Consciousness, awareness, and wakefulness in epilepsy: Clarifying concepts in the 2025 ILAE classification

Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:

Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...

Consciousness can be defined as the state of being aware of and able to think about one's existence, sensations, and surroundings. It encompasses two major components: awareness and arousal. Awareness pertains to the recognition of environmental stimuli and internal states. At the same time, arousal refers to the physiological readiness to engage with these stimuli, which varies significantly between states like sleep and wakefulness.
Sleep, a crucial state, is characterized by reduced...

Brain waves are electrical signals generated by the neurons in the brain, which are regularly monitored to measure mental activities. Brain waves and their frequency ranges can be measured using an electroencephalogram or EEG. There are four main types of brain waves, each with distinct characteristics:

The concept of subconscious awareness refers to the processing of information below the level of conscious thought, which significantly influences both behaviors and decisions. It is also known as waking subconscious awareness. This complex level of cognition operates without the direct awareness of the individual, facilitating rapid and simultaneous handling of multiple information streams.
An illustrative example of subconscious processing is its role in problem-solving. Often, individuals...

Controlled processes in human consciousness represent high-alert mental states where individuals deliberately focus their attention on achieving specific goals. Controlled processes can be seen in situations like mastering new technology, where a person might become so absorbed that they ignore surrounding distractions. Such processes involve selective attention, requiring one to concentrate on particular elements of experience while disregarding others. These are governed by executive...