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Victoria Epilepsy & Parkinson's Centre

Seizures 101

 

2017 Revised Classification of Seizures

The International League against Epilepsy (ILAE) is the world's main scientific body devoted to the study of epilepsy, has recently revised its classification of seizures. The changes will help make diagnosing and classifying seizures more accurate and easier.

For more information click here

What is a seizure?

The brain is responsible for everything we do from executing motor functions, to our emotions, thoughts and feelings. Different areas of the brain are responsible for different functions. The brain is made up of many pathways and chemical electricity flows along these pathways to carry out functions. Seizures are brief, uncontrolled surges of electrical activity in the brain. They can affect how a person senses, feels, or behaves but they ways in which a seizure manifests depends on how much of the brain is involved and the area(s) of the brain involved in the seizure. For example, a person having a seizure in the left motor cortex of the brain may experience twitching in their right leg. Seizures are usually symptoms of epilepsy but may be the result of another condition such as a high fever or diabetes.

 

What is epilepsy?

Practical definition of epilepsy

Epilepsy is a disease of the brain defined by any of the following conditions

1. At least two unprovoked (or reflex) seizures occurring >24 h apart

2. One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years

3. Diagnosis of an epilepsy syndrome

Epilepsy is considered to be resolved for individuals who had an age-dependent epilepsy syndrome but are now past the applicable age or those who have remained seizure-free for the last 10 years, with no seizure medicines for the last 5 years

Seizures in epilepsy are not provoked by a condition that is likely to be over quickly. For example, a child with a high fever may have two seizures before the fever ends but if the seizures stop when the fever abates, that child would not be considered to have epilepsy. If, on the other hand, that child’s seizures were to continue even after the fever ends, he/she might be considered to have epilepsy.

 

Seizure Classifications....

Focal Onset Aware Seizures (simple partial seizures)

Focal Onset Impaired Awareness Seizures (complex partial seizures)

Describing Generalized Onset Seizures

Seizures that start in both sides of the brain, called generalized onset, can be motor or non-motor.

  • Generalized motor seizure: The generalized tonic-clonic seizure term is still used to describe seizures with stiffening (tonic) and jerking (clonic). This loosely corresponds to “grand mal.” Other forms of generalized motor seizures may happen. Many of these terms have not changed, and a few new terms have been added. 
  • Generalized non-motor seizure: These are primarily absence seizures, and the term corresponds to the old term "petit mal." These seizures involve brief changes in awareness, staring, and some may have automatic or repeated movements like lipsmacking.

Describing Unknown Onset Seizures

When the beginning of a seizure is not known, this classification still gives a way to describe whether the features are motor or non-motor.

 

Here are a few videos:

 

Focal Onset Impaired Awareness Seizure was also know as complex-partial seizure

 

 

Thank you to Epilepsy Ontario and Epilepsy Toronto with funding provided by Ontario Trillium Foundation for the use of these videos.