o Tonic-clonic [grand mal, generalized tonic-clonic (gtc)]: Prodrome of unease or irritability hours to days before the episode( the earliest portion of a seizure recognized, the only part remembered by the patient, it may act as warning) Tonic ictal phase: muscle rigidity Clonic ictal phase: repetitive violent jerking of face and limbs, tongue biting, cyanosis, frothing, incontinence Post-ictal phase: flaccid limbs, extensor plantar reflexes, headache, confusion, aching muscles, sore tongue, amnesia, elevated serum ck lasting hours o Absence (petit mal): usually only seen in children, unresponsive for 5-10 s with arrest of activity, staring, blinking or eye-rolling, no post-ictal confusion; 3 hz spike and slow wave activity on eeg o Tonic: muscle rigidity in flexion or extension o Clonic: repetitive rhythmic jerking movements o Myoclonic: sporadic contractions localized to muscle groups of one or more extremities o Atonic: loss of muscle tone leading to drop attack Partialseizures o Simpleorcomplexcansecondarilygeneralize,or simplecomplexgeneralizedseizures o Simple(preservedloc) Motor:postural,phonotory,forcefulturningofeyesand/orhead, focalmusclerigidity/jerkingjacksonianmarch(spreadingto adjacentmusclegroups) Sensory:unusualsensationsaffectingvision,hearing,smell,taste ortouch Autonomic:epigastricdiscomfort,pallor,sweating,flushing, piloerection,pupillarydilatation Psychiatric:symptomsrarelyoccurwithoutimpairmentof consciousnessandaremorecommonlycomplexpartial o Complex(alteredloc) Patientmayappeartobeawakebutwithimpairmentofawareness Classiccomplexseizureischaracterizedbyautomatismssuchas chewing,swallowing,lipsmacking,scratching,fumbling,running, disrobingandotherstereotypicmovements Otherforms:dysphasic,dysmnesic(djvu),cognitive(disorientationoftimesense), affective(fear,anger),illusions,structuredhallucinations(music,scenes,taste,smells), epigastricfullness