For thousands of years, people have been trying to describe different types of seizures. If you lived in ancient Mesopotamia and had a seizure where your arms, legs and neck tensed up, your eyes stayed open and you lost consciousness, your doctor might have said you had experienced antašubbȗ. This term translates as ‘the falling disease’. Today, this type of seizure would probably be called a focal unaware tonic seizure.
As our knowledge of epilepsy has improved, we have started to use different terms to describe seizures. In 2017, the International League Against Epilepsy (ILAE) updated its list of words to describe seizures. Medical professionals are now more likely to use the ILAE’s definitions.
For example, they might talk about ‘generalized onset tonic clonic seizures’ instead of ‘grand mal seizures’. Or, they might describe a ‘focal seizure’ instead of a ‘partial seizure’.
However, if you were diagnosed with epilepsy before 2017 you might be used to some of the older terms. Let’s see why experts have changed the names for different types of seizures, as well as some of the new and old definitions.
Why have experts changed names for types of seizures?
Our understanding of epilepsy has developed over thousands of years. Over time, we’ve used increasingly specific terms to explain why seizures happen. This can help us describe them more accurately. Older epilepsy classifications weren’t as precise as the new approach.
According to the most recent classification, seizures should be described in the following order:
- Onset: This is about where in the brain the seizure begins. It can be focal - meaning it happens in one specific area, generalized - which means the seizure happens all over the brain, or unknown. Some seizures can also be focal to bilateral, which is when the seizure begins in one part of the brain before spreading.
- Level of awareness: Some people are conscious during their seizures while others aren’t (this is only for focal seizures since people are never conscious during generalized seizures).
- Other characteristics: Some types of seizures may also come with other features, such as how the person’s body moves.
Example: Focal impaired awareness seizure. This means the seizure begins in a particular part of the brain, but the person is not aware of what is happening around them.
Example: Generalized myoclonic seizure. This means the person’s seizures begin all over the brain, they will not be aware (as it’s generalized), and they will have a series of sudden short twitches in their body.
Related: What’s the difference between generalized and focal seizures?
Is it a problem if I use old words to describe types of seizures?
If you have had epilepsy for many years and are most comfortable using terms like ‘partial seizure’ or ‘grand mal’, this isn't necessarily a problem. As long as you and your doctor understand what you mean by them. Still, it might be worth trying to learn the new terms. If you were to begin working with a new treatment team who used the new words, it would make communicating a lot easier.
Partial (simple and complex) vs. Focal (aware and unaware)
For decades, epilepsy specialists used the word ‘partial’ to talk about what we now call ‘focal’ seizures. They would also describe a seizure as ‘simple’ – meaning you are conscious, or ‘complex’ – meaning you aren’t aware of what's happening around you.
Recommended: Everything you need to know about focal seizures
Glossary of new and old types of seizures
There are many different types of seizure, but the following glossary can help you understand the difference between some of the more common terms:
New and old terms
Generalized absence seizure (new term) > Petit-mal (old term)
Description: You lose consciousness for a few seconds, but don’t fall over (read more about absence seizures here)
Focal atonic or generalized atonic (new term) > Drop attack (old term)
Description: Your muscles suddenly go limp.
Generalized onset tonic clonic (new term) > Grand mal (old term)
Description: You lose consciousness, fall to the floor and experience convulsions (read more about tonic clonic seizures here)
Focal or generalized myoclonic (new term) > Myoclonic (old term)
Description: You jerk briefly (read more about myoclonic seizures here)
Focal or generalized tonic (new term) > Tonic or drop attack (old term)
Description: You stop what you’re doing, your body goes stiff and you may fall over
Focal impaired awareness (new term) > Complex partial (old term)
Description: You become unaware of your surroundings, examples include picking at your clothes or smacking your lips (read more about focal impaired awareness seizures here)
Focal aware (new term) > Simple partial (old term)
Description: You are fully aware of what is going on around you, but may feel ‘frozen’ or unable to move
This list only covers some common types of seizures – there are plenty more.
Learn more about your seizures
By learning more about different types of seizures you’ll be able to describe them better. And that might mean you can have more productive conversations with your doctor.
Check out the Epsy blog where we provide definitions and information about many different types of epileptic seizures.