Focal EEG abnormalities and focal ictal semiology in generalized epilepsy

In clinical practice, the dichotomy of focal vs generalized epilepsy dictates the choice of antiepileptic drugs (AEDs) for treatment and subsequent management of epileptic patients. In general, patients with focal epilepsy are good candidates for excisional epilepsy surgery, whereas those with generalized epilepsy are not. In most cases, the diagnosis of focal vs generalized epilepsy is clear after a careful consideration of the seizure semiology and results from diagnostic testing, namely video electroencephalography (VEEG), neuroimaging, and genetic testing.

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