Focal seizures – only part of one lobe is affected. The child is conscious and often remembers the seizure afterwards. They can be associated with an aura or warning. Symptoms vary with the lobe affected e.g. temporal lobe with unusual tastes or smells, occipital lobe with visual disturbances.
Focal seizures with secondary generalisation – start as a focal seizure but then spread to both hemispheres and the child will then become unconscious and usually have a tonic-clonic type of generalised seizure. This can happen quickly after the onset of the focal seizure which is why it is important to be very clear if there was any focality to start with and to ask what happened right at the beginning of the episode.
Generalised tonic-clonic seizure – affect both sides of the brain at once and can happen without warning. The child may suddenly stiffen, can cry out and then have rhythmic convulsions of all 4 limbs. There may be a colour change. After the seizure they may be tired, confused or sleepy.
Absence seizure – very brief loss of consciousness and this is a generalised seizure. The child may look blank and stare or their eyelids may flicker. They will not respond to people around them or their surroundings. They can be difficult to differentiate them from daydreaming episodes – children with absence seizures won’t respond to be touched whilst those with daydreams will.
Atonic seizures – often called ‘drop attacks’, the child’s muscles suddenly relax and they can fall. They are generally brief and without warning.
Tonic seizures – the child’s muscles suddenly become stiff and they can fall. These are again brief and without warning.
Myoclonic seizures – ‘muscle jerks’. These are a type of generalised seizure but the child is conscious. They are brief and can occur in clusters.