Approach To The Patient With Seizures

OVERIVEW

This page is dedicated to helping develop a framework on how to approach patients who have seizures.

CLASSIFICATIONS OF SEIZURES

There are a few important categories of seizures that are useful for organizing the approach to seizures. One of the most important questions to answer early on is whether or not the seizures the patient is experiencing are focal or generalized (or….both as focal seizures can secondarily generalize). Really what these terms refer to is exactly WHERE in the brain do these seizures arise from? The major categories are listed below.

Focal seizures:

1. Simple partial seizure
2. Complex partial seizure

Generalized seizures:

1. Absence seizure 
2. Tonic-clonic seizure
3. Others: atonic, tonic, clonic, myoclonic

Secondarily generalized seizures:

FOCAL SEIZURES

As the name very clearly suggests, focal seizures arise form a specific location in the brain. With this in mind there are actually two major types of focal seizures that are worth distinguishing due to their characteristics.

Simple partial seizures:

These types of seizures do not impair awareness, and focal areas of the body will exhibit seizure activity.

Complex partial seizures:

These seizures do alter consciousness, and the seizure activity exhibited by the patient