Absence epilepsy with focal clinical and electrographic seizures

Primary generalized seizures occur in half of all children with epilepsy. Correct classification carries important diagnostic, therapeutic, and prognostic information. Approximately half of all patients with generalized juvenile myoclonic epilepsy may have a partial semiology or focal electroencephalographic features although similar findings have not been described in absence epilepsy. Two examples, one with semiology characteristic of focal seizures and the other with a video-electroencephalogram documented partial seizure emanating after the completion of typical 3-Hz generalized spike-wave absence epilepsy, are discussed.