What are the different kinds of seizures? [Focal seizures, Lip-smacking seizures, generalized-tonic etc]

It is easy to get confused by the many names that seizures have.

But, it’s actually very simple. There are only 2 kinds of seizures: Focal and Priamry generalized.

The other names for seizures are based on the symptoms they produce. For example, a seizure during which someone laughs is called a “Gelastic seizure” – based on the greek word for laughter.

A seizure which is very subtle and only causes short blanking out is called “petit mal” – based on the French word for “small”… and so on…

Hello! I am Dr Siddharth Kharkar, a Neurologist in Thane, India and a Neurologist in Mumbai, India. I provide Parkinson’s treatment in India and am an Epilepsy specialist in India. I provide Epilepsy surgery in India at Mumbai & Parkinson’s surgery in India.

Come, let’s learn about these things:

What are the two types of seizures?

When we talk about “Types of Seizures”, it is absolutely critical to keep our thought process crystal clear.

Repeat after me: There are only two types of seizures.

Types of Seizures
1. Focal Seizures
2. Primary Generalized seizures

Yes, only two. The various seizure names that you may have heard: lip-smacking seizures, myoclonic seizures, deja-vu seizures, generalized tonic-clonic seizures – fall into one of these two types.

What is the basis of this division into two types?

These two types are based on how a seizure BEGINS.

  • Focal seizure: A focal seizure starts in one part of the brain. The electrical surge caused by the seizure may remain restricted to the part where it starts, OR it may later spread over the entire brain.
  • Primary Generalized Seizure: The word “Generalized” means all over. A primary generalized seizure starts all over the brain, all at once. There is a sudden surge of electricity, all over the brain, all at once.
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Types of seizures – Focal and Generalized

This classification also helps us in selecting the right medication. Certain medications work only for Focal seizures, and giving them to a patient with Primary Generalized seizures can actually worsen his/her condition.

So why are there so many other names for seizures?

The names describe what HAPPENS to the person, when he/she has that type of seizure.

For example, “Gelos” in the Greek language means “Laughter”. Therefore, a “Gelastic seizure” is a seizure in which the person laughs for no reason.

Laughing for no reason could be due to a seizure! This kind of seizure is called a “Gelastic seizure”

It is really unfortunate that there are so many names of seizures. This multitude of names is a source of confusion for patients, and also for doctors.

Having names does help in describing the symptoms succinctly, but many doctors have now started standardizing the words they use. For example, the International League Against Epielpsy (ILAE) now recommends that certain terms such as “dyscognitive seizures” have become old and should no longer be used.

For our purposes, just remembering the names below will be more than adequate.

What are some names of Focal Seizures?

Although it is impossible to list each and every name for focal seizures ever invented, it is useful to know some of these names.

Name of the seizureWhat happensOrigin of the word
Automatisms (e.g. lip-smacking, hand-wringing)Automatic, half-purposeful movements of body partsEnglish: From the word “automatic”
DissociativeThe patient becomes “dissociated” from reality
Deja-vuAn intense feeling of familiarity, as if “this has happened before”.French: Déjà vu means “Already seen”
Jamais-vuAn intense feeling of unfamiliarity e.g. towards your own home or neighbourhoodFrench: Jamais vu means “Never seen”
Hyper-kineticDramtic, violent, flinging movements of the entire bodyGreek: Hyper means “too much” & kinein means “movement”
DacrysticThe patient criesGreek: Dakyron means tear

Here is a video of a young girl having automatisms. Notice the involuntary right eye blinking, then eye flutter. During this time, the girl also becomes less responsive.

This video has been posted on youtube by Paramedical Services Education Group.

At the other end of the spectrum are hyperkinetic seizures. As described, patients have wild flinging movements of the limbs during these seizures.

Incidentally, hyperkinetic seizures usually start from the front of the brain, and mostly happen at night.


What are some names of Primary Generalized Seizures?

Primary Generalized Seizures – Remember: These are seizures that start all over the brain, all at once.

Name of the seizure

What happens

Origin of the word

Absence (also called petit-mal)The child blanks outFrench: Petit-mal means little-illness, indicating how subtle these seizures are.
AtonicThe child suddenly loses all muscle power, and may fall down (A drop-attack)Greek: Tonos means tension. In atonic seizures, all tension within the muscles is suddenly lost, hence A-tonic or without-tone.
MyoclonicThere is a sudden jerk of the body, usually the upper bodyGreek: Myo=Muscle & Klonos=violent motion
Epileptic SpasmsThe child’s entire body stomach and shoulders go into spasm, only for a moment so that the baby suddenly lurches forward. 

Here is a video of a very small absence seizure, posted by a well-informed parent on youtube. Notice how subtle the symptoms are.

