[Limitations of the concept of idiopathic generalized epilepsy]

The 1989 International Classification of Epilepsies confirmed the existence of a category of Idiopathic Generalized Epilepsies (IGE), which includes a list of age-dependent syndromes that are supposed to share a common mechanism. Recent clinical, experimental and genetic data have shown that the group of IGEs is indeed heterogeneous, that various mechanisms are implied, and that the limits of this category remain comparatively unclear, especially versus cryptogenic or symptomatic generalized epilepsies. There is no such thing as a truly "generalized" epilepsy, and "idiopathic" means in fact that epileptic seizures are the only, or predominant symptom of the condition. The pharmacological sensitivity (some drugs control IGEs, other drugs usually aggravate them) seems to be common to a majority of the syndromes of IGE. The concept of IGE remains useful in clinical practice, and should be widened to include newly described syndromes.