Epilepsy classification changes again…

Actually the classification of seizures changed in July 2017 but I’ve only just been brought up to date by Emily O’Connor, a medical student who writes blog posts for Paediatric Pearls.  Here is her article:

In 2017 the International League Against Epilepsy revised their classification of seizure types, with the aim of creating greater flexibility, accuracy and transparency in the naming of seizures. Below, is a brief guide to applying this new approach to classification and a summary of the changes in terminology.

The new approach can be applied by asking two or three questions about the seizure:

  1. Where was the onset of the seizure?
    • It could be: focal/generalised/focal to bilateral/unknown
  2. What was the patient’s level of awareness during the seizure?FOR FOCAL SEIZURES ONLY
    • It could be: focal aware/focal impaired awareness
  3. What was the first prominent sign or symptom of the seizure?
    • It could be: motor/non-motor
    • This can then be further classified according to the specific symptom

This new classification system for seizures has led to a change in some of the traditional terminology used to describe seizure types, the below table shows a summary of these changes:

Traditional/‘Obsolete’ Term New/‘Replacement’ Term
Partial seizure Focal seizure
Simple partial seizure Focal aware seizure
Complex partial/Dyscognitive seizure Focal impaired awareness seizure
Psychic seizure Cognitive seizure
Primary generalised seizure Generalised seizure
Secondary generalised seizure Focal to bilateral tonic-clonic seizure

 

For more information on the ILEA 2017 classification system, please see the below references:

1.       Fisher 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. 4. 522-530.

2.       Epilepsy Foundation of America. 2017 Revised Classification of Seizures. [online] Epilepsy Foundation of America. 2017. 18/02/2018. <https://www.epilepsy.com/article/2016/12/2017-revised-classification-seizures>

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