Jacksonian seizures are a type of simple partial seizure in which people do not lose awareness. They only affect one part of the brain and cause twitching, tingling, and weakness.

Epilepsy is a long-term brain disorder that causes atypical activity in the brain’s nerve cells — known as neurons — leading to seizures. Seizures occur when many more neurons than usual send faster electrical signals simultaneously to trigger involuntary movements, emotions, feelings, or behaviors.

Many different types of seizures can occur due to epilepsy, which has a wide range of causes. However, not every seizure results from epilepsy.

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Jacksonian seizures are a subtype of focal onset seizures or simple partial seizures. “Partial” means that atypical neuron activity only occurs in a single part of the brain. “Simple” implies that an individual has full awareness during the seizure.

Jacksonian seizures used to be known as the Jacksonian march. This refers to the rapid but regular movement of symptoms from the corner of the mouth, one finger, or one toe to the rest of the facial muscles, foot, or hand.

According to the Epilepsy Foundation, Jacksonian seizures are recognizable by only occurring on a single side of the body and through this predictable pattern in which symptoms move across muscle groups.

According to the National Institute of Neurological Disorders and Stroke (NINDS), people who have focal seizures account for around 60% of those with epilepsy.

Jacksonian seizures are typically mild in comparison to other types of seizures and do not last long. They do not cause confusion afterward, and many people do not even know they are happening. Some who experience Jacksonian seizures might experience automatism, a series of compulsive movements that may include:

  • lip-licking
  • fiddling with clothing
  • rhythmic finger movement

Other symptoms might include:

  • eye movement
  • muscle cramps
  • head-turning
  • tingling
  • numbness
  • a “skin crawling” feeling
  • hallucinations in which a person may see or hear stimuli that are not present

Many possible factors can cause epilepsy, but there is no identifiable cause in roughly 50% of those with the condition. It may have links to changes in the usual pattern of nerve cell activity for any reason, including the following:

Jacksonian seizures are a type of focal motor seizure, meaning they affect movement due to changes in a specific part of the brain. According to a 2023 review, they occur due to an epilepsy-triggering lesion on the brain’s frontal lobe that generally sends excessive signals through the motor cortex, a part of the brain that controls movement.

For example, a 2013 case report suggested that an individual with multiple sclerosis (MS) developed Jacksonian seizures resulting from brain lesions that develop during flares of MS symptoms.

Seizures may occur as responses to certain triggers in people with epilepsy. These may include:

  • alcohol consumption or withdrawal
  • stress
  • skipping meals
  • dehydration
  • exposure to toxins
  • medication overdoses
  • hormonal changes due to menstruation
  • not getting enough sleep
  • flashing lights or moving patterns
  • use of illegal drugs

Learn more about epilepsy triggers.

Jacksonian seizures may be difficult to diagnose. This is because the symptoms of other health problems can involve weakness on one side of the body and changes in sensation, such as stroke or migraine.

Capsular warning syndrome — a series of symptoms that sometimes occur ahead of stroke — can involve Jacksonian symptoms moving from the foot to the hand on one side of the body.

As such, healthcare professionals cannot diagnose these seizures from symptoms alone and will need to request multiple tests, including:

  • MRI scans to show the brain, including its blood vessels and lining
  • electroencephalography (EEG), which shows where the unusual electric signals are occurring in the brain, as well as EEG video monitoring
  • lab tests to assess liver and kidney function, identify unusual immune activity, or highlight the ingestion of poisons
  • a lumbar puncture to collect spinal fluid for testing if the doctor suspects an infection or autoimmune cause

When presenting seizure symptoms to a healthcare professional, having a parent, caregiver, or other bystander attend the appointment can help the individual better describe symptoms for a more precise diagnosis. However, most people are fully conscious during Jacksonian seizures.

The healthcare professional may also ask about symptoms that can occur after the seizure, such as dizziness, changes to smell or taste, tinnitus, or visual disturbances.

Clinicians may also perform neurological exams to examine how seizures affect an individual’s consciousness, speech, and memory. They can also help identify any continuing seizure activity, such as unusual face or limb movement.

While Jacksonian seizures are not severe in themselves, most people who experience these also have more severe ones.

Jacksonian seizures do not often need direct treatment as they are brief and mild.

However, people may need to take anti-seizure medications to reduce the frequency and intensity of more severe seizures that may occur along with the Jacksonian seizure.

Narrow-spectrum anti-epileptic medications may help treat focal seizures and may include:

Broad-spectrum anti-epileptic medications might treat various seizure types and include:

If seizures occur due to an underlying condition, such as a tumor, an individual might require treatment for the condition before seizures reduce or stop.

Do Jacksonian seizures show up on an EEG?

Jacksonian seizures might appear on an EEG while they occur, as they can trigger excessive electrical signals in a specific part of the brain. However, as a focal aware seizure, Jacksonian seizures may not always show on an EEG. If an EEG does not show electrical output, a healthcare professional may still need to investigate to rule out Jacksonian seizures.

What is the difference between a focal seizure and a generalized seizure?

Focal seizures start in a single part of the brain, while generalized seizures affect both sides of the brain.

Epilepsy resources

Visit our dedicated hub for more research-backed information and in-depth resources on epilepsy and seizures.

A Jacksonian seizure, or Jacksonian march, is a one-sided, mild, brief seizure that affects a single part of the brain. They are a type of focal onset or partial simple seizure. They cause twitching that spreads from a single toe, finger, or the corner of the mouth to nearby muscles. People may not even know they happen.

These seizures may resemble symptoms of other conditions, such as stroke or migraine. Diagnosis involves an electroencephalogram (EEG) and MRI scan, but Jacksonian seizures may not need direct management as they are so mild. Underlying causes, such as tumors, brain injuries, or more severe seizures, might require treatment.