This document discusses seizure classification according to the International League Against Epilepsy in 2017. It defines a seizure as the clinical expression of abnormal neuronal activity in the brain, typically lasting seconds to minutes. Seizures are classified as focal onset, generalized onset, or unknown onset, with further subcategories of motor or non-motor seizures. Focal onset seizures may be subtle or unusual, while generalized onset include absence seizures, tonic-clonic, and myoclonic jerks. The document provides descriptions to help classify example seizure histories.

1. Seizure and its classification
International League Against Epilepsy
2017

2. What is a seizure?
• A seizure represents the
clinical expression of
abnormal, excessive,
synchronous discharges of
neurons residing primarily
in the cerebral cortex.
– intermittent
– usually self-limited,
– lasting seconds to a few
minutes
– status epilepticus.
• A sudden, involuntary,
time-limited alteration
in behavior,
– Motor activity,
– Autonomic function,
– Consciousness, or
– Sensation.

3. Seizure types (ILAE- 2017)
• Focal onset
– Aware
– Impaired awareness
– Motor onset
– Non motor onset
• Focal to bilateral tonic-clonic
• Generalized onset
– Motor
• Tonic-clonic
• Other motor
– Non motor (absence seizure)
• Unknown onset
– Motor
• Tonic clonic
• Other motor
– Non motor
– Unclassified

4. Focal onset seizures
• These seizures can often be subtle or unusual
and may go unnoticed or be mistaken for any
thing from being intoxicated to daydreaming.
• 60% of people with epilepsy have focal onset.
– Focal aware
– Focal impaired awareness (person may appear
confused , vague or disoriented.

5. Classify this seizure: History

7. Types of generalized onset seizure
• Absence seizure:
– Sudden lapse of awareness and responsiveness
• Staring spells or day dreaming
• Tonic clonic
• Myoclonic:
– Sudden single jerks of a muscle or a group of muscle
last no more than a second or two.
• Tonic
• Atonic
• Clonic

8. Seizure history

9. What type of seizure is this?

10. Generalized motor onset
stiffening/jerking/tonic clonic

11. What type of seizure is this?

12. Generalized non motor onset
brief changes in awareness/ staring / lipsmacking

13. What type of seizure is this?

14. Generalized motor myoclonic….

15. Focal motor, with awareness

16. Focal motor with awareness….

21. Generalized non-motor

22. Mimicking seizure