Epilepsy is a very common neurological disorder, and many people feel confident they can recognise an epileptic seizure when they see one. In the popular imagination, epilepsy consists of falling to the ground, shaking all the limbs vigorously, foaming at the mouth, biting the tongue, and wetting the pants. This is of course an accurate depiction of the iconic generalised tonic-clonic seizure – more graphically epitomised by its old name, grand mal!
A less dramatic but relatively familiar expression of epilepsy is the absence seizure – again better depicted by its defunct name of petit mal. This consists of a brief vacant or staring spell which may occasionally be associated with minor eyelid, lip, or hand movements. The International League Against Epilepsy (ILAE) also lists the following classical epilepsy types – myoclonic, atonic, tonic, and clonic – and these are all fairly descriptive of the abnormal electrical brain discharge that symbolises epilepsy.
Many people with epilepsy however do not have these classical symptoms of epilepsy. Indeed many will manifest with what are simply bizarre and peculiar features. These, rather than the conventional grand mal or petit mal, are what keep neurologists awake at night. To ferret out the most unusual presentations of what is arguably the most clandestine neurological disorder, I scoured Neurochecklists and unearthed these 140 extraordinarily deceptive manifestations of epilepsy. Peruse and then follow the links at the end.
Coproplalia (foul speech)
Signum crucis: sign of the cross
Unilateral eye blinking
Unilateral droopy eyelid (ptosis)
Miosis (small pupils)
Forced head turning
Making a fist
Cupping the fingers
Extending the hand
Dorsiflexion of the toes
Delusion of sexual transformation
Inability to perceive motion (akinetopsia)
Perception of multiple images (polyopsia)
Attraction to television (telephilic syndrome)
Chest pain (epileptic angina)
Pain behaviour without pain
Eating or chewing-induced
Urge to defecate
Rhythmic tongue movements
Prosopagnosia (inability to recognise faces)
Isolated enuresis (bedwetting)
Neurological manifestations of seizures
Systemic manifestations of seizures
Transient epileptic amnesia (TEA)
Have we missed any? Please drop a hint!