What a Seizure Feels Like: Beyond the Seizure Itself
- Austin Cole
- 3 days ago
- 7 min read
Key Takeaways
Seizures are not just convulsions. Seizures often begin with subtle changes in mood, perception, or "gut feelings" long before any physical shaking occurs.
The "Aura" is a seizure. Sensations like déjà vu, sudden fear, or a rising feeling in the stomach are actually small, focal seizures where you remain aware.
It happens in phases. A seizure event can have four distinct parts: the warning (prodrome), the start (aura), the event (ictal), and the recovery (post-ictal).
You might not remember. Memory loss and profound confusion are common during and after the event as the brain attempts to "reboot".
Recovery takes time. The "post-ictal" phase can leave you exhausted, emotional, or foggy for hours or even days.
Table of Contents
One of the most isolating aspects of living with epilepsy is the challenge of translation. How do you explain to a friend, a partner, or even a doctor the sudden sensation that the room is tilting, or the overwhelming wave of fear that arrives without a trigger?
For many young adults, the clinical definition of a seizure (a sudden, uncontrolled electrical disturbance in the brain) feels distinct from the lived reality. The clinical definition describes the mechanism. It does not describe the experience.
This guide breaks down the anatomy of a seizure from the inside out to help you validate your feelings and recognize warning signs.
The Four Phases of a Seizure
Not everyone experiences every phase. Your epilepsy is as unique as your fingerprint. However, understanding the potential progression helps you distinguish between anxiety and neurological activity.
Prodrome: Hours or days before.
Aura: The start of the seizure (seconds to minutes).
Ictal: The seizure event itself.
Post-ictal: The recovery period.
Phase 1: The Prodrome
Long before a seizure occurs, some people experience a subtle shift in their baseline state known as the prodrome. Unlike an aura, which is the start of the seizure itself, the prodrome is a pre-seizure state that can last for hours or even days. Think of it like the changing barometric pressure before a storm; you might not see the rain yet, but you can feel that something in the atmosphere has shifted.
Mood Volatility and Irritability
For many, the first sign is emotional rather than physical. You might find yourself feeling intensely irritable, depressed, or anxious in a way that feels disproportionate to your circumstances. Small annoyances that you would usually ignore might suddenly feel overwhelming. It is common for patients to look back after a seizure and realize that their "bad mood" the day before was actually a physiological warning sign.
Cognitive and Physical Changes
The prodrome can also manifest as a difficulty in focusing or a sense of mental "fogginess." You might struggle to find words or feel a general sense of confusion. Physically, this phase often presents as a headache, sensitivity to light, or significant sleep disturbances. You might find yourself unable to sleep (insomnia) or feeling an exhaustion that sleep does not cure. Tracking these subtle shifts can be a powerful tool; if you notice a pattern, you can take precautionary measures like prioritizing rest or avoiding alcohol.
Phase 2: The Aura (Focal Aware Seizure)
The Warning Is the Event
The term "aura" is traditional but slightly misleading. An aura is not just a warning sign; it is a seizure. Specifically, it is a focal aware seizure. This means the electrical activity is currently localized to one specific part of the brain, and you remain fully conscious. Because the activity is localized, the symptoms you feel depend entirely on which part of the brain is involved.
The Rising Sensation
One of the most frequently reported sensations, particularly in temporal lobe epilepsy, is an epigastric rising sensation. Patients often describe this as a "rollercoaster feeling" in the pit of the stomach that rises upward toward the throat. It is distinct from nausea. It feels more like the physical sensation of anticipation or dropping, even while you are sitting perfectly still.
Sensory Distortions and Phantosmia
When seizure activity affects the areas of the brain responsible for processing senses, the world can warp. You might smell a sudden, usually unpleasant scent like burning rubber, rotting food, or sulfur (known as phantosmia). You might experience a strong metallic or bitter taste in your mouth, hear buzzing or muffled voices, or see flashing lights and static. In rarer cases, objects may appear to shrink or grow, a phenomenon sometimes called "Alice in Wonderland Syndrome."
Psychic and Emotional Experiences
The brain controls memory and emotion just as it controls movement. Consequently, a seizure can manifest as a pure feeling. You might be hit with a wave of intense déjà vu, a sense that "I have been here before" that is far stronger and more unsettling than the normal experience. Conversely, you might feel jamais vu, where a familiar place, person, or word suddenly feels alien or unrecognizable. Others report a rush of sudden fear or panic rising from the gut that is purely physiological and not triggered by frightening thoughts.
