We investigated electroclinical features in patients with symptomatic or cryptogenic generalized epilepsies except for West syndrome. They were divided into a tonic group and a myoclonic group. As a result these groups exhibited different features with some overlap between them. They included Lennox-Gastaut syndrome, severe epilepsy with multiple independent spike foci (SE-MISF), Doose syndrome and other unclassifi ed cases. Thus the boundary between these epilepsy syndromes is sometimes blurred. In patients with SE-MISF, main seizure types were minor generalized seizures though the main EEG fi ndings were multifocal spikes. The role of both cortical and subcortical mechanisms in the occurrence of symptomatic generalized epilepsies should be further clarifi ed.