This is the usual type, but seizures vary in different patients, and in the same sufferer at different times. The cry and the biting of the tongue may be absent, the first spasm brief, and the convulsions mild. Epilepsy of all kinds is characterized by an _alteration_ (not necessarily a _loss_) of consciousness, followed by loss of memory for events that occurred during the time that alteration of consciousness lasted.

Attacks may occur by day only, by day and by night, or by night only, though in so-called nocturnal epilepsy, it is _sleep_ and not night that induces the fit, for night-workers have fits when they go to sleep during the day.

Epilepsy, Hysteria, and Neurasthenia — Part 4

Victims of nocturnal epilepsy may not be awakened by the seizure, but pass into deeper sleep. Intermittent wetting of the bed, occasional temporary mental stupor in the morning, irritability, temporary but well-marked lapses of memory, sleep-walking, and causeless outbursts of ungovernable temper all suggest nocturnal epilepsy.

Epilepsy, Hysteria, and Neurasthenia — Part 4

Such a victim awakes confused, but imputes his mental sluggishness to a hearty supper or "a bad night". A swollen tongue, blood-stained pillow, and urinated bed arouse suspicion as to the real cause, suspicion which is confirmed by a seizure during the day. He is more fortunate (if such a term can rightly be used of any sufferer from this malady) than his fellow victim whose attacks occur during the day, often under circumstances which, to a sensitive nature, are very mortifying.

Epilepsy, Hysteria, and Neurasthenia — Part 4

Epileptic attacks are of every degree of violence, varying from a moment's unconsciousness, from which the patient recovers so quickly that he cannot be convinced he has been ill, to that awful state which terrifies every beholder, and seems to menace the hapless victim with instant death. Every degree of frequency, too, is known, from one attack in a lifetime, down through one in a year, a month, a week, or a day; several in the same periods, to _hundreds_ in four-and-twenty hours.

This is incomplete _grand mal_, the starting stages only of a fit, recovery occurring before convulsions.

_Petit mal_ often occurs in people who do not suffer from _grand mal_, the symptoms consisting of a loss of consciousness for _a few seconds_, the seizure being so brief that the victim never realizes he has been unconscious. He suddenly stops what he is doing, turns pale, and his eyes become fixed in a glassy stare. He may give a slight jerk, sway, and make some slight sound, smack his lips, try to speak, or moan. He recovers with a start, and is confused, the attack usually being over ere he has had time to fall.