2017 Revised Classification of Seizures

The International League against Epilepsy (ILAE) is the world's main scientific body devoted to the study of epilepsy, and it has recently revised its classification of seizures. The changes will help make diagnosing and classifying seizures more accurate and easier. In this article, you'll find the new general outline and basic seizure classification. In the coming weeks, epilepsy.com will be updated to reflect the new classification to help users searching for both the older and newer terms.

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  • Atypical means unusual or not typical.
  • The person will stare, as in an absence seizure, but also be somewhat responsive.  
  • Many children also have Lennox-Gastaut Syndrome.
  • Medicine can help prevent atypical absence seizures.

What is an atypical absence seizure?

Atypical (a-TIP-i-kul) means unusual or not typical. The person will stare (as they would in any absence seizure) but often is somewhat responsive. Eye blinking or slight jerking movements of the lips may occur. This behavior can be hard to distinguish from the person's usual behavior, especially in those with cognitive impairment. Unlike other absence seizures, these seizures usually cannot be produced by rapid breathing. These seizures usually last 5 to 30 seconds (commonly more than 10), with a gradual beginning and ending.

Who is at risk for atypical absence seizures?

They generally begin before age 6. Most of the children affected have below-average intelligence and other types of seizures that are difficult to control. Many have Lennox-Gastaut syndrome.

What’s it like to have an atypical absence seizure?

When people have atypical absence seizures, they are unaware of what is going on around them. For example, they will not notice if someone is talking to them. If they are talking to someone, they simply may stop talking in the middle of the sentence. Atypical absence seizures most often affect school age children so the teacher may want to talk to you as a parent because the child is having problems at school. Atypical absence seizures usually continue into adulthood.

What happens after an absence seizure?

When an atypical absence seizure ends, the person usually continues doing whatever they were doing before the seizure. They are awake. No first aid is needed during the seizure.

If someone has atypical absence seizures, how often will they happen?

It depends. People who have atypical absence seizures may have just one seizure or they can have several in a row. The seizures could also be spaced out throughout the day.  

How can I tell if someone is having an atypical absence seizure?

A lot of times these seizures are not very obvious. Sometimes ordinary behavior for these children will look like an atypical absence seizure. Daydreaming and inattentiveness can mimic these seizures.

How are atypical absence seizures diagnosed?

The diagnosis can be difficult if the behavior during seizures is similar to the child's usual behavior. The EEG (electroencephalogram), which records brain waves, will be used, but most children with these seizures have patterns on their EEG when they're not having a seizure that are similar to the seizure pattern.

How are atypical absence seizures treated?

There are medicines that can help prevent atypical absence seizures.

What should I do if I think my child may have atypical absence seizures?

If you think your child may be having absence seizures, talk to your child’s doctor about your concerns right away. Atypical absence seizures may cause your child to:

  • Have trouble learning at school
  • Have social problems
  • Misbehave more than normal
Authored by: Steven C. Schachter, MD | Joseph Sirven, MD | Joan Sirven
Reviewed by: Joseph I. Sirven, MD | Patricia O. Shafer, RN, MN on 7/2013
What It Looks Like...

It's hard to tell when Kathy's having one of her "staring spells". During the spells she doesn't respond as quickly as at other times. But even when she's not having a seizure she often just stares and responds slowly.