Medical Questions » Epilepsy Questions » Question No. 315
| Question: | What are the different types of epilepsy? |
| Answer: | There are several quite distinct types of epilepsy, but one patient may have fits that are combinations of the different types, or different types of fit at different times.
Grand mal is the massive fit which most people associate with epilepsy. The patient becomes rigid, falls to the ground and stops breathing. The muscles in different parts of the body become alternately rigid and slack, causing gross abnormal movements and twitching of the arms, legs and trunk. The patient may urinate, pass faeces and become blue. Epileptics who have grand mal fits have no knowledge of what happens during the attack. They may have a brief warning aura, but then they lose consciousness and wake up some time after the fit has finished, not knowing if they have been unconscious for a few seconds or an hour. After recovering from the fit, the patient is confused, drowsy, disoriented and may have a severe headache, nausea and muscle aches.
Status epilepticus is the condition where one grand mal attack follows another without the patient regaining consciousness between attacks. Urgent medical attention is required for these patients.
Petit mal (absences, drop attacks) attacks are periods of unconsciousness that may last from one or two seconds to a minute or more. There may be some unusual movements associated with them but nothing as violent as in a grand mal attack. The patient may appear totally normal during the attack, may stumble momentarily, or drop to the ground and rapidly recover. The attacks come without warning, and may appear merely as an unusual break of several seconds in a sentence while speaking. Patients are often unaware that they have had an attack. Petit mal epilepsy is far more common in children and teenagers than adults.
Partial seizures (temporal lobe epilepsy) occur when the abnormal brain wave is restricted to only one part of the brain, usually the temporal lobe of the brain on one side. The seizures can vary greatly in their severity, and in some cases the patient remains conscious while one arm and/or leg contracts and relaxes, thrashing about outside the conscious control of the patient. The fit can vary from minor twitches of the fingers or eyelid, to apparent grand mal fits, but involving only one side of the body. In other cases they may present as difficulty in talking or swallowing, as an unexplained loss of memory, or an abnormal shift of mood and emotion (eg. a sudden unexplained fear or terror, or ecstasy). At other times, partial seizures may be unnoticed by others but felt as abnormal sensations (eg. tingling, burning) by the patient. Other manifestations include flashes of light, strange smells, buzzing noises, sweats, flushes and hallucinations.
An unusual and common form of very mild epilepsy is deja vu. Deja vu is a feeling of intense familiarity when confronted with someone, something, or a place that is actually totally unfamiliar to the individual. This happens occasionally in normal people but is more commonly associated with some types of epilepsy or psychiatric disorders. Deja vu means ' already seen' in French.
Convulsions in children due to a high fever are not true epilepsy and do not lead to epilepsy in later life. They are caused by a temporary short-circuit in the brain when it is overheated.
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