EPILEPSY: CLASSIFICATION (ELDERLY)

The diagnosis of epilepsy in adults should be established by a specialist medical practitioner with training and expertise in epilepsy.
Epileptic seizures and epilepsy syndromes should be classified according to the description of seizure, the seizure type, the epilepsy syndrome and the aetiology.

 The seizure type(s) and epilepsy syndrome, aetiology, and comorbidity should be accurately determined, because failure to classify the epilepsy syndrome correctly can lead to inappropriate treatment and persistence of seizures.

 A wrong diagnosis of epilepsy can cause severe restrictions on a patient's lifestyle as well as unnecessarily side-effects from long-term medication.

Seizures can be classified as being:

Generalised seizures Partial seizures (focal is now preferred to partial)

Partial with secondary generalisation

GENERALISED SEIZURES
impairment of consciousness
distortion of the electrical activity of the whole or a large part of both sides of the brain May be tonic-clonic (the term generalised tonic-clonic is now preferred to grand mal), isolated tonic or clonic, myoclonic (brief, shock-like muscle contractions) or absence (petit mal) in children.

PARTIAL SEIZURES
originate within networks limited to one hemisphere discretely localised or more widely distributed.
They may be divided into simple partial (motor or sensory) with retained awareness or complex partial (impaired awareness). Partial seizures may progress into generalised seizures.

 Approximately a third of people with epilepsy in the UK have an anatomically-identifiable cause (symptomatic epilepsy), eg cerebrovascular disease, cerebral tumour, head injury.