The ILAE classification of seizures and epilepsies: implications for the clinic

ABSTRACT

Introduction: The classification of epileptic seizures and the epilepsies has recently been revised by the International League Against Epilepsy (ILAE) and a new classification scheme issued.

Areas covered: The new classification scheme has been critically appraised in the light of the previous classifications and subsequent revisions. The purposes of the classification and its potential use have been extensively discussed.

Expert commentary: This ILAE classification scheme, the latest of a series of proposals published in the last 30 years, has made progress as it has a multi-level structure (seizure types, epilepsy types, epilepsy syndromes) allowing for differing uses and combines the previously separate seizure types and epilepsies schemes into a single instrument. Seizures and epilepsies can also be classified based on the available diagnostic aids, which may differ substantially between counties with mature economies and resource-poor countries. An intrinsic limitation of the classification, however, is the attempt to box cases as seen in clinical practice into schematic categories, leaving no room for variants and atypical clinical presentations. Another limitation is the lack of flexibility which hampers the ability to link the instrument to the preceding classifications in order to preserve continuity and monitor disease trends in time and space.

KEYWORDS:

• Epilepsy
• classification
• clinicians
• health care planners
• researchers
• multi-level stratification

Acknowledgments

JW Sander is based at UCLH/UCL Comprehensive Bio-Medical Research Centre, which received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme

Declaration of interest

E Beghi reports grants from UCB-Pharma, grants from Shire, grants from EISAI, personal fees from Viropharma, grants from Italian Ministry of Health, grants from Fondazione Borgonovo, grants from Associazione IDIC 15, grants from European Union, outside the submitted work.

JW Sander reports personal fees from Eisai, personal fees from UCB, grants and personal fees from Eisai, grants and personal fees from UCB, grants from Eisai, grants from WHO, grants from NEF, personal fees from Janssen Cilag, outside the submitted work; his current position is endowed by the Epilepsy Society; he is a member of the Editorial Board of the Lancet Neurology; he receives research support from Dr. Marvin Weil Epilepsy Research Fund and the UK Epilepsy Society. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. A peer review on this manuscript was on the Task Force that developed the classification of seizures that are the subject of this paper but have no relevant financial relationships to disclose

Additional information

Funding

This paper was not funded.