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Symptoms — Epilepsy

Seizures can affect people in different ways, depending on which part of the brain is involved.

Some seizures cause the body to jerk and shake (a «fit»), while others cause problems like loss of awareness or unusual sensations. They typically pass in a few seconds or minutes.

Seizures can occur when you’re awake or asleep. Sometimes they can be triggered by something, such as feeling very tired.

Types of seizures

Simple partial (focal) seizures or ‘auras’

A simple partial seizure can cause:

a general strange feeling that’s hard to describe
a «rising» feeling in your tummy – like the sensation in your stomach when on a fairground ride
a feeling that events have happened before (déjà vu)
unusual smells or tastes
tingling in your arms and legs
an intense feeling of fear or joy
stiffness or twitching in part of your body, such as an arm or hand

You remain awake and aware while this happens.

These seizures are sometimes known as «warnings» or «auras» because they can be a sign that another type of seizure is about to happen.

Complex partial (focal) seizures

During a complex partial seizure, you lose your sense of awareness and make random body movements, such as:

smacking your lips
rubbing your hands
making random noises
moving your arms around
picking at clothes or fiddling with objects
chewing or swallowing

You will not be able to respond to anyone else during the seizure and you will not have any memory of it.

Tonic-clonic seizures

A tonic-clonic seizure, previously known as a «grand mal», is what most people think of as a typical epileptic fit.

They happen in 2 stages – an initial «tonic» stage, shortly followed by a second «clonic» stage:

tonic stage – you lose consciousness, your body goes stiff, and you may fall to the floor
clonic stage – your limbs jerk about, you may lose control of your bladder or bowel, you may bite your tongue or the inside of your cheek, and you might have difficulty breathing

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The seizure normally stops after a few minutes, but some last longer. Afterwards, you may have a headache or difficulty remembering what happened and feel tired or confused.

Absences

An absence seizure, which used to be called a «petit mal», is where you lose awareness of your surroundings for a short time. They mainly affect children, but can happen at any age.

During an absence seizure, a person may:

stare blankly into space
look like they’re «daydreaming»
flutter their eyes
make slight jerking movements of their body or limbs

The seizures usually only last up to 15 seconds and you will not be able to remember them. They can happen several times a day.

Myoclonic seizures

A myoclonic seizure is where some or all of your body suddenly twitches or jerks, like you’ve had an electric shock. They often happen soon after waking up.

Myoclonic seizures usually only last a fraction of a second, but several can sometimes occur in a short space of time. You normally remain awake during them.

Clonic seizures

Clonic seizures cause the body to shake and jerk like a tonic-clonic seizure, but you do not go stiff at the start.

They typically last a few minutes and you might lose consciousness.

Tonic seizures

Tonic seizures cause all your muscles to suddenly become stiff, like the first stage of a tonic-clonic seizure.

This might mean you lose balance and fall over.

Atonic seizures

Atonic seizures cause all your muscles to suddenly relax, so you may fall to the ground.

They tend to be very brief and you’ll usually be able to get up again straight away.

Status epilepticus

Status epilepticus is the name for any seizure that lasts a long time, or a series of seizures where the person does not regain consciousness in between.

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It’s a medical emergency and needs to be treated as soon as possible.

You can be trained to treat it if you look after someone with epilepsy. If you have not had any training, call 999 for an ambulance immediately if someone has a seizure that has not stopped after 5 minutes.

Seizure triggers

For many people with epilepsy, seizures seem to happen randomly.

But sometimes they can have a trigger, such as:

stress
a lack of sleep
waking up
drinking alcohol
some medicines and illegal drugs
in women, monthly periods
flashing lights (this is an uncommon trigger)

Keeping a diary of when you have seizures and what happened before them can help you identify and avoid some possible triggers.

Want to know more?

Epilepsy Action: common seizure triggers
Epilepsy Action: epileptic seizures explained
Epilepsy Society: epileptic seizures

Page last reviewed: 18 September 2020
Next review due: 18 September 2023

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Blank expression

A blank expression is a facial expression characterized by neutral positioning of the facial features, implying a lack of strong emotion. It may be caused by a lack of emotion, depression, boredom or slight confusion, such as when a listener does not understand what has been said.

Another possible cause for a blank expression is traumatic brain injury such as a concussion. If someone has just been hit on the head and retains a blank or dazed expression, this can be an early warning of a concussion. [1]

Psychiatric disorders such as schizophrenia, facial paralysis, and post-traumatic stress disorder, may also cause a blank expression. [2] If medical conditions such as these are the cause of the blank expression, medication and therapy may be used as treatment to regain normal expression. [3]

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Poker face [ edit ]

A deliberately-induced blank expression meant to conceal one’s emotions is also known as a poker face, referring to the common practice of maintaining one’s composure when playing the card game poker. [4] [5] This term comes from the special language used in poker, [6] and is not only about your facial expression but also other extraneous movements that could give insight into what you are feeling, such as clenching fists, bouncing a leg, or constant repositioning of your body and or cards. [7] If someone has expressed that you have a poker face, it generally tends to mean that you are hard to read and they do not know what you are thinking.

