[Diagnostic focus on the child with generalized seizures].

We have carried out an overall analysis of the diagnostic approach to generalized epileptic crises in children. It is emphasized that the clinical history is an essential factor in reaching the correct diagnosis. This is inevitably followed by a general and then a specifically neurological physical examination. Four parameters are considered in order to reach an initial diagnosis: a) The probability of the various types of crises in view of the timing of the clinical features. b) Knowledge of the clinical characteristics of the types of epileptic crises which may occur. c) The interrelation of these two parameters, seeking a specific syndrome which would fit the facts. d) Consideration of the most usual etiological factors of the tentative diagnosis. Subsequently the necessary complementary tests are carried out, but these are always based on rational clinical grounds. The commonest clinical and electroencephalic characteristics of generalized epileptic crises (except for myoclonic crises) are discussed. These are neonatal crises, 'absence', generalized tonic-clonic crisis, generalized crises with predisposing activation mechanisms, West's syndrome and the Lennox-Gastaut syndrome. The diagnostic value of other complementary tests in such crises is considered.