EMS Neurological Emergencies - Seizure Disorder Classification

Seizure disorders can be classified into several types based on their characteristics and underlying causes. 

Here are some common types of seizure disorders:

Generalized Seizures:

Tonic-Clonic Seizures: These seizures involve loss of consciousness, muscle stiffening (tonic phase), followed by rhythmic jerking of the limbs (clonic phase). They can be associated with convulsions and may result in injuries. Formerly known as Grand Mal Seizures.

Absence Seizures: Absence seizures typically occur in children and involve brief periods of staring or "spacing out." The person may appear to be unaware of their surroundings and may not remember the seizure afterward. Formerly known as Petit Mal Seizures.

Myoclonic Seizures: These seizures involve sudden, brief muscle jerks or twitches, often affecting the arms and legs. They can occur in various epilepsy syndromes.

Atonic Seizures: Atonic seizures cause sudden loss of muscle tone, leading to the person collapsing or falling ("drop attacks"). These seizures can result in injuries due to falls. Also known as Drop Attacks.

Partial (Focal) Seizures:

Simple Partial Seizures: These seizures affect a specific area of the brain and may cause twitching, sensory changes, or other symptoms without loss of consciousness.

Complex Partial Seizures: Complex partial seizures involve altered consciousness or awareness, with or without automatisms (repetitive, purposeless movements) and other behavioral changes. They may start as simple partial seizures and progress to affect larger areas of the brain.

Focal to Bilateral Tonic-Clonic Seizures: Focal seizures that spread to involve both hemispheres of the brain, resulting in generalized tonic-clonic activity.

Other Types:

Febrile Seizures: These seizures occur in young children as a result of fever, typically between the ages of 6 months and 5 years. They are usually brief and do not cause long-term harm.

Psychogenic Non-Epileptic Seizures: Some seizures may mimic epileptic seizures but are not caused by abnormal electrical activity in the brain. These may be due to psychological factors or other medical conditions.

It's important to note that within each type of seizure, there can be variations in presentation and severity. Proper diagnosis and classification of seizures are essential for determining appropriate treatment and management strategies. 

Further Reading:

Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education

Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice Volume 2 (6th Ed) Pearson.

Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education

Online Resources:

EpilepsyU