These blanking out episodes can happen 100s of times in a day! As a result, the child may lose focus repeatedly. He/she may start doing very poorly in school. Teachers may complain (incorrectly) that he/she has become inattentive!

This is a mis-diagnosis that truly pains my heart. It is so easily treatable!

To ensure that you don’t miss this type of seizure, here is another video. This has been posted by Dr. Rajeev Gupta on youtube.

Infantile spasms are common in tuberous sclerosis. Here is an excellent educational video about infantile spasms posted by the TSC alliance.


Which symptoms can be produced by either kind of seizures?

There are some symptoms – such as stiffening or violent movements of the body – which can be produced by either kind of seizure.

When these symptoms are due to a focal seizure, they start in one part of the body. For example, if the focal seizure starts on the left side of the head, then the right side of the body may start to have jerking movements. Gradually, the seizure may spread all over the brain. When this happens, the entire body starts shaking violently.

On the other hand, a primary generalized seizure starts all over the body at once. Therefore the symptoms (e.g. shaking) are seen all over the body, all at once.

Name of the seizure

What happens

Origin of the word

TonicA body part or the entire body stiffens upSame as above, except here “tonic” actually means “too much tension”
ClonicA body part or the entire body shakes violentlyGreek: Klonos means violent motion
Tonic – ClonicAlternate stiffening & violent shaking 
Drop attacksThe child suddenly drops to the ground, most commonly due to A-tonic seizures. But this can also happen with tonic, myoclonic, myoclonic-astatic and other seizures 

Here is a video of a drop attack, posted by a parent on youtube.

And here is one more, of a child having repeated drop attacks. Again, this has been posted by a parent.

Notice how the child has to wear a helmet – to prevent head injury due to a fall.


Here is a another drop attack, this time due to a myoclonic seizure:


Note: Our knowledge of seizures and epilepsy continues to grow every year. We now know now that in uncommon cases atonic/myoclonic/spasms seizures can have a focal onset. This opens the doors to newer medications and the possibility of surgery for these patients – but to avoid confusion, this area of active is not highlighted in this article.

Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

Call 022-4897-1800

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near LIC, Dr Balabhai Nanavati hospital, near LIC, Swami Vivekananda Road, LIC Colony, Vile Parle

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  • Avatar Paras Prabhu ★★★★★ 6 months ago
    Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted … More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
  • Avatar Dr Shobha Sankhe ★★★★★ a month ago
    Dr Kharkar is gem of a doctor with tremendous patience, empathy, genuine concern for his patients .He guides them very methodically & scientifically … More for their neurological ill healthOur epilepsy patient is extremely happy with his treatment , Patient feels better by just visiting him too!May his selfless service to humanity flourish to reach all the needy patients!!
  • Avatar shrruti khanna ★★★★★ a month ago
    I consulted Dr Sidharth for my sister who has become very hyper and aggressive and we could not understand the issue. Keeping in mind she is someone with … More special needs Dr Sidharth was extremely understanding of the situation and did not put her through unnecessary investigation and avoided a very long stay at the hospital. He was infact more keen on her returning home to her natural environment. We highly appreciate Dr Sidharth for his effort and for looking into the matter with utmost care. It was a very difficult decision for my family to get my sister admitted but we are glad we did it under his care.Thankyou Doc.
  • Avatar Prashant Purohit ★★★★★ a month ago
    my name is prashant purohit. I m become completely bed ridden from last 9 months and was unable to walk. I couldnt find out the cause even after visiting … More many doctors and many hospital in Ahmedabad nd jodhpur.started losing hope. A good friend of mine suggested to visit a neurologist. After searching a lot, I came to know about Dr. Siddharth Kharkar and took his appointment in Nanavati Hospital. He examined and said that he suffered from \u201cPKD(PAROXYSMAL KNESIGENIC DYSKNESIA\u201c. He assured us to reverse this in 5 days time. And indeed this happened. I started recovering miraculously. today I am fully well fit I m walking as normal . Many Many thanks to Dr. Siddharth Kharkhar sir for giving me a new life.
  • Avatar Sanjay Pradhan ★★★★★ 7 months ago
    Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond … More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
  • Avatar N N ★★★★★ 11 months ago
    We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications … More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
  • Avatar Manish Ranjan ★★★★★ a year ago
    I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains … More the issue in much greater details. He has really been of great help. My father is much better now.
  • Avatar Pinakin Shah ★★★★★ 9 months ago
    One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and … More cons.
  • Avatar Lawrence Castellino ★★★★★ 11 months ago
    Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for … More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
  • Avatar Hemant Kansara ★★★★★ a year ago
    Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed … More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you

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