Generalised-onset seizures with focal evolution (GOFE)

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Generalised-onset seizures with focal evolution (GOFE). This is a childhood or adolescent onset generalized epilepsy. Fully referenced neurology checklist.

Defining features

  • This is a childhood or adolescent onset generalized epilepsy
  • It evolves into focal absence or myoclonic seizures years later
  • The evolution may occur at a different brain region

Onset features

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Focal evolution features

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Magnetic resonance imaging (MRI) brain

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Electroencephalogram (EEG)

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Treatment

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References

  1. Linane A, Lagrange AH, Fu C, Abou-Khalil B. Generalized onset seizures with focal evolution (GOFE)-a unique seizure type in the setting of generalized epilepsy. Epilepsy Behav 2016; 54:20-29.
  2. Williamson R, Hanif S, Mathews GC, Lagrange AH, Abou-Khalil B. Generalized-onset seizures with secondary focal evolution. Epilepsia 2009; 50:1827-1832.
  3. Lamy F, Valenti-Hirsch MP, Gauer L, et al. Genetic generalized epilepsy and generalized onset seizures with focal evolution (GOFE). Epilepsy Behav Rep 2022; 19:100555.
  4. Saglam H, Tolaymat S, Ewida A. Teaching NeuroImages: Generalized onset with focal evolution (GOFE) seizures: a rare and newly recognized seizure pattern in generalized epilepsy. Neurology 2026; 106:e214826.
  5. Brandhoff F, Mayer T, Wienecke M, Kovacevic-Preradovic T, Holtkamp M, Breuer E. Generalized onset seizures with focal evolution (GOFE) - a largely unknown ictal variation in genetic generalized epilepsies. Seizure 2024; 114:40-43.

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