Epilepsy is a neurological disorder characterized by repeated seizures. Seizures result from abnormal electrical activity in the brain, and the symptoms vary depending on which parts of the brain are affected. A generalized seizure impacts both hemispheres of the brain, while a focal seizure is limited to one area.

Common symptoms include loss of consciousness, muscle stiffness, twitching, and staring spells. For example, tonic-clonic seizures—also known as grand mal seizures—affect both sides of the brain and often cause jerking movements and unconsciousness.

Epilepsy affects approximately 1.2% of the U.S. population. The brain’s neurons normally communicate through electrical impulses. A seizure happens when there’s a sudden burst of abnormal electrical activity. These seizures can result in unusual physical sensations, jerking, and fainting. People with epilepsy experience these seizures repeatedly.

There are many possible causes of epilepsy, including brain injuries from trauma or stroke, infections, genetic mutations, and autoimmune conditions where the immune system mistakenly attacks healthy brain tissue.

Prodromal Symptoms

Over 20% of people with epilepsy experience prodromal symptoms—early warning signs that appear hours or days before a seizure. These can include:

  • A strange or “funny” feeling
  • Anxiety
  • Confusion
  • Headaches
  • Irritability

Generalized Seizure Symptoms

Generalized seizures affect both sides of the brain and often cause a person to fall or lose consciousness. Different types of generalized seizures have distinct symptoms:

  • Absence seizures: Brief staring episodes, sometimes with minor muscle twitching
  • Atonic seizures: Sudden loss of muscle tone, often resulting in falls
  • Clonic seizures: Repetitive jerking movements, usually accompanied by unconsciousness
  • Myoclonic seizures: Sudden, brief muscle jerks, often in the arms or legs
  • Tonic-clonic (grand mal) seizures: Muscle stiffening followed by jerking, typically with loss of consciousness
  • Tonic seizures: Muscle stiffening in the back, legs, or arms, usually lasting less than 20 seconds

Sometimes, seizures begin as focal seizures and spread to both sides of the brain, becoming generalized.

Focal Seizure Symptoms

Focal seizures, which affect a specific brain region, account for about 60% of epilepsy cases. These seizures may last a few seconds or several minutes. Symptoms vary depending on where in the brain the seizure originates.

Focal seizures in the frontal or medial temporal lobes can cause:

  • Intense déjà vu
  • False smells or tastes
  • Auditory or visual hallucinations
  • Repetitive movements (blinking, twitching, lip-smacking)
  • Strong emotions like fear, joy, or anger
  • A dreamlike state or disconnection from surroundings

Less commonly, focal seizures in the occipital or parietal lobes may result in:

  • Difficulty with language, reading, or writing
  • Rapid or uncontrollable eye movements
  • Visual disturbances in one part of your vision
  • Feeling like a body part is missing or has changed in size
  • Sensations of floating or altered body awareness
  • Tingling, numbness, or burning
  • Seeing flashing lights or vivid images
  • Unusual sensations, including sexual feelings

What Are Auras?

An aura is a type of focal seizure that can act as a warning before a more severe seizure. Symptoms include déjà vu, sudden fear or euphoria, or changes in vision, hearing, smell, or taste.

Post-Seizure (Postictal) Symptoms

After a seizure, many people experience postictal symptoms as the brain returns to normal activity. These can last a few minutes to several days and may include:

  • Mood changes
  • Weakness on one side of the body
  • Confusion, psychosis, or mania
  • Repetitive behaviors like coughing or wiping the nose
  • Problems with speech, memory, or movement
  • Amnesia of the seizure event

Symptoms in Children

Epilepsy is the most common neurological disorder in children, often appearing after age 5. It may lead to learning difficulties in school. Symptoms vary by seizure type:

  • Absence seizures: Brief staring spells that are easy to miss
  • Tonic-clonic seizures: Whole-body convulsions with muscle stiffness and unconsciousness
  • Focal seizures: Any symptoms noted above, depending on the brain area involved

What About Febrile Seizures?

Febrile seizures are seizures triggered by fever in children. They are typically isolated events and are not considered signs of epilepsy.

When To Contact a Healthcare Provider

Seek emergency medical attention if:

  • A second seizure occurs immediately after the first
  • The person does not have a medical ID or emergency instructions
  • The person has diabetes or is pregnant
  • The person is injured during the seizure
  • The person does not regain consciousness or acts unusually afterward
  • The seizure is different from their typical pattern
  • The seizure lasts longer than five minutes
  • The seizure happens in water
  • It is their first-ever seizure

A Quick Review

Epilepsy is a neurological disorder involving repeated seizures caused by abnormal brain activity. Symptoms depend on the type of seizure and the area of the brain involved. Tonic-clonic seizures are among the most severe, causing full-body convulsions and unconsciousness.

If someone experiences a seizure lasting more than five minutes or shows signs of injury or altered behavior afterward, emergency medical attention should be sought immediately.