Clinical features of epilepsy are specific to the type of seizure. With complex partial seizures, auras such as unexpected tastes, smells or paraesthesia can occur prior to the seizure or partial seizures, which can include focal motor (jerking movements to the face and hands that spread to the limbs) and focal sensory seizures.

Specific features of generalised seizures are:

• Tonic seizures: Impairment of consciousness and stiffening
• Clonic seizures: Cause jerking and impairment of consciousness
• Tonic-clonic seizures: Cause stiffening and jerking and impairment of consciousness. Ninety per cent of people with generalised tonic-clonic seizures only will achieve seizure control
• Typical absence seizures: Quick onset and offset with no symptoms (e.g. child stares for a few seconds – normally less than 30 seconds). Around 80 per cent of people with childhood absence epilepsy will be in remission by adulthood
• Myoclonic seizures: Brief, shock-like contraction of the limbs, with no impairment of consciousness
• Atonic seizures: Sudden brief attacks of loss of tone, associated with falls and impairment of consciousness.
• Many people believe epilepsy is triggered by flashing lights but photosensitive epilepsy only occurs in up to 3 per cent of people.

Goals of treatment

The NICE guidelines goals of treatment are to:

• Diagnose an individual by referral to a specialist after a first seizure
• Prescribe drug treatment following specialist assessment to stop or reduce seizure frequency and severity
• Monitor and review regularly to minimise effects of seizures on daily life
• Provide adequate and appropriate information to people with epilepsy