Seizures can be scary to watch, but most are not medical emergencies. Nevertheless, correctly identifying a seizure can help keep the person safe and rule out other emergencies such as a stroke.

There are many types of seizures, and they all look different. People tend to think of seizures as being when people lose consciousness, shake, and twitch. But not all seizures look like this. They look different depending on the cause and type.

Keep reading to learn more about what the different types of seizures look like, the signs to look for, and when to seek emergency medical care.

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While many epileptic seizures involve shaking or twitching in a person who does not seem responsive, there are many different types of seizures. They all look different. The way a seizure appears depends on the areas and amount of the brain involved.

The most common types of seizures, and what they look like, include:

Generalized seizures

Generalized seizures affect both sides of the brain. Some examples include:

  • Tonic-clonic seizures: With a tonic-clonic seizure, there is a tonic phase during which the muscles stiffen and a clonic phase during which they jerk. These seizures happen suddenly, and the person might fall. People having these seizures do not appear aware of their surroundings and may be unable to control bowel or bladder functions. Doctors used to call these grand mal seizures.
  • Myoclonic seizures: These seizures cause short, jerky movements. It may look like the person is being shocked or poked. Most people are partially aware and might be able to respond during these seizures. They last only about a second, but tend to come in groups.
  • Tonic seizures: Tonic seizures cause a person’s muscles to stiffen uncontrollably. They may suddenly fall or lose control over their bodies. Some people make a noise at the beginning of the seizure, and if the seizure lasts for a long time, it may look like the person is shaking as their muscles tense.
  • Atonic seizures: Sometimes called drop attacks, these seizures cause a person to suddenly lose control of their muscles. They might go limp or fall. The seizures are usually very short, lasting just a second or two.
  • Clonic seizures: These look similar to tonic-clonic seizures, but cause jerky movements without muscle stiffening. Both sides of the body usually jerk or move.
  • Absence seizures: An absence seizure causes a person to suddenly appear unaware, like they have left their body. They may blink uncontrollably, suddenly stop talking, or seem confused. These seizures are generally short, and a person has no memory of the seizure afterward. Sometimes absence seizures combine with other types of seizures, producing jerks and a loss of awareness.

Focal seizures

Focal seizures often affect small regions on one side of the brain, producing smaller, less noticeable symptoms. In some cases, the person remains aware that they are having a seizure and may even respond to other people. In other cases, they are not aware of what is happening and become unresponsive.

Examples of focal seizures include:

  • Simple focal seizures: These affect small brain regions, causing subtle changes. For example, a person might twitch or perceive a strange taste.
  • Complex focal seizures: These cause confusion, and a person may be unable to respond for several minutes.
  • Secondary generalized seizures: These seizures begin as focal seizures but then spread to both sides of the brain, gradually causing more noticeable symptoms.

A seizure can look a lot like other things, such as a person daydreaming, fainting, or even having a stroke. So it is important to observe the person carefully. Err on the side of caution and seek emergency care if there is reason to believe they are experiencing something other than a seizure.

It is reasonable to assume a person is having a seizure any time they appear to be not fully conscious, are unable to control their movements, or become suddenly confused. Some classic signs and symptoms of a seizure include:

  • shaking or twitching, either of the entire body or parts of the body
  • suddenly falling and losing control of motor functions
  • rapid blinking or twitching in the face
  • changes in sensory perceptions, such that a person may smell or hear something others do not
  • suddenly crying out or making unusual noises
  • suddenly seeming confused or disconnected from reality
  • suddenly appearing very stiff, either in the entire body or in just one area, such as the legs and face
  • sudden jerking movements that may happen just once or repeatedly in an apparent spasm

Most seizures last less than 5 minutes, and often less than a minute. The length of a seizure depends on the type of seizure a person has.

In some cases, seizures may come in groups. For example, epileptic spasms are smaller, more subtle seizures that cause jerking movements lasting only a second or two. The spasms tend to come in groups, though, and the seizure attack can last several minutes.

Not all seizures require medical treatment, especially in people with epilepsy and those whose seizures follow a predictable pattern. But it is a good idea to follow up with a doctor if:

  • a person with epilepsy or a history of seizures has a seizure that significantly deviates from their usual pattern
  • a person begins having more frequent or longer seizures than usual
  • a child has a seizure during a fever that lasts less than 5 minutes

Go to the emergency room or call 911 if:

  • the person who had the seizure is pregnant
  • the person who had the seizure has an underlying medical condition, such as diabetes
  • bystanders are not sure whether there was a seizure or another issue, such as a fall or a stroke
  • a person falls or gets a serious injury during a seizure
  • a person has a seizure in water
  • the seizure lasts longer than 5 minutes
  • this is the person’s first seizure

Seizures can be scary to watch. Do not try to restrain the person, yell at them, throw water at them, or otherwise attempt to stop the seizure.

It is better to remain present with the person and take steps to keep them safe, such as comforting them or removing anything that might constrict their breathing. However, it is important to note, a person should never put anything in the mouth of the person having a seizure.

If a loved one frequently has seizures, try talking with them about how best to help them during a seizure.