The stereotypy of the attacks is an important diagnostic point, because for the individual patient, seizures are highly consistent whe events. Even when there is more than one seizure type, each type has its own stereotypy. Significant variation in the pattern of attacks argues against epilepsy.
The duration of seizures is generally invariant. Except for brief absence or myoclonic seizures, which generally last 5 to 15 seconds, most focal or tonic-clonic seizures last 30 to the 90 seconds. The postictal recovery period depends on the type of seizure, but actual seizure- like episodes that last many minutes to hours epi are usually not epileptic.
Finally, a brief history from a witness is often crucial. What does the witness see and how does the attack begin? Patients with complex partial seizures sometimes recall the aura that begins the seizure, but are unaware of the subsequent loss of awareness. A witness may provide the crucial description of the blank stare and unresponsiveness typical of this type of seizure. The details of such seizres are crucial in discussing safety issues such as driving.
The stereotypy of the attacks is an important diagnostic point, because for the individual patient, seizures are highly consistent whe events. Even when there is more than one seizure type, each type has its own stereotypy. Significant variation in the pattern of attacks argues against epilepsy. The duration of seizures is generally invariant. Except for brief absence or myoclonic seizures, which generally last 5 to 15 seconds, most focal or tonic-clonic seizures last 30 to the 90 seconds. The postictal recovery period depends on the type of seizure, but actual seizure- like episodes that last many minutes to hours epi are usually not epileptic. Finally, a brief history from a witness is often crucial. What does the witness see and how does the attack begin? Patients with complex partial seizures sometimes recall the aura that begins the seizure, but are unaware of the subsequent loss of awareness. A witness may provide the crucial description of the blank stare and unresponsiveness typical of this type of seizure. The details of such seizres are crucial in discussing safety issues such as driving.
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