Updated classification of epileptic seizures: Position paper of the International League Against Epilepsy.
Beniczky Sándor, Trinka Eugen, Wirrell Elaine, Abdulla Fatema, Al Baradie Raidah, Alonso Vanegas Mario, Auvin Stéphane, Singh Mamta Bhushan, Blumenfeld Hal, Bogacz Fressola Alicia, Caraballo Roberto, Carreno Mar, Cendes Fernando, Charway Augustina, Cook Mark, Craiu Dana, Ezeala-Adikaibe Birinus, Frauscher Birgit, French Jacqueline, Gule M V, Higurashi Norimichi, Ikeda Akio, Jansen Floor E, Jobst Barbara, Kahane Philippe, Kishk Nirmeen, Khoo Ching Soong, Vinayan Kollencheri Puthenveettil, Lagae Lieven, Lim Kheng-Seang, Lizcano Angelica, McGonigal Aileen, Perez-Gosiengfiao Katerina Tanya, Ryvlin Philippe, Specchio Nicola, Sperling Michael R, Stefan Hermann, Tatum William, Tripathi Manjari, Yacubian Elza Márcia, Wiebe Samuel, Wilmshurst Jo, Zhou Dong, Cross J Helen
Epilepsia · 2025 · PMID 40264351 · 인용 491
The International League Against Epilepsy (ILAE) has updated the operational classification of epileptic seizures, building upon the framework established in 2017. This revision, informed by the implementation experience, involved a working group appointed by the ILAE Executive Committee. Comprising 37 members from all ILAE regions, the group utilized a modified Delphi process, requiring a consensus threshold of more than two thirds for any proposal.
Following public comments, the Executive Committee appointed seven additional experts to the revision task force to address and incorporate the issues raised, as appropriate. The updated classification maintains four main seizure classes: Focal, Generalized, Unknown (whether focal or generalized), and Unclassified. Taxonomic rules distinguish classifiers, which are considered to reflect biological classes and directly impact clinical management, from descriptors, which indicate other important seizure characteristics.
Focal seizures and those of unknown origin are further classified by the patient's state of consciousness (impaired or preserved) during the seizure, defined operationally through clinical assessment of awareness and responsiveness. If the state of consciousness is undetermined, the seizure is classified under the parent term, that is, the main seizure class (focal seizure or seizure of unknown origin). Generalized seizures are grouped into absence seizures, generalized tonic-clonic seizures, and other generalized seizures, now including recognition of negative myoclonus as a seizure type.
Seizures are described in the basic version as with or without observable manifestations, whereas an expanded version utilizes the chronological sequence of seizure semiology. This updated classification comprises four main classes and 21 seizure types. Special emphasis was placed on ensuring translatability into languages beyond English.
Its aim is to establish a common language for all health care professionals involved in epilepsy care, from resource-limited areas to highly specialized centers, and to provide accessible terms for patients and caregivers.