Some epilepsy syndromes involve focal seizures, which affect only part of the brain:

• Benign rolandic epilepsy: Thought to be inherited, this syndrome makes up about 15% of epilepsy cases in children. Seizures typically stop by age 15. Seizures can last up to two minutes, and children remain conscious.
• Panayiotopoulos syndrome: This childhood epilepsy starts between ages 3 and 10. Seizures can last 20 to 60 minutes and often occur during sleep. Seizures stop after about three years.
• Rasmussen’s syndrome: The immune system attacks brain cells and causes inflammation that can lead to brain damage. People often need surgery because medications can’t control the seizures well.

• Doose syndrome: Also known as myoclonic astatic epilepsy, this type starts in early childhood. Medications might not manage it effectively, but dietary therapy can work well.
• Juvenile absence epilepsy: JAE usually begins between ages 10 and 17. It is a lifelong condition requiring medication. JAE can cause attention, concentration and memory issues. Treatment can improve symptoms.
• Juvenile myoclonic epilepsy: JME is the most common generalized epilepsy syndrome that starts in mid- to late childhood, from ages 5 to 16. Medications usually control this inherited syndrome well.

• Infantile spasms, also known as epileptic spasms or West syndrome: This syndrome begins in infants 4 to 6 months old. It requires early treatment to avoid issues with learning, thinking, behavior and development.
• Lennox-Gastaut syndrome: This syndrome usually starts in childhood and lasts into adulthood. It is difficult to manage with medications and can result in problems with thinking and behavior.

• Frontal lobe epilepsy: This syndrome may be inherited, and its seizures can usually be controlled with medications. It can affect various body parts, depending on where in the frontal lobe the seizures start.
• Temporal lobe epilepsy: This type is the most common syndrome related to focal (partial) seizures. Because the temporal lobe controls many vital functions, seizures in this part of the brain can dramatically affect quality of life.

The first category describes seizure onset, or how seizures start in the brain. Seizure onset indicates possible causes, and it guides treatment decisions.

• Focal seizures start on one side or part of the brain.
• Generalized seizures involve both sides of the brain.
• Unknown onset for seizures of unknown origin. Doctors can adjust the type if they find the onset area later.
• Focal to bilateral seizures begin on one side or part of the brain before spreading to both sides.

This category describes the person’s level of awareness during a seizure. Gauging awareness is important to keeping the person safe and determining the type of seizure.

• Focal aware seizures: The person is awake and aware, even if they are unable to speak.
• Focal impaired awareness: The person is not completely aware, even if they are conscious.
• Unknown awareness: No one else was around to determine whether the person was aware.
• Generalized seizures: The person’s awareness or consciousness is always affected.

This category describes whether seizures begin with movement. Movement during seizures helps doctors determine the type. Seizures with onsets that are focal, generalized or unknown can all have motor or non-motor symptoms.

Motor symptoms include:

• Rhythmic jerking movements
• Weakened or limp muscles
• Tense or rigid muscles
• Muscle twitching or spasms
• Repetitive movements, such as hand clapping or rubbing, lip smacking, chewing or running

Non-motor symptoms include:

• Staring
• Brief twitches in the eyelids or another area of the body
• Changes in sensation, emotions or thinking
• Autonomic functions, such as gastrointestinal sensations, feelings of heat or cold, goose bumps or rapid heartbeat
• Lack of movement, known as behavior arrest

Other categories of seizure symptoms include:

• Absence: Previously known as a petit mal seizure, this generalized-onset seizure results in a short staring “spell” that may include minor eye movements. Absence seizures usually last less than 10 seconds. The person has impaired awareness during the seizure.
• Atonic: The muscles suddenly go limp, and the person’s head or body may go limp or fall. Atonic seizures can be generalized or focal onset. They have motor symptoms and involve impaired awareness.
• Atypical absence: These generalized-onset seizures differ from typical absence seizures because they involve slight facial or hand movements and can last 20 seconds or longer.
• Behavior arrest: In this focal, non-motor seizure type, the person freezes and has impaired awareness.
• Clonic: Clonic seizures have motor symptoms such as repetitive jerking movements. They can be either focal or generalized onset and can last from a few seconds up to two minutes.
• Epileptic spasms: Also known as infantile spasms or West syndrome, this type can be focal or generalized onset, and involves motor symptoms.
• Myoclonic: These seizures can be either focal or generalized onset. They involve rapid, short periods of muscle jerking or twitching. They may come with impaired awareness.
• Tonic: The person experiences sudden muscle stiffness and is usually aware. Tonic seizures can be either focal or generalized onset and usually last less than 20 seconds.
• Tonic-clonic: Previously known as a grand mal seizure, this motor seizure usually begins as a generalized-onset seizure, but it can also start as a focal to bilateral seizure. The person loses consciousness, and all the muscles stiffen before jerking movements begin.