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How generalised are secondarily "generalised" tonic clonic seizures?

Schindler K, Leung H, Lehnertz K, Elger CE

Klinik für Epileptologie, Sigmund-Freud-Str 25, D-53105 Bonn, Germany. kschindler@smile.ch

In clinical practice, epileptic seizures with focal onset and subsequent generalised motor involvement are referred to as secondarily generalised seizures. The purpose of this study was to investigate the degree of electrophysiological generalisation in seizures that are clinically secondarily generalised. Intracranial EEG recordings of secondarily generalised tonic-clonic seizures were visually and quantitatively analysed for the presence of epileptiform activity. In 24 (26%) of 93 seizures recorded from 17 (27%) of 64 patients, intracranial EEG channels were found that never recorded epileptiform activity during secondarily generalised tonic-clonic seizures. Our results demonstrate that seizures that are secondarily generalised clinically are not always generalised electrophysiologically. This may have therapeutic implications.

Published 17 August 2007 in J Neurol Neurosurg Psychiatry, 78(9): 993-6.
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