Phase 3: The Ictal Phase
The Event Itself
This is the phase most people think of as ''the seizure''. This is the period from the first symptom to the end of the seizure activity.
Focal Impaired Awareness Seizures
Formerly known as complex partial seizures, these involve a change in consciousness. You are not unconscious, but you are not fully present. From the inside, this often feels like missing time.
You might be having a conversation, and suddenly you "wake up" a few minutes later to discover you have walked to a different room, rearranged objects, or continued a repetitive motion like rubbing your hands or chewing.
Some people recall a dream-like state, describing it as being underwater or separated from reality by a thick pane of glass; you can hear people talking to you, but you cannot understand the words or figure out how to respond.
Generalized Tonic-Clonic Seizures
Formerly called grand mal seizures, these involve a total loss of consciousness and convulsions. The most common question from friends and family is, "Does it hurt?" For the vast majority of people, the answer is no. Because consciousness is lost instantaneously, you do not feel the fall or the convulsions. The experience is usually binary: you are there (perhaps having an aura), and then you are waking up. There is no passage of time. It is deeper than sleep; it is a void.
Witnesses may report a frightening scream or cry at the start of the seizure. It is important to know that this is not a cry of pain. It is simply the sound of air being forced through the vocal cords as the chest muscles contract.
Phase 4: The Postictal Phase
For many young adults, the seizure itself is less difficult than the aftermath. The postictal phase is the brain's recovery period, and it can last minutes, hours, or even days depending on the severity of the event.
The Physical Toll
A generalized seizure is an intense physical workout. Every muscle in the body has contracted simultaneously. You may feel as though you ran a marathon without training. This is due to the buildup of lactic acid and micro-tears in the muscle fibers. Headaches and nausea are very common after a seizure. You may discover a bitten tongue, cheek, or bruises from a fall; the pain from these usually registers only after you regain full consciousness.
The Cognitive Fog
The brain has just experienced an electrical storm, and reorienting takes time. You may not know your name, the day of the week, or why paramedics are standing over you. This profound confusion can be frightening, but it is temporary. You might also lose memories of the hours leading up to the seizure.
The Emotional Crash
This is rarely discussed in clinical pamphlets but is deeply familiar to the YAWE community. The biochemical changes in the brain often result in a severe emotional drop. You may feel intense embarrassment or shame, especially if the seizure happened in public. Acute anxiety, vulnerability, or uncontrollable tearfulness are also common. It is vital to recognize that this is a "chemical hangover." Your neurochemistry has been depleted. Be gentle with yourself; this emotional weight is a symptom, not a permanent state.
Navigating Daily Life
Talking to Friends and Partners
You do not need to share your medical history with everyone, but close friends need to know what to do. A simple script works best: "I have epilepsy. Sometimes I might zone out or act confused. If that happens, just stay with me and make sure I’m safe. You don't need to call 911 unless it lasts more than 5 minutes."
Dating and Intimacy
For women, hormonal changes during the menstrual cycle can impact seizure frequency (catamenial epilepsy). Open communication with a partner builds trust. If you are concerned about seizures during intimacy, discuss it beforehand so your partner knows how to support you. Also, be aware that some anti-seizure medications can interact with hormonal birth control.
School and Work
You may be eligible for extra time on exams or a flexible schedule to manage fatigue. While laws regarding driving vary by state, losing a license is often temporary until seizures are controlled.
Frequently Asked Questions
Q: Can an aura be a seizure?
A: Yes. An aura is a focal aware seizure. It means the seizure activity is happening in a small area of your brain while you are awake.
Q: Do seizures hurt?
A: Generally, the seizure itself does not hurt because you are often unconscious or in an altered state. However, injuries or muscle soreness afterward can be painful.
Q: How do I tell panic attacks from auras?
A: Panic attacks are often triggered by a stressor and build up. Auras tend to happen suddenly, last a shorter time (seconds to minutes), and usually feel exactly the same every time.
Q: How long does the post-ictal phase last?
A: It varies. Some people recover in minutes; others feel "off" or tired for several days.
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