movements occur The child is unresponsive during the seizure and remains so postictally for a variable period After the seizure, there may be weakness or paralysis of one or more areas of the body (Todd paralysis) In atonic, or akinetic, seizures (drop attacks), there is abrupt loss of muscle tone and consciousness Myoclonic seizures are characterized by a sudden dropping of the head and flexion of the arms (jackknifing); however, extensor posturing may also occur The episodes occur quickly and frequently, as often as several hundred times daily TABLE 97.2 SEIZURE TYPES Generalized Partial (focal) Absence (petit mal) Typical Atypical Tonic–clonic (grand mal) Clonic Tonic Myoclonic Akinetic/atonic (drop attacks) Simple (no impaired consciousness) Motor Sensory Autonomic Psychic Complex (impaired consciousness) Partial seizures becoming partially generalized Absence (petit mal) seizures are generalized seizures, marked by sudden and brief loss of awareness, usually lasting to 30 seconds With typical absence seizures, there is no loss of posture or tone and no postictal confusion There may be a minor motor component such as eyelid blinking The child with simple partial (focal) seizures has unimpaired consciousness Motor signs are most common in children, although sensory, autonomic, and psychic manifestations are possible The motor activity usually involves the hands or face and spreads in a fixed pattern determined by the anatomic origin of the nerve fibers that innervate the various muscle groups Focal seizures may become secondarily generalized, in which case there will be alteration of consciousness Complex partial seizures, also called psychomotor or temporal lobe seizures, exhibit a diverse set of clinical features, including alterations of perception, thought, and sensation In children, they are usually marked by