Epilepsy vs. Seizure: Understanding a Symptom vs. Disease
Similarities and Differences
Medically reviewed by Huma Sheikh, MD
Seizures are the main symptom of epilepsy. However, there’s a difference between having a single seizure and having a diagnosis of epilepsy. Epilepsy is a condition that causes recurrent seizures, but people who don’t have epilepsy can experience seizures due to certain health conditions.
This article describes the differences and similarities between a seizure and epilepsy, as well as the treatment approaches for each.
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Classifying Epilepsy vs. Seizure
A seizure is an episode of uncontrolled physical movements or changes in awareness that is caused by a brief period of disruption of the electrical activity in the brain.
The symptoms of a seizure can vary and may include jerking of the extremities, stiffening of the extremities, staring without reacting to anything, loss of consciousness, or any combination of these symptoms.
Epilepsy is also described as a seizure disorder. It is a condition in which people have a high risk of recurrent seizures, sometimes without any type of trigger.
Main Differences
The main difference between epilepsy and a seizure is that a seizure is an individual event, and epilepsy is a condition that causes recurrent seizures. People who have epilepsy have an underlying and permanent alteration in the brain that causes a predisposition to seizures.
Seizures can also occur without epilepsy due to medical problems that alter the chemical composition of the blood, cause inflammation in the brain, or cause brief and temporary changes in the concentration of the neurotransmitters in the brain (such as due to medication).
Learn More: How Common Is Epilepsy?
Main Similarities
The symptoms of a single seizure are the same as those of epilepsy.
Symptoms can include any of the following:
Uncontrolled and repetitive jerking of the extremities, usually on one side of the body
Stiffening of the extremities, usually on one side of the body
Alternating stiffening and jerking of the extremities
Staring into space without responding to others
Unusual eye movements or eyelid fluttering
Unusual and involuntary grunting or screeching noises
Loss of bowel or bladder control
Falling to the ground
Complete loss of consciousness
Several hours of weakness of the affected extremity after the episode
Fatigue after the episode
Forgetting the whole event or forgetting some of the details of the event
Symptoms of a seizure correspond to the area of the brain affected by some type of permanent or temporary seizure-inducing condition.
Types of Seizures
There are several types of seizures, and they often correlate to the underlying cause or with the affected region of the brain.
Common seizure types:
Focal seizures: This seizure type begins in one specific region of the brain and causes stiffening or jerking of one part of the body. Usually, these seizures cause impairment of consciousness without a complete loss of consciousness. Common causes include stroke damage, head trauma, and brain tumors.
Absence seizures: This type of seizure causes a brief episode (lasting for a few seconds) of staring into space, often with lip smacking. A person experiencing an absence seizure is unaware of their surroundings and can appear to be daydreaming. These are generalized seizures, meaning they begin on both sides of the brain. They are more common during childhood or among people with epilepsy syndromes with several seizure types.
Myoclonic seizures: These seizures cause stiffness of one extremity (usually one arm). They can affect people who have epilepsy.
Generalized tonic-clonic seizures: These are the most recognizable seizure types. They begin on both sides of the brain and cause jerking and stiffening of the body, with unawareness and unresponsiveness.
Status epilepticus: This describes a prolonged seizure or a rapid recurrence of seizures. Status epilepticus can cause severe brain damage. While this type of seizure is uncommon, it affects people who have epilepsy that is not easily controlled with treatment.
Most of the time, an individual seizure that occurs without underlying epilepsy would be a generalized tonic-clonic seizure, as other seizure types are caused by epilepsy.
Symptoms of Having Seizures, But Not Epilepsy
Usually, seizures that occur without epilepsy cause symptoms very similar to those of seizures that occur due to epilepsy. However, seizures without epilepsy may also be accompanied by other symptoms that correspond to the underlying cause of the seizure.
Examples of symptoms that occur along with non-epileptic seizures include:
Low urine output when chemical abnormalities cause seizures due to kidney failure
Jaundice (yellow of the skin and whites of the eyes), when seizures are associated with liver failure
Bruising and loss of consciousness when seizures occur due to head trauma
Neurological symptoms, particularly involving eye movements or pupil abnormalities, when a brain aneurysm (defective blood vessel) causes seizures
Weakness or a change in sensation on one side of the body when a brain tumor causes seizures
When Do Seizures Become Epilepsy?
Usually, seizures do not cause epilepsy, but they can be a sign of epilepsy. This is because a seizure can occur due to a temporary or permanent condition affecting brain function.
When someone has their first seizure, the healthcare team will work to determine whether it is a sign of epilepsy or a sign of a temporary medical condition.
Epilepsy occurs when a person has certain types of permanent damage in a region of the brain. If the damage makes a person susceptible to intermittent seizure episodes, this is often called a lower seizure threshold.
Anyone can have a seizure due to severe alterations in neurotransmitters or chemical concentrations in the brain. People with epilepsy can have a seizure due to triggers that would not cause a seizure in someone who doesn’t have epilepsy. People who have epilepsy may even have seizures without any trigger at all.
