THE BOTTOM LINE: Epilepsy & Seizure Classification

[brain]

Due to so much confusion among individuals
as which is what and what is which, I have
provided you several information which will
follow: One from the Government and the
other from the ILAE (International League
Against Epilepsy) and links will be provided
so you may read up more details pertaining
at their website. Hope this helps and ease
off much confusion and brings forth much
clarification!

[brain]

Seizure Types - by ILAE

Seizure Types


EPILEPTIC SEIZURE TYPES AND
PRECIPITATING STIMULI FOR REFLEX SEIZURES

Self-limited seizure types

Generalized seizures

* Tonic-clonic seizures (includes variations beginning with a clonic or myoclonic phase)
* Clonic seizures
o Without tonic features
o With tonic features
* Typical absence seizures
* Atypical absence seizures
* Myoclonic absence seizures
* Tonic seizures
* Spasms
* Myoclonic seizures
* Massive bilateral myoclonus
* Eyelid myoclonia
o Without absences
o With absences
* Myoclonic atonic seizures
* Negative myoclonus
* Atonic seizures
* Reflex seizures in generalized epilepsy syndromes
* Seizures of the posterior neocortex
* Neocortical temporal lobe seizures

Focal seizures

* Focal sensory seizures
o With elementary sensory symptoms (e.g., occipital and parietal lobe seizures)
o With experiential sensory symptoms (e.g., temporo parieto occipital junction seizures)
* Focal motor seizures
o With elementary clonic motor signs
o With asymmetrical tonic motor seizures (e.g., supplementary motor seizures)
o With typical (temporal lobe) automatisms (e.g., mesial temporal lobe seizures)
o With hyperkinetic automatisms
o With focal negative myoclonus
o With inhibitory motor seizures
* Gelastic seizures
* Hemiclonic seizures
* Secondarily generalized seizures
* Reflex seizures in focal epilepsy syndromes



Continuous seizure types

Generalized status epilepticus

* Generalized tonic-clonic status epilepticus
* Clonic status epilepticus
* Absence status epilepticus
* Tonic status epilepticus
* Myoclonic status epilepticus

Focal status epilepticus

* Epilepsia partialis continua of Kojevnikov
* Aura continua
* Limbic status epilepticus (psychomotor status)
* Hemiconvulsive status with hemiparesis



Precipitating stimuli for reflex seizures

* Visual stimuli
o Flickering light -color to be specified when possible
o Patterns
o Other visual stimuli
* Thinking Music
* Eating
* Praxis
* Somatosensory
* Proprioceptive
* Reading
* Hot water
* Startle
* Precipitating stimuli for reflex seizures

This website has more information
and you are encouraged to visit it.

[brain]

Straight to the Point - Seizure disorders: Classification and diagnosis by PUBMED

NOTE: This is only a partial excerpt of what is on
the page:

West J Med. 2001 August; 175(2): 99–103.
PMCID: PMC1071497
Copyright © Copyright 2001
BMJ Publishing Group

Straight to the Point
Seizure disorders: Part 1.
Classification and diagnosis

Sandra Kammerman and Lloyd Wasserman

Department of Medicine New York University School of Medicine
Bellevue Hospital
462 First Ave New York, NY 10016

EPIDEMIOLOGY

CLASSIFICATION OF SEIZURES

* Seizures are the most common acute neurologic problem in the United States
* Epilepsy (recurrent seizures) is the third most common serious neurologic disorder, following stroke and Alzheimer's disease.
* The age-adjusted incidence of newly diagnosed epilepsy is 44 per 100,000 person-years.
* The incidence of epilepsy increases with advanced age; people over 75 are twice as likely to develop new-onset epilepsy as all adult age groups under 65.1
* By age 74, 3% of all people will have had epilepsy at some point in their lives. For those living to 85, the cumulative incidence rises to 4.4%.1
* The prevalence of active epilepsy is 0.68%. The prevalence of all unprovoked seizures (including epilepsy) is 0.82%.2

