| Generalized* | Localization-related (partial or focal)† | |||
|---|---|---|---|---|
| Idiopathic‡ | Seizure types: absence, myoclonic, tonic-clonic | Seizure types: simple partial (awareness unimpaired), complex partial (awareness impaired), secondarily generalized tonic-clonic | ||
| Neurologic examination: normal | Neurologic examination: normal | |||
| Neuroimaging: normal | Neuroimaging: normal | |||
| EEG: Normal background with fast (3 to 6 Hz) generalized spike-and-wave discharges | EEG: Normal background with focal epileptiform discharges | |||
| Common examples: | Common examples: | |||
| Childhood absence epilepsy Juvenile myoclonic epilepsy Epilepsy with generalized tonic-clonic seizures on awakening | Benign childhood epilepsy with centro-temporal spikes (Rolandic epilepsy) Benign epilepsy with occipital paroxysms | |||
| Treatment: valproate (Depakote), ethosuximide (Zarontin [effective for absence seizures only]), lamotrigine (Lamictal), topiramate (Topamax), felbamate (Felbatol) | Treatment: carbamazepine (Tegretol), phenytoin (Dilantin) | |||
| Symptomatic¶ | Seizure types: atypical absence, myoclonic, tonic, atonic, tonic-clonic | Seizure types: simple partial (awareness unimpaired), complex partial (awareness impaired), secondarily generalized tonic-clonic | ||
| Neurologic examination: diffuse or multifocal abnormalities | Neurologic examination: focal abnormalities or normal | |||
| Neuroimaging: diffuse or multifocal abnormalities common | Neuroimaging: focal abnormalities common | |||
| EEG: Abnormal background with slow (<3 Hz) generalized and/or multifocal epileptiform discharges | EEG: Normal or abnormal background with focal or multifocal epileptiform discharges | |||
| Common examples: | Common examples: | |||
| Lennox-Gastaut syndrome | Temporal lobe epilepsy | |||
| Progressive myoclonus epilepsies | Frontal lobe epilepsy | |||
| Treatment: valproate, lamotrigine, topiramate, felbamate, ketogenic diet, corpus callosotomy | Treatment: carbamazepine, phenytoin, valproate, new agents (gabapentin [Neurontin], lamotrigine, tiagabine [Gabitril] topiramate, felbamate), vagus nerve stimulator, resective surgery | |||