Classification of

seizure

Amarendra B. Singh
090201263
Classification of seizure
• It is important to determine the type of
seizure that has occurred – to find out the
etiology, selecting the appropriate therapy
and providing information regarding prognosis

• ILAE- International League against Epilepsy

Definitions
• Aura is the subjective sensation or phenomenon
that precedes and marks the onset of the
epileptic seizure - it may localize the seizure
origin within the brain.

• Ictus is the attack or seizure itself.

• Postictal period is the time after the ictus during

which the patient may be drowsy, confused, and
disoriented.
 Classification
• Partial seizure originates
from a paroxysmal discharge
in a focal area of cerebral
cortex (temporal lobe). *

• In Primary generalized
seizure the abnormal
electrical discharges originate
from the diencephalic
activating system and spread
simultaneously to all areas of
brain.
Different parts have different functions, and
different seizures!
Classifying Seizures
Focal (previously ‘partial’) seizure – initial activation of only part
of one cerebral hemisphere occurs. (although may generalize*)

Generalized seizure – discharge from both cerebral hemispheres

occurs. Loss of consciousness may occur.
 Seizure types:

Partial Generalized
Simple Complex Absence Convulsive

Consciousness Consciousness Altered awareness Characterized by

is maintained is lost or impaired muscle contractions
with or without loss
of consciousness
I. Generalized seizures II. Focal seizures
Tonic 1. Simple
Clonic Motor
Sensory
Tonic – clonic
Autonomic
Absence (typical / atypical)
2. Complex
Myoclonic
(temporal lobe or frontal lobe)
Atonic 3. Focal seizure with secondary
generalization

III. Unknown
Epileptic spasms
 Generalized Seizures Symptoms
(Produced by the entire brain)

1. "Grand Mal" or Generalized tonic-clonic Unconsciousness, muscle rigidity, convulsions.

2. Absence Brief loss of consciousness

3. Myoclonic Sporadic (isolated), jerking movements

4. Clonic Repetitive jerking movements

5. Tonic Muscle stiffness, rigidity

6. Atonic Loss of muscle tone

Generalized Tonic Clonic
Seizures
Generalized Tonic Clonic Seizures
Tonic seizure
Clonic seizure
Absence seizures
 Scheme of Seizure
Spread
Thalamocortical
relays are
believed to act
on a
hyperexcitable
cortex

A low threshold Ca2+ current

Oscillatory responses in thalamic neurons
EEG: Bilaterally synchronous, high voltage 3-per-second spike-and-wave discharge
pattern.
Myoclonic seizure
Myoclonic seizure
Atonic seizure
• These are seizure involving brief loss of muscle
tone, usually resulting in heavy falls with or
without loss of consciousness.
 Focal Seizures Symptoms
(Produced by a small area of the
brain)

a. Jerking, muscle rigidity, spasms,

1. Simple(awareness is retained)
head-turning
a. Simple Motor
b. Unusual sensations affecting either
b. Simple Sensory
the vision, hearing, smell, taste, or
c. Simple Autonomic
touch
c. Memory or emotional disturbances
Automatisms such as lip smacking,
2. Complex chewing, fidgeting, walking and other
(Impairment of awareness) repetitive, involuntary but coordinated
movements

3. Focal seizure with secondary

generalization
• Jacksonian March
Some attacks begin in one part of the body (e.g.
mouth, thumb, great toe) and spread (march)gradually
towards other parts of the body.

• Attacks vary in duration from few seconds to several

hours (epilepsia partialis continua)

• Todd’s palsy
is paresis of the involved limb lasting for several
hours after the seizure ceases.