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. 2019 Jun;60(6):1032-1039.
doi: 10.1111/epi.14699. Epub 2019 Mar 28.

Critique of the 2017 epileptic seizure and epilepsy classifications

Hans Lüders  1 , Naoki Akamatsu  2 , Shahram Amina  1 , Christoph Baumgartner  3   4 , Selim Benbadis  5 , Adriana Bermeo-Ovalle  6 , Andrew Bleasel  7 , Alireza Bozorgi  1 , Mar Carreño  8 , Michael Devereaux  1 , Guadalupe Fernandez-Baca Vaca  1 , Stefano Francione  9 , Naiara García Losarcos  1 , Hajo Hamer  10 , Hans Holthausen  11 , Shirin Jamal Omidi  1 , Giridhar Kalamangalam  12 , Andrés Kanner  13 , Susanne Knake  14 , Nuria Lacuey  1 , Samden Lhatoo  1 , Shih-Hui Lim  15 , Jayanthi Mani  16 , Riki Matsumoto  17 , Jonathan Miller  1 , Soheyl Noachtar  18 , André Palmini  19 , Jun Park  1 , Felix Rosenow  20 , Asim Shahid  1 , Stephan Schuele  21 , Bernhard Steinhoff  22 , Charles Ákos Szabo  23 , Nitin Tandon  24 , Kiyohito Terada  25 , Walter Van Emde Boas  26 , Peter Widdess-Walsh  27 , Philippe Kahane  28
Affiliations

Critique of the 2017 epileptic seizure and epilepsy classifications

Hans Lüders et al. Epilepsia. 2019 Jun.

Abstract

This article critiques the International League Against Epilepsy (ILAE) 2015-2017 classifications of epilepsy, epileptic seizures, and status epilepticus. It points out the following shortcomings of the ILAE classifications: (1) they mix semiological terms with epileptogenic zone terminology; (2) simple and widely accepted terminology has been replaced by complex terminology containing less information; (3) seizure evolution cannot be described in any detail; (4) in the four-level epilepsy classification, level two (epilepsy category) overlaps almost 100% with diagnostic level one (seizure type); and (5) the design of different classifications with distinct frameworks for newborns, adults, and patients in status epilepticus is confusing. The authors stress the importance of validating the new ILAE classifications and feel that the decision of Epilepsia to accept only manuscripts that use the ILAE classifications is premature and regrettable.

Keywords: classification; epileptogenic zone; etiology; semiology.

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