Brain Break

Day to day

Step by step

Think im ok

Brain feels if

Start out slow

Where am I

Dark encircles

Optics blinded

Consciousness

No longer

Wake up

Wake up

Crack your eyelids

White just white

Damage unearthed

Smash!

There’s the hole

Epilepsy: Seizure Classification 2017

• “Grand Mal”
• “Petit Mal”
• Absent”
• “Partial”
• “Generalized”

These terms are most commonly heard when classifying seizures.  However, a new article has been released that reclassifies seizure types based on the beginning of the seizure, level of awareness, and whether movement happens during the event.

“Partial seizures” and “generalized seizures” along with their subsets have been used for over thirty-five years, but have not captured many types of seizures.  The hope is that the new 2017 classification system will.

Let’s take a look at this new system.  According to the International League Against Epilepsy (ILAE), the world’s main scientific body devoted to the study of epilepsy, The new seizure classification breaks down the type by generally using a 3 step process.  However, they do have an expanded system, but for now let’s look at the simple classification:

1. Define where seizure begins:
   • focal seizures ( previously partial): their onset begins on one side/part of the brain
   • Generalized seizures (Previously primary generalized):  both sides of the brain
   • Unknown onset: This category can change later on when new information comes to light.  However, if the onset of a seizure is unclear, it is placed in this category.
   • Focal to bilateral seizure: This type begins in one side/part of the brain and spreads to other areas of the brain.

1. Describe Awareness.  This is extremely important because it affects a person’s safety:
   • Focal aware:  This replaces the term simple partial.  This term is used if a person remains aware during a seizure even if they are unable to speak or respond.
   • Focal impaired awareness:  We will use this term to replace  Complex partial seizures, which was used to define seizures in which a person was unaware even if they have a vague idea of what happened.
   • Awareness unknown: In some cases such as if a person seizes in their sleep or lives alone, it will not be possible to use the awareness term or would be described as awareness unknown.
   • Generalized seizures: no term is needed for generalized seizures because they are presumed to affect a person’s awareness in someway.
2. Describe motor and other symptoms in focal, generalized and unknown seizures:
   • This step is divided into 3 subsets: Focal, Generalized, and unknown
     1. Focal seizures 
        • Focal motor seizure: exactly what the name implies.  Movement occurs whether it is twitching, stiffening, jerking, lip-smacking, etc.
        • Focal non-motor seizure: This type of seizure has other symptoms that occur first, such as changes in sensation, emotions, thinking, or experiences.
        • It is also possible for a focal aware or impaired awareness seizure to be sub-classified as motor or non-motor onset.
        • Auras: this is not a new term, but still may be used to describe feelings, smells, etc before the start of a seizure.
     2. Generalized seizures
        • Generalized motor seizure: This term for this type has not changed over the years and is still used today.  Generalized tonic(stiffening) clonic (jerking) seizures loosely refer to “grand mal”.
        • Generalized non-motor seizure: This involves brief changes in awareness such as staring and/or repeated movements.  These are primarily absence seizures and the term corresponds to the old term “petit mal.”
     3. Unknown Seizures
        • This classification gives a way to describe whether the features of an unknown seizure are motor or non-motor.

You can use these three steps or you can check out the ILAE website for the article and expanded classification which is shown below:

~Siren Cay