Learn More: How to Identify Your Epileptic Seizure Triggers
Causes and Risk Factors
Certain medical conditions can cause epilepsy and others may cause an individual seizure. Some causes may overlap and could lead to either one isolated seizure or epilepsy.
Causes of individual seizures include:
Significant changes in electrolytes (especially calcium, potassium, sodium, and magnesium)
Certain medications, such as antipsychotic drugs and opioids
A high fever above 102 degrees F (especially in young children)
Head trauma
A brain aneurysm
A brain tumor
Meningitis (infection or inflammation surrounding the brain)
Encephalitis (infection or inflammation of the brain tissue)
Causes of epilepsy include:
Conditions present at birth affecting the brain structure
Brain damage due to head trauma
Damage due to a stroke or a ruptured brain aneurysm
Permanent damage due to an episode of meningitis or encephalitis
Permanent damage due to a tumor in the brain
Treatment Comparison: Epilepsy vs. Seizure
Having an individual seizure does not mean that you have epilepsy. However, if you have an individual seizure, it’s important that your healthcare team determine whether you have epilepsy —which would mean that you have a predisposition to recurrent seizures.
Diagnostic testing may include brain imaging to identify structural abnormalities in the brain and an electroencephalogram (EEG) to identify electrical brain wave changes that may be observed during or between seizures.
Seizure Treatment
If you have a seizure, it’s important to get prompt treatment. This may include rapid-acting antiepileptic medication, oxygen supplementation, and checking for any seizure-related injuries. You would also need treatment for any underlying cause, such as electrolyte abnormalities or a brain tumor.
Epilepsy Treatment
If you have epilepsy, you need to take daily anti-epilepsy medication to prevent recurrent seizures. It's also important that you maintain lifestyle adjustments to avoid seizure triggers.
Common antiepileptics (AEDs) for people who have epilepsy include:
Keppra (levetiracetam)
Trileptal (oxcarbazepine)
Depakote (valproic acid)
Topamax (topiramate)
Lyrica (pregabalin)
Over 40 approved AEDs are available. Your healthcare provider will decide what's right for you based on the seizure type you are experiencing, your improvement with treatment, other medications you take, and any side effects you're experiencing.
Usually, taking only one medication rather than two or more is ideal, but some people need several AEDs To experience adequate seizure control.
Lifestyle measures to avoid seizure triggers include:
Taking AED medication as prescribed
Avoiding alcohol and drugs
Getting enough sleep
Practicing ways to lower stress
Following a well-balanced diet, including drinking enough water and not skipping meals
If you have epilepsy, it's also crucial that you discuss any new medication, herbs, or supplements with your physician and pharmacist. Many medications and other substances interact with AEDs and can make them less effective or may cause harmful drug interactions.
How to Help Someone Having a Seizure
If you witness someone having a seizure, try to keep them safe by moving away any sharp objects and keeping them away from anything that could injure them.
For a generalized tonic-clonic seizure (with shaking, jerking, and falling), ease them to the floor and place them on their side. Put something soft under their head to protect it (like a folded item of clothing).
If you do not know if a person has epilepsy, if the seizure has caused an injury, or if the seizure lasts for more than a few minutes, it’s important to call for emergency help right away.
Do not try to move or interfere with someone who is having a seizure because this could cause injury. However, if you can wait with them and describe the incident to emergency services, this can be helpful.
Related: First Aid for Epilepsy Seizures
Prevention
Prevention is a primary component of managing epilepsy. Prevention includes lifestyle adjustments and medications.
Medical Care
If you have epilepsy, you could be at a higher risk of having a seizure if you develop an infection or a medical illness. So, maintaining your health while you have epilepsy involves more than just seeing your healthcare providers for epilepsy control.
You need to get your yearly health checkups, including blood tests, so that your healthcare providers can identify any medical issues at an early stage. For example, liver disease or kidney disease can cause chemical abnormalities in the blood, which can trigger seizures.
Preventing Infection
If you have epilepsy, be vigilant about avoiding infectious illnesses. Even a mild respiratory infection can trigger a seizure for someone who has epilepsy.
Ways to prevent infection include:
Avoiding people who are sick so that you won’t catch contagious infections
Handwashing, especially after contact with other people or after touching public items, such as door knobs
Staying up-to-date on your recommended vaccines
Even with these measures, it’s not uncommon to catch an infection. If you are at an increased risk of having a seizure due to an infection or any other trigger, consider safety measures while the risk resolves. This could include avoiding driving, not swimming, not using machinery, and avoiding any other activity that could be dangerous if you have a seizure.
Summary
Epilepsy is a medical condition that causes people to have recurrent seizures. Many people can experience a seizure, even without having epilepsy. Usually, a seizure that happens without epilepsy is caused by a serious medical or neurological risk factor, such as head trauma or extreme electrolyte imbalances.
A seizure can be treated with medication, and after the medical condition is stabilized, many people who experience a seizure will not develop recurrent seizures. Sometimes, an individual seizure is a sign of a new diagnosis of epilepsy. Epilepsy is treated with daily antiepileptic medications to prevent seizures and lifestyle measures to avoid triggers.
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