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Secondary Generalized Seizures

Dr. Elizabeth Thiele

Elizabeth Thiele, MD, PhD
Epileptologist, MGH

This is a transcript of a video from the Growing Up with Epilepsy Web site. For more information visit

Dr. Elizabeth Thiele: If a child has a generalized tonic-clonic seizure, it can either occur as a primary generalized seizure, meaning from the onset the child has stiffening clonic activity, so the whole brain at onset of the seizure is diffusely involved. Generalized tonic-clonic seizures can also occur from a partial seizure, so a seizure that has onset in a very specific area of the brain that then spreads to involve the whole brain. And that is a secondary generalized seizure. That spread can be extremely fast. So sometimes it's actually very difficult to tell when a person has a generalized tonic-clonic seizure, did that have a partial onset or was it generalized in onset? And we often try, if we can, to figure out which of those two it was, because it would help us not only determine cause of the seizure, but what the best treatment for the seizure would be.