ILAE classification of seizures and epilepsy
- Christian M Korff, MD
Christian M Korff, MD
- Head, Pediatric Neurology
- Geneva University Hospitals
- Elaine Wirrell, MD
Elaine Wirrell, MD
- Professor of Neurology and Director of Pediatric Epilepsy
- Mayo Clinic
- Section Editors
- Timothy A Pedley, MD
Timothy A Pedley, MD
- Editor-in-Chief — Neurology
- Section Editor — Epilepsy
- Henry and Lucy Moses Professor of Neurology
- Columbia University College of Physicians and Surgeons
- Douglas R Nordli, Jr, MD
Douglas R Nordli, Jr, MD
- Section Editor — Pediatric Neurology
- Chief of Neurology
- Children’s Hospital Los Angeles
- Vice Chair of Neurology
- USC Keck School of Medicine
Epilepsy is defined as a disorder of the brain characterized by an enduring predisposition to epileptic seizures . It is a heterogenous condition characterized by multiple possible seizure types and syndromes, diverse etiologies, and variable prognoses. Accurate classification is essential for several reasons :
●To provide a framework for understanding the type(s) of seizure(s) a patient has, other types that are more likely to occur, potential seizure triggers, and prognosis
●To inform the risk of comorbidities (eg, psychiatric, cognitive) and mortality, including sudden unexpected death in epilepsy
●To guide choice of optimal antiseizure drug and surgical therapies
Over the past several decades, significant advances in neuroimaging, genomic technologies, and molecular biology have improved the understanding of the pathogenesis of seizures and epilepsy. In addition, additional epilepsy syndromes have been delineated. As a result, existing International League Against Epilepsy (ILAE) classification systems for seizures and epilepsies have become outdated and inadequate [3,4].
- Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia 2014; 55:475.
- Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017; 58:512.
- Proposal for revised clinical and electroencephalographic classification of epileptic seizures. From the Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia 1981; 22:489.
- Proposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia 1989; 30:389.
- Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia 2010; 51:676.
- Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017; 58:522.
- Fisher RS, Cross JH, D'Souza C, et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia 2017; 58:531.
- LEVEL 1: SEIZURE TYPE
- LEVEL 2: EPILEPSY BASED ON SEIZURE TYPE
- Generalized epilepsy
- Focal epilepsy
- Generalized and focal epilepsy
- Unknown if generalized or focal epilepsy
- LEVEL 3: EPILEPSY SYNDROME
- LEVEL 4: EPILEPSY WITH ETIOLOGY
- OTHER CLASSIFICATION VARIABLES
- - Genetic
- - Structural
- - Metabolic
- - Immune
- - Infectious
- - Unknown
- OTHER TERMINOLOGY