Clinical and Neurophysiological features of different forms of epileptic falls

Falling seizures are a heterogeneous group of epileptic seizures in which the fail represents the main or only clinical manifestation. In this chapter, we discuss the clinical and neurophysiological characteristics of focal atonic epileptic events, such as epileptic negative myoclonus, and of different types of epileptic falling seizures, occurring in generalized and partial epilepsies. Pathophysiological hypotheses on epileptic negative myoclonus indicate the involvement of frontal areas with inhibitory effect on the motor system. Current knowledge on basic mechanisms of epileptic falling seizures is still limited; subcortical as well as cortical mechanisms have been suggested to play a role in the origin of these types of seizures. Appropriate neurophysiological investigations, particularly video-polygraphic recordings, have been, so far, extremely useful to describe the electroclinical characteristics of these phenomena, and it is conceivable that a more diffuse application of these techniques will provide further insights on the different types of falling seizures and their pathophysiological mechanisms.