Myth: A seizure has to involve shaking or convulsions.
Fact: Many seizures do not cause shaking. Some affect sensation, memory, language, behaviour, emotion, autonomic function or consciousness with little or no obvious movement.
Why this myth persists
Public awareness has long centred on tonic-clonic seizures because they are dramatic and recognisable. That can make other seizure types easier to miss or dismiss.
What non-convulsive seizures can look like
Depending on where and how a seizure begins, a person may experience a sudden smell, fear, rising abdominal sensation, speech disturbance, visual change, brief unresponsiveness, automatisms, a pause in behaviour, altered memory or other subtle symptoms. Some focal seizures occur with consciousness preserved.
What the ILAE classification shows
The ILAE seizure classifications include focal seizures with observable or non-observable manifestations, generalized absence seizures and other seizure types that are not defined by convulsive shaking. The 2025 update explicitly separates seizure class from the many different manifestations a seizure may have.
Why recognition matters
If people expect every seizure to look convulsive, diagnosis can be delayed and bystanders may not realise that someone needs support. Subtle seizures can also be mistaken for daydreaming, panic, confusion, behavioural problems or other conditions.
Sources
ILAE — Updated classification of epileptic seizures, 2025
Beniczky et al., 2025 — ILAE position paper