ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology

Ingrid E Scheffer^{1

2

3}, Samuel Berkovic¹, Giuseppe Capovilla⁴, Mary B Connolly⁵, Jacqueline French⁶, Laura Guilhoto⁷, Edouard Hirsch^{8

9}, Satish Jain¹⁰, Gary W Mathern¹¹, Solomon L Moshé¹², Douglas R Nordli¹³, Emilio Perucca¹⁴, Torbjörn Tomson¹⁵, Samuel Wiebe¹⁶, Yue-Hua Zhang¹⁷, Sameer M Zuberi^{18

19}

Affiliations

¹ Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Victoria, Australia.
² Department of Paediatrics, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
³ Florey Institute, Melbourne, Victoria, Australia.
⁴ Child Neuropsychiatry Department, Epilepsy Center, C. Poma Hospital, Mantova, Italy.
⁵ Department of Pediatrics, British Columbia's Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
⁶ Department of Neurology, NYU School of Medicine, New York, New York, U.S.A.
⁷ Department of Neurology, Federal University of São Paulo; University Hospital, University of São Paulo, São Paulo, Brazil.
⁸ University Hospital INSERM U 964, Strasbourg, France.
⁹ IDÉE, Lyon, France.
¹⁰ Indian Epilepsy Centre, New Delhi, India.
¹¹ Departments of Neurosurgery, Psychiatry and Biobehavioral Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, U.S.A.
¹² Saul R. Korey Department of Neurology, Dominick P. Purpura Department of Neuroscience and Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, U.S.A.
¹³ Division of Neurology, Children's Hospital Los Angeles, Los Angeles, California, U.S.A.
¹⁴ C. Mondino National Neurological Institute and Clinical Pharmacology Unit, University of Pavia, Pavia, Italy.
¹⁵ Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
¹⁶ Departments of Clinical Neurosciences and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
¹⁷ Department of Pediatrics, Peking University First Hospital, Beijing, China.
¹⁸ Paediatric Neurosciences Research Group, Fraser of Allander Neurosciences Unit, Royal Hospital for Children, Glasgow, United Kingdom.
¹⁹ School of Medicine, University of Glasgow, Glasgow, United Kingdom.

PMID: 28276062
PMCID: PMC5386840
DOI: 10.1111/epi.13709

ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology

Ingrid E Scheffer et al. Epilepsia. 2017 Apr.

. 2017 Apr;58(4):512-521.

doi: 10.1111/epi.13709. Epub 2017 Mar 8.

Authors

Affiliations

¹ Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Victoria, Australia.
² Department of Paediatrics, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
³ Florey Institute, Melbourne, Victoria, Australia.
⁴ Child Neuropsychiatry Department, Epilepsy Center, C. Poma Hospital, Mantova, Italy.
⁵ Department of Pediatrics, British Columbia's Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
⁶ Department of Neurology, NYU School of Medicine, New York, New York, U.S.A.
⁷ Department of Neurology, Federal University of São Paulo; University Hospital, University of São Paulo, São Paulo, Brazil.
⁸ University Hospital INSERM U 964, Strasbourg, France.
⁹ IDÉE, Lyon, France.
¹⁰ Indian Epilepsy Centre, New Delhi, India.
¹¹ Departments of Neurosurgery, Psychiatry and Biobehavioral Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, U.S.A.
¹² Saul R. Korey Department of Neurology, Dominick P. Purpura Department of Neuroscience and Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, U.S.A.
¹³ Division of Neurology, Children's Hospital Los Angeles, Los Angeles, California, U.S.A.
¹⁴ C. Mondino National Neurological Institute and Clinical Pharmacology Unit, University of Pavia, Pavia, Italy.
¹⁵ Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
¹⁶ Departments of Clinical Neurosciences and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
¹⁷ Department of Pediatrics, Peking University First Hospital, Beijing, China.
¹⁸ Paediatric Neurosciences Research Group, Fraser of Allander Neurosciences Unit, Royal Hospital for Children, Glasgow, United Kingdom.
¹⁹ School of Medicine, University of Glasgow, Glasgow, United Kingdom.

PMID: 28276062
PMCID: PMC5386840
DOI: 10.1111/epi.13709

Abstract

The International League Against Epilepsy (ILAE) Classification of the Epilepsies has been updated to reflect our gain in understanding of the epilepsies and their underlying mechanisms following the major scientific advances that have taken place since the last ratified classification in 1989. As a critical tool for the practicing clinician, epilepsy classification must be relevant and dynamic to changes in thinking, yet robust and translatable to all areas of the globe. Its primary purpose is for diagnosis of patients, but it is also critical for epilepsy research, development of antiepileptic therapies, and communication around the world. The new classification originates from a draft document submitted for public comments in 2013, which was revised to incorporate extensive feedback from the international epilepsy community over several rounds of consultation. It presents three levels, starting with seizure type, where it assumes that the patient is having epileptic seizures as defined by the new 2017 ILAE Seizure Classification. After diagnosis of the seizure type, the next step is diagnosis of epilepsy type, including focal epilepsy, generalized epilepsy, combined generalized, and focal epilepsy, and also an unknown epilepsy group. The third level is that of epilepsy syndrome, where a specific syndromic diagnosis can be made. The new classification incorporates etiology along each stage, emphasizing the need to consider etiology at each step of diagnosis, as it often carries significant treatment implications. Etiology is broken into six subgroups, selected because of their potential therapeutic consequences. New terminology is introduced such as developmental and epileptic encephalopathy. The term benign is replaced by the terms self-limited and pharmacoresponsive, to be used where appropriate. It is hoped that this new framework will assist in improving epilepsy care and research in the 21st century.

Keywords: Classification; Epilepsy syndromes; Etiology; Terminology.

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Figures

**Figure**
Framework for Classification of the Epilepsies. * Denotes onset of seizure

See this image and copyright information in PMC

Comment in

How Have We Come This Far? Epilepsy Classification Through the Ages.
Nickels K. Nickels K. Epilepsy Curr. 2017 Jul-Aug;17(4):229-231. doi: 10.5698/1535-7597.17.4.229. Epilepsy Curr. 2017. PMID: 29225528 Free PMC article. No abstract available.

References

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1. Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia. 1989;30:389–399. - PubMed

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ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology

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ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology

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MeSH terms

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