EEG and Semiology in Generalized Epilepsies

Abstract

With advancements in electroencephalography (EEG) and genetics, the older predominantly clinical semiology-based seizure classification needed to be updated. The recently proposed classification of seizures emphasizes the electro-clinical features in addition to genetics. Without EEG information, atypical absence and some frontal lobe seizures could not be classified or would be misclassified as “generalized” seizures. Also clinically identical seizures can have very different electrophysiology. For example, sudden falls can occur in generalized atonic seizures or generalized tonic seizures. Recognizing atypical absence is clinically important as this seizure type rarely occurs outside the context of Lennox–Gastaut syndrome. A better understanding of genetics in epilepsy can help patients plan their career and could influence life partner choices. This chapter focuses on the clinical semiology and correlative EEG of the generalized seizures.