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Seizure Type

If your doctor concludes that you had a seizure, then he or she should tell you what type of seizure you had.

Seizures take many forms. Before your doctor can prescribe treatment that should be effective for your seizures, he or she must figure out the type (or types) of seizure(s) that you have had. That's one of the purposes of all the tests discussed in the “When First Diagnosed” section.

Seizures are usually classified into one of two types: primary generalized seizures and partial seizures. The difference between these types is in how they begin in the brain.

• Primary generalized seizures begin with a widespread electrical discharge that involves both sides of the brain at once. Hereditary factors are important in many of these seizures. There are many varieties of primary generalized seizures.
• Partial seizures begin with an electrical discharge in one limited area of the brain. In some people, partial seizures are related to a previous head injury, brain infection, stroke, or tumor, but in most people, the cause is unknown.

If the diagnosis or seizure type remains unclear after your initial evaluations by the primary care physician, then you should be referred to a neurologist or epileptologist.

Treatment

If none of the items listed under “Beginning Treatment After a First Seizure” on the page called “When First Diagnosed” pertain to you, and you have gone on to have a second seizure that has no identifiable cause other than epilepsy, then your doctor will probably diagnose you as having epilepsy and should discuss with you starting a seizure medication. This discussion should include the possible benefits and potential side effects of seizure medicines.

When you begin drug therapy, you should be started on only medication at first (which is called “monotherapy”). The doctor chooses a particular medication based on the type of seizure you had, your age, and whether you have any other medical conditions and take any other prescription or over-the-counter medications.

The doctor should discuss how to start and how to take the medicine, what side effects to look for and what to do if they occur, possible interactions of the seizure medicine with other drugs, and when to come back for a follow-up visit. If you are taking other medications, make sure your doctor knows about them because some seizure medications have interactions with other drugs that can make your seizure medications less able to prevent seizures, or make your other medications less able to do what they are supposed to, or that could cause side effects from any of the drugs.

If you are over the age of 60 and not currently on any seizure medicine, then those seizure medicines that are known to cause interactions with other drugs should not be started unless at least two other seizure medicines that do not cause such interactions have been unsuccessful in stopping your seizures or cause you to have significant side effects.

Likewise, no matter what your age, if you are taking medications for other disorders, then your doctor should choose a seizure medicine that has a minimal risk of interactions with your other medication(s).

Women who are pregnant or could become pregnant in the future should receive a referral from their primary care physician to a neurologist or an epilepsy specialist to discuss treatment options, as discussed later in the “Just for Women” section.

The doctor or nurse should provide you information on the following topics, which are also discussed in great detail on epilepsy.com along with many other subjects at www.epilepsy.com/epilepsy/preparedness.

• Driving restrictions
• First aid for seizures
• Preventing injuries from seizures
• Your diagnosis and treatment options, including the importance of taking your medications as directed
• Other things you can do to control your seizures besides taking medicines (such as getting enough sleep and not using alcohol/recreational drugs)
• Possible triggers to seizures
• Contraception and family planning

For more information:

• Types of Seizures
• Animations
• Treatment 101: The Basics
• Seizure Medicines
• Seizure Preparedness
• Safety
• Compliance
• Seizure Triggers
• Understanding My Seizure Triggers

Topic Editor: Mary Jo V. Pugh, PhD, RN and Steven C. Schachter, MD.
Last Reviewed: 7/30/08