THE MANY TYPES OF SEIZURE: PARTIAL AND GENERALIZED SEIZURES

Partial seizures have implications different from generalized seizures. Since they start in one particular area of the brain, they may require special evaluation; they may also require the use of particular medications or other therapy. To help the physician determine the proper course, it is important, as noted earlier, for you to focus carefully on the very onset of the seizure and its progression so you may be able to describe it precisely to him.
When seizures start focally in a particular area of the brain, and when they spread slowly enough, in seconds or minutes as in William’s seizure, so that their onset is experienced and witnessed or remembered, this onset is the “aura” or warning, the warning that bigger things are coming.
How do focal seizures spread to become generalized? Why don’t all focal seizures spread? What contains a focal seizure? If we knew the answers to these questions, we would understand far more about epilepsy and be better able to prevent or limit seizures than we are. But we have few answers at the present time. Generalized seizures that appear to start in all parts of the brain simultaneously have no identifiable focal onset. We do not understand their anatomy. It does not make sense for the whole brain spontaneously and suddenly to experience a disruption. Nevertheless, in generalized seizures this is what appears to occur, causing disruptions like staring, stiffening, or shaking.
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