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)