March 12, 2024/Brain & Nervous System

Seizure Warning Signs and Symptoms May Not Be What You Expect

Seizure symptoms can go far beyond convulsions and may include feelings of déjà vu, temporary confusion and unusual movements

Hand trying to write on paper, with hand shaking, tremoring

Hollywood may have you believe that seizures are always dramatic, fall-to-the-ground convulsions that happen completely out of the blue.

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For some people, that’s true. Some seizures cause people to lose consciousness, tense up and involuntarily shake and tremble their entire body. They can come on without any warning signs and be an emergency experience that can put you at risk for falls and injuries.

But not always.

For some people, a seizure can be a major event. But for other people, seizures present themselves in far more subtle ways. Ways that can be easy to overlook or misunderstand. But still pose a risk to their safety and well-being.

“Epileptic seizures are the result of a surge of abnormal brain electricity. They often create brief episodes of symptoms as a result of rogue electricity,” says epilepsy specialist Deepak Lachhwani, MD.

“Depending on the part of the brain where this abnormal electricity takes place, the symptoms and signs of a seizure can manifest in very different ways.”

In other words, a seizure is like an electrical storm, or a jolt of lightning in your brain. And the way you experience a seizure depends on where that lightning strikes.

Dr. Lachhwani shares the warning signs that some people experience when a major seizure is on its way — and how one person’s seizure warning sign can be another person’s entire seizure experience.

What are the warning signs of a seizure?

People experience seizures in a number of ways.

Some seizures cause people to pass out and have uncontrolled convulsions for several minutes (tonic-clonic seizures).

Others may look like a person “spacing out” or staring off into the distance (absence seizures).

And some people don’t experience any symptoms associated with a seizure at all. Those are called silent seizures or electroencephalographic seizures.

For most people, seizures can’t be predicted. They just ... happen.

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For others, there are early warning signs that a seizure is on its way. That’s called an aura or prodrome. That’s typical of a focal seizure. They’re seizures that may start in just one part of your brain.

“An aura doesn’t always progress into a more involved seizure. Some people with seizures have brief symptoms that are only in the form of auras,” Dr. Lachhwani shares. “Because these are often brief and subtle, they may not even recognize that they’re even having seizure symptoms and brush them off as something else, until one day the aura progresses into a more involved seizure episode.”

For some people, auras can turn into convulsions in a matter of seconds. Others may take several minutes to progress from warning sign to loss of consciousness. If you recognize aura symptoms as a sign that you’re about to have a major seizure, take steps to protect yourself. That may mean not driving. Or lying down to avoid a fall.

Dr. Lachhwani shares some examples of seizure warning signs and unexpected seizure symptoms.

Déjà vu

Déjà vu is a feeling that you’ve been there, done that. It happens when an entirely unfamiliar situation may appear as familiar.

It’s French for “already seen,” and it’s a sense that you’re experiencing something identical to a past experience. Maybe it’s a conversation you could swear you’ve had before. Or the sense that a new place you’re visiting is somehow already familiar to you.

Lots of people experience déjà vu here and there. Some estimates say that as many as 97% of us report having déjà vu at least once in our lives.

But for people who experience déjà vu as a seizure warning sign or a seizure symptom, it can happen more repeatedly.

“It’s not that every time you feel déjà vu it has to be related to a seizure,” Dr. Lachhwani reassures. “But if this kind of phenomenon keeps happening, or is followed by a more involved seizure, it’s worth noting.”

A feeling of déjà vu can also lead to some momentary confusion. You may notice that someone stops in their tracks for a second. Or takes a minute to process their surroundings as they come to grips with this odd feeling of familiarity.

In that way, brief moments of confusion may also be a sign that a person is experiencing a seizure or that a major seizure is on the horizon.

Odd sensory experiences

Seizure signs can also come in the form of unusual sights, smells, sounds, tastes or feelings.

This happens if a seizure affects a part of your brain that’s connected to those senses. Dr. Lachhwani says some people experience sensory symptoms associated with seizures, like:

  • Changes in their vision, like seeing sparkling lights, dark circles or colorful splotches.
  • Hearing things that no one else does, like a ringing, buzzing or whistling.
  • Noticing an odd smell, such as burning rubber.
  • Feeling numbness, tingling, heat or pain in a specific body part.
  • Having an unusual — and typically unpleasant — taste in your mouth, like something bitter, metallic or sour.

Again, these seizure warning signs last for a brief time, maybe even less than a minute. And they happen often enough to catch your attention as more than a one-off experience.

Out-of-context behaviors

For some people, a seizure or a seizure aura can manifest as a brief, odd behavior that’s out of context or inappropriate for the situation.

That may look like:

  • Sudden and short-lived changes in demeanor, like becoming momentarily confused, subdued, irritated, anxious, excited or fearful.
  • Walking away or disengaging in the middle of a conversation.
  • Saying something completely unrelated to the conversation at hand.
  • Disruptive behaviors, like uncontrollably yelling out in a classroom or in a meeting.

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Twitches and other unusual movements

In some cases, seizures can cause involuntary and non-purposeful movements. They may be subtle or they could be more noticeable.

For some people that can look like:

  • A sudden cramping or tensing of a muscle group, stiffening of your head and neck muscles, involuntarily posturing your fingers or hand, or exaggerated blinking.
  • Moving your jaw as if you’re chewing or swallowing when you’re not eating or drinking.
  • Pacing or moving about with a sudden burst of energy.
  • Fidgeting with your hands, such as adjusting your clothes.

“These are normal behaviors in proper context. But when they happen out of context and can’t be controlled, they aren’t purposeful in that moment,” Dr. Lachhwani elaborates. “So they can be a sign that something is off.”

Autonomic symptoms

Things like your sweat, saliva and digestive system are handled by your body’s autonomic system. Those are the functions that happen “behind the scenes” and that you rarely have to think about.

In some people, seizure warnings can impact these automatic processes in your body and make them suddenly and temporarily more noticeable.

That could look like:

  • Sweating.
  • An influx of saliva or drooling.
  • Flushing or reddening in your skin.
  • “Gastric uprising,” where you feel a rising or fluttering sensation in your belly, similar to when you speed down the hill of a roller coaster.

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When to seek help

The key to identifying seizure warning signs and subtle seizure symptoms is that they happen for brief periods of time. And they happen somewhat repetitively.

For most people, their seizure auras are consistently the same experience. Your seizure aura is likely a set of symptoms that you’ll experience in the same way time and time again. It’s your signature symptom.

“When suspecting epileptic seizures, one is looking for relatively consistent, self-limited symptoms that you can’t control,” Dr. Lachhwani notes. “You’ll notice a discrete start and finish to the symptoms. Probably 30 to 60 seconds. They’ll be involuntary, likely to occur anywhere and at any time of day.”

“If you notice the same brief symptoms over and over, over a matter of days, weeks or even months, it’s time to seek help,” he adds.

Prompt, accurate diagnosis and a treatment plan that controls your seizures are important. Even if your seizure warnings haven’t progressed into something more major, they could. And they may still be putting you at risk.

“It’s really important to get a quick diagnosis and an appropriate treatment so you experience a full and productive life,” Dr. Lachhwani advises. “Seizures can impair your quality of life, and put you at risk for car accidents and injuries. For kids, they can affect learning and proper development.”

If you think you may be experiencing seizure warning signs or auras, Dr. Lachhwani suggests having a friend or family member try to take a video of the experience.

“A home video is worth a thousand words,” he emphasizes. “I often encourage family members of children with seizures who come to see me to make a small home video if they can safely do so. Videos can help your provider see what’s happening and get you the help you need.”

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