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Classification of seizures
The ILAE Classification of the Epilepsies was updated in 2017[1][2] to reflect the advances made in recent years in the understanding of the epilepsies and their pathophysiologies since the classification was last ratified in 1989[3]. The current classification is based on the 1981 classification[4] which was extended in 2010[5]. It addresses the three levels of (1) identifying epilepsy (2) identifying the epilepsy type and (3) identifying the epilepsy syndrome where possible. In addition at each level it takes into account the aetiological diagnosis.
Generalised seizures
- Tonic-Clonic (in any combination)
-
- typical
- atypical
- absence with special features
- myoclonic absence
- Myoclonic
- myoclonic
- myoclonic atonic
- myoclonic tonic
- Clonic
- Tonic
- Atonic
Focal seizures
Unknown
Epileptic spasms
Electroclinical syndromes and other epilepsies
- Electroclinical syndromes arranged by age at onset
- Neonatal period
- Early myoclonic encephalopathy (EME)
- Infancy
- Myoclonic encephalopathy in nonprogressive disorders
- Childhood
- Febrile seizures plus (FS+)1)
- late onsert childhood occipital epilepsy (Gastaut type)
- Landau-Kleffner syndrome (LKS)
- Adolescence – adult
- Epilepsy with generalized tonic–clonic seizures alone
- Other familial temporal lobe epilepsies
- Less specific age relationship
- Familial focal epilepsy with variable foci (childhood to adult)
- Reflex epilepsies
- Distinctive constellations
- mesial_temporal_lobe_epilepsy_with_hippocampal_sclerosis (MTLE with HS)
- gelastic seizures with hypothalamic hamartoma
- Epilepsies that do not fit into any of these diagnostic categories can be distinguished first on the basis of the presence or absence of a known structural or metabolic condition (presumed cause) and then on the basis of the primary mode of seizure onset (generalized vs. Focal)
- Epilepsies attributed to and organized by structural-metabolic causes
- Malformations of cortical development (hemimegalencephaly, etc.)
- Neurocutaneous syndromes (tuberous sclerosis complex, etc.)
- Tumor
- Infection
- Trauma
- Angioma
- Perinatal insults
- Stroke Etc
- Epilepsies of unknown cause
- Conditions with epileptic seizures that are traditionally not diagnosed as a form of epilepsy per se
- benign neonatal seizures (BNS)
- febrile seizures (FS)
Discussion