Caring for people with generalised epilepsy: a literature-based guide to clinical practice

Generalised epilepsy is a diverse group of epilepsies characterised by widespread neuronal activity, constituting about one-third of all epilepsies. The main types of generalised seizures include tonic-clonic, absence, myoclonic and atonic seizures. Each presents unique diagnostic and treatment challenges. To accurately diagnose generalised epilepsy, a thorough clinical assessment is required, including patient history, seizure semiology and electroencephalogram testing. While the EEG is not a perfect tool to assess and diagnose epilepsy, it typically reveals generalised spike- and-wave discharges, which help to differentiate generalised from focal epilepsy. Advances in neurophysiology have enhanced medical understanding of the mechanisms underlying these seizures, thereby improving diagnostic accuracy and treatment options. Generalised epilepsy is managed with a multi-faceted approach, primarily using antiseizure medications tailored to the seizure type and patient needs. If ASMs are ineffective, options like dietary therapies, neurostimulation or surgery may be considered. Management also involves patient education, lifestyle changes, and psychosocial support to improve quality of life.