Seizure Semiology: An Overview of the ‘Inverse Problem’

Abstract

In clinical practice, a classification of seizures based on clinical signs and symptoms leads to an improved understanding of epilepsy-related issues and therefore strongly contributes to a better patient care. The inverse problem involves inferring the anatomical brain localization of a seizure from the scalp surface EEG, a concept we apply here to correlate seizure origin with seizure semiology. The spheres of sensorium, motor features, consciousness changes and autonomic alterations during ictal and postictal manifestations are reviewed, including several subdivisions used to better categorize particular features. Particular attention is given to behavioral features, as well as to features occurring in idiopathic generalized epileptic syndromes and psychogenic nonepileptic spells.

A five-year follow‐up study of the general public awareness and perception of epilepsy in Croatia

“…Importantly, the published studies seem to support a widely held misconception that "the majority of persons with epilepsy shake," while it is established that convulsions represent the minority of epileptic seizures [34][35][36][37]. It, thus, remains surprising that such an important question has not been asked more frequently and in standardized fashion.…”

“…Fear of seizures was favored by those 36-45 years old and injuries and rejection by others by those 26-35 years of age. Young participants (26)(27)(28)(29)(30)(31)(32)(33)(34)(35) selected limited activities least frequently, and those 36-45 years old most frequently. Those with primary school level of education favored seizures, those with secondary school level injuries and those with a university degree the fear of seizures.…”

Indications and methodology for video‐electroencephalographic studies in the epilepsy monitoring unit

“…Every EMU needs to have a protocol for testing people systematically irrespective of shift or staff involved . Technologists should be comfortable with observing and documenting relevant clinical and behavioral semiology details accurately and consistently, as well as a person's response to commands or maneuvers (eg, a hand drop, resistance to passive eye opening, arm or leg elevation, etc) . Additional specifics for testing individuals with suspected nonepileptic events should be an integral part of the same protocol .…”

Complete seizure freedom is possible in patients with MTLE-HS after surgery in spite of extratemporal electro-clinical features

“…Rossetti and Kaplan noted that a seizure classification based exclusively on seizure semiology tended to improve and complement the clinical information essential for presurgical evaluation (Rossetti and Kaplan, 2010). The authors discussed the value of less frequently reported clinical features besides the most frequently reported signs and symptoms, including various epileptic seizures related to different etiologies.…”