Generalized epilepsy [Neurosurgery Wiki]

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====== Generalized epilepsy ======

Generalized epilepsy is a type of epilepsy in which seizures appear to originate simultaneously in both hemispheres of the brain. The **International League Against Epilepsy (ILAE)** provides a classification system that helps clinicians describe and categorize epilepsy types more precisely.

### 🔷 **Generalized Epilepsy: ILAE 2017 Classification**

#### ✅ **1. Generalized Seizure Types**
These are seizure types that start in both hemispheres at once:

- **Generalized Tonic-Clonic Seizures (GTCS)**  
  ➤ Convulsions with stiffening (tonic) and jerking (clonic) phases.

- **Absence Seizures**  
  ➤ Brief lapses in consciousness (e.g., staring spells).  
  Subtypes:  
  - Typical  
  - Atypical  
  - Myoclonic absence  
  - Eyelid myoclonia

- **Myoclonic Seizures**  
  ➤ Sudden, brief muscle jerks, often in the arms or shoulders.

- **Tonic Seizures**  
  ➤ Sustained muscle stiffening, typically during sleep.

- **Atonic Seizures**  
  ➤ Sudden loss of muscle tone, causing drop attacks.

- **Clonic Seizures**  
  ➤ Rhythmic jerking movements (rare in isolation in generalized epilepsy).

#### ✅ **2. Generalized Epilepsy Syndromes**
These are broader syndromes that include multiple seizure types and typically have a known electroclinical pattern:

- **Childhood Absence Epilepsy (CAE)**
- **Juvenile Absence Epilepsy (JAE)**
- **Juvenile Myoclonic Epilepsy (JME)**
- **Epilepsy with Generalized Tonic-Clonic Seizures Alone**
- **Lennox-Gastaut Syndrome (LGS)** – although often considered combined generalized and focal
- **Dravet Syndrome** – also has generalized and focal components

#### ✅ **3. Etiological Classification**
ILAE recommends classifying the **cause** of generalized epilepsy under one or more of the following categories:

- **Genetic** (e.g., [[idiopathic generalized epilepsy]], JME) [[Genetic generalized epilepsy]]
- **Structural** (less common in generalized forms)
- **Metabolic**
- **Immune**
- **Infectious**
- **Unknown**

#### ✅ **4. EEG Findings**
- Generalized spike-and-wave or polyspike-and-wave discharges
- Bilaterally synchronous
- Normal background (in idiopathic types)