Epilepsy is an umbrella term for a group of seizure disorders. Different warning signs may indicate you have epilepsy.

While many people think of epilepsy as one syndrome, it is actually an umbrella term for a range of different seizure disorders. The signs and symptoms of epilepsy can differ from person to person and are affected by the type of epilepsy.

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Are There Warning Signs of Epilepsy?

Doctors usually don’t make a diagnosis of epilepsy unless a person has had at least two “unprovoked” seizures that occur greater than 24 hours apart. Unprovoked seizures are those that don’t have a clear cause. Clear causes may include a high fever, an acute brain injury or head trauma within the last week, or alcohol or drug withdrawal.

“Our brains make electricity normally,” Christina Patterson, MD, director of Epilepsy Services, UPMC Children’s Hospital of Pittsburgh, tells WPXI. “That’s how we do everything we do. That’s how we talk, that’s how we walk, and that’s how we play.

“When our brains make an unexpected, abnormal surge of electricity, that’s actually a seizure. That abnormal surge of electricity can cause our bodies to do abnormal things — move in funny ways, feel funny things — and it can sometimes alter awareness.”

If someone has experiences two or more seizures that are more than a day apart and unprovoked, they meet the clinical criteria for a diagnosis of epilepsy. Epilepsy can begin anytime, but most often starts in childhood or in older adulthood (above age 65).

“Epilepsy is when you have had or will have a risk for repeated, unpredictable seizures,” Dr. Patterson says.

Febrile seizures — or seizures that result from a high fever — are usually not a sign of epilepsy. However, children who have prolonged seizures of 30 minutes or more are at a higher risk of developing epilepsy.

Beyond actual seizures, there are no early warning signs of epilepsy. However, some factors can put children or adults at a higher risk of epilepsy. These include:

  • A family history of epilepsy.
  • Dementia.
  • Developmental delay.
  • Intellectual disability.
  • Premature birth.
  • Previous damage to the brain, such as from an injury, stroke, or cancer.
  • Personal history of meningitis or encephalitis.
  • Some developmental disorders.

Are There Warning Signs a Seizure Is About to Occur?

If you or your child have experienced a seizure due to epilepsy, you may worry about having another one. You may fear having a seizure in public, for example.

Some people have no warning signs that a seizure is about to happen, while others do. These warning signs may occur either before or during the beginning of a seizure.

The prodromal phase: Before a seizure

Most people don’t experience what’s called the “prodromal phase.” However, 20% of people with epilepsy notice signs and symptoms minutes, hours, or even a few days before a seizure begins.

The signs and symptoms that a seizure is coming can include:

  • A “funny feeling.”
  • Anxiety.
  • Confusion.
  • Difficulty staying focused.
  • Headache.
  • Insomnia.
  • Mood or behavior changes.

If a person experiences a prodromal phase, they can take actions to avoid injury due to involuntary movements of a seizure. They should avoid swimming, traveling, or cooking over heat without supervision, for example.

Aura: The first part of a seizure

For more than half of people with epilepsy, their seizure starts while their awareness is maintained, which can produce symptoms they remember. Some people refer to this as the “aura” or the early stage of a seizure. Focal, or partial, seizures also can happen on their own, without progression to loss of awareness or a generalized seizure.

This focal seizure, or “aura,” may occur just prior to progression with impaired consciousness. The person may be able to tell someone they are having a seizure or lie or sit down. In other words, an aura can be a warning sign that can prevent someone from being injured during their seizure.

For people with epilepsy, signs and symptoms of an “aura,” or focal seizure, include:

  • A change in heart rate or blood pressure.
  • A strong sense of déjà vu (the feeling that something has happened before).
  • Confusion.
  • Hallucinations, which may mean seeing, smelling or hearing things that aren’t present.
  • Nausea.
  • Strong feelings of fear, joy, sadness or anger.
  • Sudden, intense feelings of anxiety.
  • Tingling or numbness.
  • Twitching or jerking movements on only one side of the body.

The warning signs of a seizure differ from person to person. The good news is that if people with epilepsy have warning signs, they usually experience the same ones each time. Paying attention to emotional and physical symptoms can help you recognize the signs of a seizure.

Life with Epilepsy

A good source of information for people living with epilepsy is the Epilepsy Foundation of Western and Central PA. This organization provides educational options, support services, and other resource lists (including transportation services information, help understanding health coverage, information about camps for kids with epilepsy, financial assistance, and more).

If you need a second opinion or more information on how to live your best life with epilepsy, contact the UPMC Comprehensive Epilepsy Center or the Epilepsy Center at UPMC Children’s Hospital of Pittsburgh.

Editor's Note: This article was originally published on , and was last reviewed on .

Dr. Frank Besag and Dr. Michael Vasey. Prodrome in epilepsy. Link

Febrile Seizures. National Institute of Neurological Disorders and Stroke. Link

Dr. Stephen Huff and Dr. Najib Murr. Seizure. StatPearls. Link

Warning Signs of Seizure. Epilepsy Foundation. Link

About UPMC

Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 800 doctors’ offices and outpatient centers, with locations throughout Pennsylvania, Maryland, New York, West Virginia, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. We are dedicated to providing Life Changing Medicine to our communities.