Seizures are bursts of brain activity that change behavior or movement. There are 2 main types of seizures. 

Generalized seizures hit both sides of your brain at once. They cause you to lose consciousness or awareness. 

• Generalized motor seizures: During a motor seizure, you have abnormal movements on both sides of your body. These can include stiffening, relaxing, jerking, spasms, or shaking. Also called "grand mal" seizures.
• Generalized nonmotor seizures: During a nonmotor seizure, you lose consciousness without major abnormal movements. These are also called absence seizures. Also called "petit mal" seizures.

Focal seizures affect one side of your brain first. You may have behavior, sensation, or movement changes on one side of your body. 

• Focal aware seizures: When you're aware of these changes in movement or sensation. Also called "simple partial seizures."
• Focal unaware seizures: When you're unaware of the seizure. To others, you may seem confused or unable to respond. Also called "complex partial seizures."

Sometimes, a focal seizure spreads to both sides of your brain. You lose consciousness and have motor seizure movements on both sides of your body. This is called a "focal to bilateral tonic-chronic seizure."

Other terms used to describe seizure movements include: 

• Myoclonic: Small, quick, jerky movements
• Clonic: Rhythmic shaking or jerking movements
• Tonic: Muscles get stiff
• Atonic: Muscles get soft and lose strength

Symptoms of a seizure

The symptoms of epilepsy may look different depending on the kind of seizures you have. Some seizures may cause you to fall or shake your body. Others make you lose awareness and become unconscious. 

More commonly, you may seem confused, stare into space, and be unresponsive to questions. You may wander around or make unusual movements. 

After a seizure, you may recover immediately, or it could take minutes to hours to feel like yourself again. While recovering, you may feel tired, sleepy, weak, or confused.

A seizure disorder is any health issue that causes seizures. Epilepsy is when you have two or more unprovoked seizures more than 24 hours apart. 

Epilepsy is a category of brain disorder that causes seizures. There are hundreds of epilepsy syndromes, which are disorders that include seizures as a prominent symptom. Because of that, it can be hard to categorize epilepsy into types.

Status epilepticus is an emergency seizure that lasts more than 30 minutes without stopping or recovering in between. Identifying and managing this condition accurately in the emergency room is essential. In Carilion’s emergency department we use the Ceribell point-of-care electroencephalogram (EEG) to diagnose status epilepticus. This AI-powered headband enables early detection and treatment of seizures.

What causes epilepsy?

Many times, we don't know what specifically causes seizures to start. However, some causes of epilepsy and seizures include:

• Brain injury
• Brain tumor
• Genetic conditions
• Infection
• Other neurological diseases
• Stroke

An integral part of epilepsy care is getting the right diagnosis. As the region's only Level 4 monitoring unit, Carilion can ensure you get the right diagnosis and treatment. 

Our epilepsy center applies a team approach to the diagnosis and treatment of your epilepsy. Our team cares for all aspects of your life affected by seizures. 

The team typically includes:

• Epilepsy nurse specialist
• EEG technologists
• Epileptologist (a neurologist with expertise in treating seizures)
• Neurosurgeon
• Neuropsychologist
• Social workers

Each room has computer-based equipment to evaluate seizure disorders. The EEG is the most commonly used test for seizure activity. It measures the electrical activity of your brain. 

Tools that we use to identify your seizure correctly include: 

• Home hookup EEG with video
• Intermittent and prolonged EEG
• Routine outpatient and inpatient EEG

Our expert team in the epilepsy monitoring unit gathers data before your seizure starts, while it's occurring, and during your recovery. This data helps the team learn about your seizures to shape treatment.

We also perform neuropsychological testing, including MRI and PET scans. We use a SPECT scan to help identify where the seizure is coming from. 

We use a variety of treatments, from medicines and surgeries, to get you seizure-free.

Antiseizure medicines

Antiseizure medicines treat and prevent seizures. There are multiple types, but some can cause side effects, especially at higher doses. 

If your epilepsy isn't responding to a variety of antiseizure medicines, you may have intractable or refractory epilepsy. Our epilepsy center focuses on providing the most complete treatment options for cases like these. 

Brain surgery 

Brain surgery may be an option when your seizures aren't responding to medicine. 

We offer many types of surgery, ranging from traditional open surgeries to minimally invasive approaches. We also do surgeries to implant brain pacemakers, with each approach individualized for each patient to help them become seizure free.

Surgeries we offer include:

• Brain implants to control seizures
• Cutting the link between the brain tissue that causes seizures and healthy brain
• MRI-guided laser ablation destroys the area of the brain where seizures start
• Removal of the brain tissue that causes seizures
• Robot-based surgery

Brain devices

Brain stimulation devices are implants that can help reduce seizure frequency in drug-resistant epilepsy.

• Vagus nerve stimulation: An implanted device acts as a pacemaker for the vagus nerve. It interrupts electrical signals that cause seizures.
• Responsive neurostimulation: Also a type of brain pacemaker. A surgeon implants this device near the focus of the seizure.
• Deep brain stimulation: An implanted device that sends electrical pulses through wires to the specific brain areas involved with seizures. Carilion was one of the first hospitals in the U.S. to offer deep brain stimulation for epilepsy.

Clinical trials

We're also actively performing clinical trials for chronic epilepsy management. Clinical trials are always voluntary. Your care team will discuss any options for clinical trial care.