Epileptic Seizures

Efforts to classify epileptic seizures date back to the earliest of medical literature. In 1964, the Commission on Classification and Terminology of the International League Against Epilepsy (ILAE) proposed the first official classification of epileptic seizures, which was revised in 1981. [4 , [5 Based on this classification, seizures are divided into focal, those in which the first clinical and/or electrographical

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manifestations indicate initial activation of a limited population of neurons in part of one hemisphere, and generalized, those in which the initial manifestations suggest initial activation of neurons throughout both hemispheres. Focal seizures are further subdivided into simple and complex, based on level of consciousness. Seizures in which consciousness is preserved are referred to as simple partial seizures. Those in which consciousness is impaired are classified as complex partial seizures. Secondarily generalized seizures are generalized seizures preceded by focal clinical and/or electrographical manifestations that occur in patients with focal epilepsy. The revised classification uses seizure semiology and EEG features to establish whether seizures are focal or generalized. For example, a seizure characterized by staring and loss of awareness is classified as absence when generalized spike-wave complexes are noted on the EEG, and as complex partial when associated with focal epileptiform discharges. Although this classification has gained worldwide acceptance, debate regarding terminology and the classification of seizures in infants and neonates continues.

The following discussion describes the clinical semiology of the various types of seizures. A later section describes epilepsy syndromes, which are characterized by combinations of seizure types and clinical, historical, and electrographical manifestations.

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