Supplementary table Term* Revised term** Focal seizure without impairment of A subjective sensory or psychic experience as part of migraine or epilepsy. In epilepsy it is a focal consciousness or awareness Aura seizure without loss of consciousness (a simple partial seizure). It may or may not be followed by involving subjective sensory or other seizure manifestations. psychic phenomena only Automatic behaviour associated with loss of awareness, such as lip smacking or hand wringing, Automatism Focal dyscognitive seizure occurring as part of a complex partial seizure. Convulsion (previously "grand Tonic-clonic seziure, convulsive Seizure with involuntary, irregular myoclonic, clonic or tonic–clonic movements of one or more mal") seizure limbs. Onset may be focal or primary generalised. Literally ‘already seen’, this refers to a false impression that a present experience is familiar. It is used to refer to something heard, experienced or seen. It can be the aura of a temporal lobe Déjà vu seizure, but also happens in other settings (normal experience, intoxication, migraine, psychiatric). Focal seizure (previously "partial, Focal seizure A seizure originating in a specific cortical location. May be due to a structural lesion. localization related") Literally a ‘blow’. Usually used for an epileptic seizure (but can refer to other paroxysmal events, Ictus such as migraine, transient neurological events and stroke). Similarly pre- and post-ictal are used may for the period before and after a seizure. Idiopathic Genetic In relation to epilepsy, this implies that there is an underlying genetic cause. Literally ‘never seen’, this refers to a false impression that a present experience is unfamiliar. It is Jamais vu used for something seen, heard or experienced. It can be the aura of a temporal lobe seizure, although it also happens in other settings (normal experience, intoxication, migraine, psychiatric). Major seizure A loose term that usually refers to a convulsion. A loose term that usually refers to seizures that are not convulsions, with no loss of Minor seizure consciousness, or brief loss. Easily overlooked by clinicians and patients. These seizures are not minor in significance to the diagnosis. Episodes due to psychological or psychiatric illness. Also called non epileptic seizures, Non epileptic attack disorder ( dissociative seizures, psychogenic non-epileptic seizures; previously called pseudo-seizures or
NEAD) hysterical seizures (but they are not seizures) Sometimes “non-epileptic attack” is misused for any event that is not epilepsy. (including syncope, psychiatric, psychological, migraine) The time after a seizure when behaviour or mood can be directly affected by the seizure. For Postictal example post-ictal confusion, aggression, psychosis, depression; usually lasting between 30 -120 minutes, sometimes longer. A seizure involving both hemispheres from onset. Can be an absence, myoclonic jerk, tonic- Primary generalised seizure Generalised seizure clonic seizure, or atonic seizure (drop attack). Not associated with a structural lesion. Provoked seizure Acute symptomatic seizure. Seizure occurring without an acute precipitating factor : includes remote and progressive Unprovoked seizure symptomatic seizure, idiopathic seizure, or seizure of unknown cause. Sudden, unexpected death in a person with epilepsy not due to drowning or other accident; Sudden unexplained death in without or with a seizure. Deaths during status epilepticus or those with an anatomical or epilepsy (SUDEP) toxicological explanation are excluded. Symptomatic seizure Structural/ metabolic A seizure having an identified underlying cause. -Acute symptomatic seizure With an immediate precipitant eg fever, metabolic disturbance, acute stroke, intoxication or
(provoked seizure) withdrawal, head injury or surgery. The most common is a febrile seizure. Due to an established static structural or metabolic cause. For example, head injury, stroke, -Remote symptomatic seizure previous neurosurgery; treated cerebral abscess; at least three months prior. Refers to an ongoing neurological injury causing seizure(s). For example, brain tumour, -Progressive symptomatic seizure neurodegeneration, HIV and other active infections. Syncope -reflex syncope Benign form of syncope with warning and rapid recovery. (=vasovagal syncope) Syncope due to arrhythmia or structural heart disease. An emergency needing urgent investigation Syncope-Cardiac syncope and management. Seizure lasting 30 minutes; or a series of seizures lasting 30 minutes without regaining of Status epilepticus (SE) consciousness in between. SE can be of any seizure type eg absence SE, non-convulsive SE. Convulsive SE is a life-threatening emergency.
*Terminology based on International League Against Epilepsy classification 1981,1989 (10,11)
**Term based on International League Against Epilepsy classification, 2010 (12)