsettling so giving gentle reassurance may be helpful. Complex partial seizures A complex partial seizure (CPS) affects a bigger part of the brain than a SPS. In a CPS the person’s consciousness is affected and they may be confused. You might notice them wandering around or behaving strangely and they may not know what they are doing. They may pick objects up for no reason, fiddle with their clothes or make chewing movements with their mouth. Afterwards, they may need to sleep or they might be confused for some time. CPS may last from a few seconds to a few minutes. What to do during the seizure: do not restrain them as this may upset or confuse them; gently guide them away from any danger (such as walking into the road); and speak quietly and calmly so that they are not startled. They may be confused, so if you speak loudly or act forcefully this may confuse them more. They may mistake your help for being hostile, and be upset or respond in an aggressive way. After the seizure stops: they may feel tired and need to sleep; it may help if you remind them where they are because they may be confused and not fully aware of their surroundings; and stay with them until they have recovered, and can safely return to what they were doing before the seizure.
  • 2. Some people recover quite quickly after their seizure but others may take longer to feel back to normal again. Secondarily generalised seizures For some people SPS and CPS develop into a generalised seizure (see below). When this happens the person becomes unconscious and will usually have a tonic clonic seizure. This is called a secondarily generalised seizure because it starts as a partial seizure and then becomes a generalised seizure. Some people call their partial seizure an ‘aura’ or ‘warning’ because it warns them that a generalised seizure may follow. What to do during the seizure: if the person is aware of a warning, they may need help to make themselves safe before the generalised seizure starts. Generalised seizures Generalised seizures affect btoh sides of the brain. The person becomes unconscious, and afterwards will not remember what happened during the seizure. Absences (sometimes called petit mal) During an absence a person becomes unconscious for a short amount of time, usually a few seconds. They may look blank and not respond to what is happening around them. For example, if they are walking they may continue to walk, but will not be aware of what they are doing. What to do during the seizure: stay with the person and, if necessary, gently guide them away from any danger. Tonic and atonic seizures In a tonic seizure the person’s muscles suddenly become stiff. If they are standing they often fall backwards and may injure the back of their head. In an atonic seizure (sometimes called a 'drop attack') the person’s muscles suddenly relax, and they become floppy. If they are standing they often fall forwards and may injure their face or head. Both tend to be very brief and happen without warning so you cannot help during the seizure itself. People usually recover quickly. What to do after the seizure: as the person recovers they may need reassurance. If they have been injured, they may need medical help. Myoclonic seizures Myoclonic seizures involve the jerking of a limb or part of a limb, and often happen shortly after waking up from sleep. They are brief and can happen in clusters with many happening close together in time. As
  • 3. they are so brief, there is nothing that needs to be done to help the person other than making sure they haven’t hurt themselves. Tonic clonic (convulsive) seizures (sometimes called grand mal seizures) During a tonic clonic seizure the person goes stiff, usually falls to the ground and make shakes or makes jerking movements (convulses). Their breathing can be affected and they may go pale or blue, particularly around their mouth. They may also bite their tongue. Some people have just clonic (convulsive) seizures. Although this can be frightening to see, these seizures are not usually a medical emergency. Usually, once the jerking has stopped, the person recovers and their breathing goes back to normal. What to do during the seizure: try to stay calm; check the time to see how long the seizure is going on for (because there may be a risk of status epilepticus - see below); move objects, such as furniture, away from the person if they might hurt themselves. Only move them if they are in a dangerous place; for example, at the top of stairs or in the road; put something soft (like a jumper) under their head, or cup their head in your hands, to stop it hitting the ground; do not restrain them, allow the seizure to happen; do not put anything in their mouth - there is no danger of them swallowing their tongue during the seizure; and try to stop other people from crowding around. What to do when the jerking (convulsing) has stopped (recovery): roll them on to their side into the recovery position; wipe away any spit and if their breathing is difficult check their mouth to see that nothing is blocking their airway, like food; try to minimise any embarrassment. If they have wet themselves deal with this as privately as possible; and stay with them, giving reassurance, until they have fully recovered. Some people recover quickly after these seizures but more often the person will be very tired, may want to sleep and may not feel ‘back to normal’ for several hours or sometimes days.