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A difficult case
Focal, generalised epilepsy or both?
  1. Aidan Neligan1,2,
  2. Umesh Vivekananda2,
  3. Josemir W Sander2,3
  1. 1Neurology, Homerton University Hospital NHS Foundation Trust, London, UK
  2. 2Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
  3. 3Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands
  1. Correspondence to Dr Aidan Neligan; a.neligan{at}ucl.ac.uk

Abstract

A 29-year-old woman presented with a witnessed convulsion, with semiology consistent with a focal-to-bilateral tonic-clonic seizure. Routine EEG supported a syndromic diagnosis of idiopathic generalised epilepsy with photosensitivity. We discuss the clinical utility of seizure semiology, highlighting the caveat that over-reliance or sole reliance on the ictal semiology may result in an erroneous diagnosis of focal epilepsy in someone with a generalised epilepsy.

  • EPILEPSY
  • EEG

Data availability statement

No data are available. Not applicable.

https://doi.org/10.1136/pn-2024-004290

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    Data availability statement

    No data are available. Not applicable.

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    Footnotes

    • X @leysander

    • Collaborators Not applicable.

    • Contributors AN—study concept, wrote the first draft and edited the final version. UV—obtained the EEGs, interpreted these and wrote the commentary on this and edited the final version. JWS—study concept and edited the final version. AN is the guarantor of this work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests AN and UV have no conflicts of interest. JWS reports grants and personal fees from UCB, grants from NIHR and Angelini, and personal fees from UCB and Angelini, outside the submitted work.

    • Provenance and peer review Not commissioned; externally peer reviewed by Arjune Sen, Oxford, UK.