The first recorded publication of the term poker face is from the 1875 book «Cavendish. Round games at cards.» which reads «It follows that the possession of a good poker face is an advantage. No one who has any pretensions to good play will betray the value of his hand by gesture, change of countenance, or any other symptom.» [8]

The term poker face was used outside the game of poker by American sportswriters in the 1920s to describe a competitor who appeared unaffected by stressful situations (an important skill when playing poker for money, to avoid giving an opponent any tells about one’s hand). [9] It is similarly used with reference to marketers and salespeople during business negotiations. [10]

References [ edit ]

General references [ edit ]

Jan Hargrave (2010). Poker Face: The Art of Analyzing Poker Tells. Kendall Hunt Pub Co. ISBN978-0-7575-7789-5 .
David Naimark; Ansar Haroun (2011). Poker Face in Mental Health Practice: A Primer on Deception Analysis and Detection. W W Norton & Co Inc. ISBN978-0-393-70699-4 .

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Inline citations [ edit ]

^
«Concussion: Causes, Symptoms, Diagnosis, Treatments, Prevention». Cleveland Clinic . Retrieved 21 September 2022 .
^
«Lack of Facial Expressions: Symptoms, Signs, Causes & Treatment». MedicineNet . Retrieved 21 September 2022 .
^
«Flat Affect: Treatment Options and Associated Conditions». Healthline. 4 August 2017 . Retrieved 21 September 2022 .
^
Judi James (2007). Poker Face: Mastering Body Language to Bluff, Read Tells and Win. Da Capo Press. p. 17. ISBN978-1-60094-051-4 .
^
Richard D. Harroch; Lou Krieger (2011). Poker For Dummies. For Dummies. p. 22. ISBN978-1-118-05358-4 .
^
«Poker Face: The Meaning and History». PokerTube . Retrieved 21 September 2022 .
^
How to Make & Keep a Poker Face | Poker Tutorials , retrieved 21 September 2022
^
«De la Rue, Thomas (1793–1866)», Oxford Dictionary of National Biography, Oxford University Press, 6 February 2018, doi:10.1093/odnb/9780192683120.013.7446 , retrieved 21 September 2022
^
Joey Lee Dillard (1985). Toward a social history of American English. Walter de Gruyter. p. 169. ISBN3-11-010584-5 .
^
Arnold S. Goldstein (1981). The Complete Guide to Buying and Selling a Business. Penguin Group USA. p. 154. ISBN0-452-26111-2 .

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Symptoms — Agoraphobia

For example, someone with severe agoraphobia may be unable to leave the house, whereas someone who has mild agoraphobia may be able to travel short distances without problems.

The symptoms of agoraphobia can be broadly classified into 3 types:

physical
cognitive
behavioural

Physical symptoms

The physical symptoms of agoraphobia usually only occur when you find yourself in a situation or environment that causes anxiety.

However, many people with agoraphobia rarely experience physical symptoms because they deliberately avoid situations that make them anxious.

The physical symptoms of agoraphobia can be similar to those of a panic attack and may include:

rapid heartbeat
rapid breathing (hyperventilating)
feeling hot and sweaty
feeling sick
chest pain
difficulty swallowing (dysphagia)
diarrhoea
trembling
dizziness
ringing in the ears (tinnitus)
feeling faint

Cognitive symptoms

The cognitive symptoms of agoraphobia are feelings or thoughts that can be, but aren’t always, related to the physical symptoms.

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Cognitive symptoms may include fear that:

a panic attack will make you look stupid or feel embarrassed in front of other people
a panic attack will be life threatening – for example, you may be worried your heart will stop or you’ll be unable to breathe
you would be unable to escape from a place or situation if you were to have a panic attack
you’re losing your sanity
you may lose control in public
you may tremble and blush in front of people
people may stare at you

There are also psychological symptoms that aren’t related to panic attacks, such as:

feeling you would be unable to function or survive without the help of others
a fear of being left alone in your house (monophobia)
a general feeling of anxiety or dread

Behavioural symptoms

Symptoms of agoraphobia relating to behaviour include:

avoiding situations that could lead to panic attacks, such as crowded places, public transport and queues
being housebound – not being able to leave the house for long periods of time
needing to be with someone you trust when going anywhere
avoiding being far away from home

Some people are able to force themselves to confront uncomfortable situations, but they feel considerable fear and anxiety while doing so.