A, Propagation of seizures from focal regions of the cortex can occur through fibers in the same cerebral hemisphere or fibers that connect to the contralateral cortex. B, Secondary generalization of a focal seizure can sometimes occur by spread to subcortical areas through projections to the thalamus, resulting in activation of both hemispheres. C, Primary generalized seizure spreads rapidly and simultaneously to both cerebral hemispheres through interconnections between the thalamus and cortex.