Seizure Classification

The International Classification of Epileptic Seizures (ICES) established guidelines in 1981 that were refined by the Commission on Classification and Terminology of the International League Against Epilepsy (ILAE) in 1989. These developed concise definitions of the various types of epilepsy and are widely used for diagnosis.8 These classification systems however only describe disease phenotypes and provide little information regarding the causality or severity of the condition or prognosis for the patient.

6.11.2.1.1 Partial seizures

Partial seizures can be divided into: (1) simple, where only a part of the brain is involved and consciousness is not impaired, and (2) complex, which is differentiated from simple by consciousness also being impaired. Complex partial seizures are frequently preceded by a simple partial seizure or an aura (Table 2).

6.11.2.1.2 Generalized seizures

Generalized seizures (Table 2) involve both sides of the brain and result in tonic and clonic movements (primary or secondary generalized) or another type of primary generalized epilepsy (e.g., absence or atonic seizure).

6.11.2.1.2.1 Tonic-clonic, grand mal, or major motor seizures

Tonic-clonic, grand mal or major motor seizures are characterized by a loss of consciousness, falling, muscle rigidity and jerking, and an electrical discharge that involves all or most of the brain.

6.11.2.1.2.2 Absence or petit mal seizures

Absence or petit mal seizures reflect a primary generalized epileptic seizure that usually last for less than 20 s and are characterized by a stare sometimes associated with blinking or brief automatic movements of the mouth or hands. These usually begin in childhood, are well controlled with drugs, and are outgrown in approximately 75% of children.

6.11.2.1.2.3 Atypical absence seizures

Atypical absence seizures are characterized by a staring spell characterized by partial impairment of consciousness that often occurs in children with Lennox-Gastaut syndrome, a rare disorder begining in childhood that is characterized by mental retardation, multiple multifocal seizures that do not respond well to therapy and an electroencephalograph (EEG) that shows slow (less than 3 s _ 1) spike-and-wave discharges.

6.11.2.1.2.4 Atonic or drop seizure

Atonic or drop seizure is an epileptic seizure characterized by a sudden loss of muscle tone that is usually not associated with loss of consciousness.

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