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Classification of Epileptic Seizures

Seizure Type

Features

Conventional Antiseizure Drugs

Recently Developed Antiseizure Drugs

Partial seizures: Simple partial

Complex partial

Partial with secondarily generalized tonic-clonic seizure

Generalized seizures: Absence seizure

Myoclonic seizure

Tonic-clonic seizure

Diverse manifestations determined by the region of cortex activated by the seizure (e.g., if motor cortex representing left thumb, clonic jerking of left thumb results; if somatosensory cortex representing left thumb, paresthesia of left thumb results), lasting -20-60 seconds. Key feature is preservation of consciousness.

Impaired consciousness lasting 30 seconds to 2 minutes, often associated with purposeless movements such as lip smacking or hand wringing.

Simple or complex partial seizure evolves into a tonic-clonic seizure with loss of consciousness and sustained contractions (tonic) of muscles throughout the body followed by periods of muscle contraction alternating with periods of relaxation (clonic), typically lasting 1 to 2 minutes.

Abrupt onset of impaired consciousness associated with staring and cessation of ongoing activities typically lasting <30 seconds.

A brief (perhaps a second), shock-like contraction of muscles which may be restricted to part of one extremity or may be generalized.

As described above for partial with secondarily generalized tonic-clonic seizures except that it is not preceded by a partial seizure.

Carbamazepine, phenytoin, valproate

Carbamazepine, phenytoin, valproate

Carbamazepine, phenobarbital, phenytoin, primidone, valproate

Ethosuximide, valproate

Valproate

Carbamazepine, phenobarbital, phenytoin, primidone, valproate

Gabapentin, lamotrigine, levetiracetam, tiagabine, topiramate, zonisamide

Gabapentin, lamotrigine, levetiracetam, tiagabine, topiramate, zonisamide

Gabapentin, lamotrigine, levetiracetam, tiagabine, topiramate, zonisamide

Lamotrigine

Lamotrigine, topiramate

Lamotrigine, topiramate

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