Generalized seizures in adults - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Generalized seizures are a common seizure type, characterized by loss of consciousness, widespread motor manifestations of tonic contractions followed by clonic jerking movements, and a suppressed level of arousal following the event.
They may reflect an underlying generalized-onset epilepsy or focal to bilateral tonic-clonic seizures.
An electroencephalogram (EEG) and magnetic resonance imaging are essential tests for properly diagnosing an epilepsy syndrome after a generalized tonic-clonic seizure (GTCS). During a GTCS, the EEG will demonstrate bilateral synchrony in the epileptiform activity.
After a GTCS, treatment depends on the type of epilepsy syndrome identified. Generalized-onset epilepsy is treated differently from focal-onset epilepsy. With accurate diagnosis, most seizure disorders respond to treatment, although up to 40% of patients have drug-resistant epilepsy.
The primary treatment complications include lack of efficacy and adverse effects of medication (including dose-dependent and idiosyncratic reactions).

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Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017 Apr;58(4):522-30.[Abstract][Full Text]
Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017 Apr;58(4):512-21.[Abstract][Full Text]
Bernasconi A, Cendes F, Theodore WH, et al. Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: a consensus report from the International League Against Epilepsy Neuroimaging Task Force. Epilepsia. 2019 Jun;60(6):1054-68.[Abstract]
Guery D, Rheims S. Clinical management of drug resistant epilepsy: a review on current strategies. Neuropsychiatr Dis Treat. 2021;17:2229-42.[Abstract][Full Text]
Krumholz A, Wiebe S, Gronseth GS, et al. Evidence-based guideline: management of an unprovoked first seizure in adults. Neurology. 2015 Apr 21;84(16):1705-13.[Abstract][Full Text]
Campos MSA, Ayres LR, Morelo MRS, et al. Comparative efficacy of antiepileptic drugs for patients with generalized epileptic seizures: systematic review and network meta-analyses. Int J Clin Pharm. 2018 Jun;40(3):589-98.[Abstract]

Other Online Resources

EpilepsyDiagnosis.org
Epilepsy Foundation: driving laws
The North American AED Pregnancy Registry

Referenced Articles

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