A 31-year-old man undergoes inpatient video-EEG monitoring for recurrent nocturnal convulsive episodes. During one event, the EEG recorded the following image. Based on the electroclinical evolution, which of the following is the MOST LIKELY appropriate seizure classification according to the current International League Against Epilepsy terminology?

• Generalized tonic-clonic seizure
• Focal seizure with nonobservable manifestations
• Focal to bilateral tonic-clonic seizure
• Bilateral tonic-clonic seizure unknown whether focal or generalized

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