Lesser-Known Seizure Symptoms: Everything You Need to Know

Lesser-Known Seizure Symptoms: Everything You Need to Know

New research finds that the majority of Americans cannot recognize more subtle seizure symptoms, such as laughing and blinking rapidly. Less than half of survey participants were able to identify laughing, crying or screaming, lip smacking, and rapid blinking as signs of a seizure. Experts recommend that people who think they are having a seizure move to a lower location to avoid injury and, if possible, provide a video of the seizure to health care providers to make a more accurate diagnosis.

Most people can't recognize certain seizure symptoms, like laughing and blinking rapidly, according to a new survey.

Since 2017, seizures have been categorized according to their location in the brain, the person's level of awareness of their symptoms, and whether or not the symptoms include stereotypical motor symptoms such as shaking and twitching.

The new survey, conducted last month by Ipsos on behalf of Orlando Health, aimed to find out whether or not people in the United States can recognize some of the lesser-known seizure signs.

“We need to raise awareness about seizures and epilepsy to prevent sudden unexpected death in epilepsy (SUDEP) and reduce the stigma associated with the diagnosis,” Dipali Nemade, MD, MPH, an epileptologist (a neurologist who specializes in epilepsy) at the Orlando Health Neuroscience Institute saidHealth.

Here are the subtle signs of a seizure to look out for, as well as tips for recognizing and responding to a seizure.

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What causes first seizures in adults?

The subtle signs of a seizure make it difficult to act quickly

The new survey collected data from 1,024 adults ages 18 and older. Less than half of participants were able to recognize the following as signs of a seizure:

Numbness or tingling (32%) Blinking rapidly (35%) Screaming or screaming (13%) Laughing (6%)

Whether or not someone can recognize the signs of a seizure depends on the level of consciousness associated with the seizure, according to Nemade. It also depends on whether you or someone else has the symptoms.

“Any seizure symptoms accompanied by loss of consciousness are noticed by people around or relatives/family members,” he said. “However, if seizure symptoms are not accompanied by loss of consciousness, patients are more likely to notice it.”

These symptoms include a rising feeling in the stomach or déjà vu (feeling of familiarity), an olfactory aura (pleasant or unpleasant smell), and visual or auditory hallucinations, Nemade explained.

"In general, if a seizure is not accompanied by loss of consciousness, patients are more likely to notice it themselves and vice versa," he said.

Clifford Segil, DO, a neurologist at Providence Saint John's Health Center in Santa Monica, California, confirmed this, noting that seizures with tremors can be easily observed by caregivers and family members.

"A common seizure consists of 60 to 90 seconds of shaking, followed by a period of stiffness and then a period of confusion," Segil said.

He added that a facial twitch or a twitching hand, while more subtle, are also outward signs of a seizure.

Seizures that are not accompanied by tremors or visible signs of mental change, confusion, or speech problems are simply less obvious, making them easier for both the person experiencing a seizure and family members to miss.

“Small seizures result in minor symptoms, while large seizures result in major symptoms such as tremors, tongue biting and bladder incontinence,” he said. “Subtle symptoms suggest a minor seizure.”

How is epilepsy diagnosed?

The dangers of not knowing the seizure symptoms

Ignorance of subtle signs of seizures means seizures go unreported, undiagnosed and untreated, leading to increased health risks, including sudden and unexpected death.

Nemade explained that some of the consequences of failing to recognize subtle or less noticeable signs or symptoms of seizures include an increased risk of injury when loss of consciousness accompanies seizures.

For example, "serious car accidents can occur if someone stares into space or loses consciousness for a few seconds while driving," he explained.

Likewise, drowning can occur if the person swims. Burns, etc. may occur when working with fire and cooking.

“An atonic seizure (loss of body tone) can result in falls, which can be dangerous,” he said.

Additionally, these subtle signs of a seizure can lead to cognitive problems that are difficult to detect and treat quickly.

“A subtle seizure can cause temporary confusion,” Nemade said. “Therefore, it can impact daily activities and quality of life as patients know something is wrong but don’t know how to explain it.”

Additionally, the unpredictability of these attacks can also lead to anxiety and depression, affecting a person's psychological well-being.

“Sometimes people with epilepsy experience behavioral changes,” Nemade said. “They may also exhibit symptoms of psychosis.”

While not noticing subtle symptoms of a seizure can have a negative impact on a person's quality of life, recognizing these symptoms early can have the opposite effect.

“Earlier diagnosis can lead to earlier treatment,” emphasized Nemade. “This will help patients improve their personal quality of life and enable them to function as productive members of society.”

Avoid poor seizure management

Segil explained that not knowing whether one is having a seizure leads to poor seizure treatment.

“Younger adults may be more inclined to ignore such episodes,” said Pooja S. Patel, MD, director of the epilepsy monitoring unit at Marcus Neuroscience Institute, part of Baptist Health South Florida at Boca Raton Regional HospitalHealth.

"You may dismiss these episodes as falling asleep, daydreaming, or just a few seconds of inattention, delaying seeking medical attention," she said.

Segil explained that the ability to accurately report a seizure to a healthcare provider helps professionals better treat seizures and reduce seizure frequency. This is just as important for small seizures as it is for larger, more obvious episodes.

“Often it takes a large convulsive event that shocks patients or families,” Patel said.

If a patient or family member can correctly identify a seizure, they can use available resources to help patients with seizures, regardless of size.

According to Segil, taking anti-seizure medications on time is very important to avoid prolonged seizures, which can be life-threatening.

Patel added: "If medications do not help symptoms, we may recommend neurosurgery or neurostimulation treatment using minimally invasive surgical techniques."

How is epilepsy treated?

Tips for recognizing and responding to a seizure

In a 2017 survey, few U.S. adults said they were knowledgeable about epilepsy. 20% said they had the confidence to help someone having a seizure with appropriate first aid.

According to the Centers for Disease Control and Prevention, not all seizures are emergencies, but people should call 911 if a seizure lasts longer than 5 minutes or if the person is injured during the seizure.

“In the event of a seizure warning, move to a safe location low to the ground to avoid injury,” Patel said.

Segil advises his patients to video record any event related to a possible seizure so that a trained neurologist can look at the incident and reverse engineer which part of a person's brain that is not functioning would cause this type of seizure.

"If someone fears they have had a seizure, I would also advise them to film themselves in the mirror or on their cell phone to show their doctor what happened during the seizure," he said.

If you think you or a loved one is having a seizure, seek medical attention immediately.