Table 1
Terminology

* Seizure: an uncontrolled, paroxysmal neuronal discharge in any part of the brain; it may cause physical or mental symptoms and may be convulsive or nonconvulsive
* Convulsion: involuntary contraction of body muscles
* Epilepsy: two or more unprovoked, recurrent seizures. Seventy-five percent of epilepsy is primary (idiopathic); 25% is secondary to another CNS disorder.1
* Simple seizure: no alteration of consciousness
* Complex seizure: alteration of consciousness
* Status epilepticus: epileptic seizures that last more than 30 minutes or occur so frequently that consciousness is not restored between seizures


Partial (focal) seizures

* These seizures account for almost 60% of new cases of epilepsy.
* Simple partial seizures occur in about 15% of patients with seizures. Depending on the area of cerebral cortex involved, symptoms may be motor, cognitive, sensory, autonomic, or affective. Consciousness is not impaired.
* Complex partial seizures, also known as temporal lobe or psychomotor seizures, occur in approximately 35% of patients with seizures. Consciousness is partially or completely impaired, but there is no initial generalized tonic-clonic activity. Clinical presentation is variable, but patients usually experience an aura, automatism, postictal confusion, or tiredness. They have no memory of the events during the seizure.
* Partial seizures evolving to generalized seizures begin locally but then generalize.

This system classifies seizures by clinical symptoms and is easy to use. Another widely used but more complicated system classifies epileptic “syndromes” and includes other data such as family history, exposure history, physical examination, electroencephalography (EEG), imaging, and biochemical studies.

Generalized seizures

* These seizures account for 40% of patients with epilepsy.
* Initial manifestations indicate involvement of both hemispheres, most commonly impairment of consciousness with bilateral motor involvement.
* Patients usually forget the events of the seizure.


---------------------------------------


Types and characteristics.

* Six types of generalized seizures and their presenting signs are described in table 1
* Absence (petit-mal) seizures occur in 5% of patients with seizures, primarily in children
* Tonic-clonic (grand-mal) seizures occur in 25% of all patients with seizures and are the most common type of generalized seizure in adults.


Types and characteristic signs of generalized seizures

Distinguishing secondarily generalized partial seizures from primary generalized seizures.

* Many patients with partial seizures that generalize incorrectly report their seizures as “grand mal.”
* Distinguishing factors favoring secondarily generalized partial seizures are as follows:
o Preceding the seizure: period of unresponsiveness and staring, aura, automatisms, focal motor phenomena
o Past occurrence of any of the above factors without impairment of consciousness
o Focal findings on neurologic examination, magnetic resonance imaging (MRI)
o Focal activity on the electroencephalogram (EEG)
o Adult onset of seizures


DIAGNOSIS

General approach
For a first seizure, it is important to distinguish between an isolated event that is caused by an unusual stress, such as alcohol withdrawal, high fever, or hypoglycemia, and an unprovoked event that may be the initial manifestation of a recurrent seizure disorder (epilepsy).


-----------------------------------------



Table 4

Causes of nonepileptic seizures

* Alcohol withdrawal
* Benzodiazepine withdrawal
* Massive sleep deprivation
* Excessive use of stimulants, cocaine, etc
* Psychogenic (conversion disorder, somatization, factitious disorder, malingering)
* Acute head trauma (within 1 week)
* Central nervous system infection or neoplasm
* Uremia
* Eclampsia
* High fever
* Hypoxemia
* Hyperglycemia or hypoglycemia
* Electrolyte disorders

Neurocysticercosis and malaria are common causes of seizures worldwide and should be considered in patients from high-risk areas.



-----------------------------------------



Common precipitants

* Emotional stress
* Hyperventilation
* Menstrual cycle
* Sleep deprivation
* Alcohol withdrawal or excess
* Photic stimulation (strobe lights, television)
* Febrile seizures are very rare in adults



Refer patients to the Epilepsy Foundation , an excellent resource for group support, information, and counseling.

Patients with epilepsy are protected by the Americans with Disabilities Act.

Articles from The Western Journal of Medicine are provided here courtesy of
BMJ Group

There is more information in this
website and you are encouraged
to stop in and browse and read the
entire page and learn more in specifics!

There is a lot of information on this
page; and what's quoted above is
a mere sample, a snack.