ILAE Classification and Terminology of Seizures and Epilepsies

ILAE Classification and Terminology of Seizures and Epilepsies

Classification of seizures

Note:Seizure that cannot be clearly diagnosed into one of the categories should be considered unclassified until further information allows their accurate diagnosis. This is not considered a classification category, however.

• Generalized seizures
  
  • Tonic–clonic (in any combination)
  • Absence
    • Typical
    • Atypical
    • Absence with special features
      • Myoclonic absence
      • Eyelid myoclonia
    • Myoclonic
      • Myoclonic
      • Myoclonic atonic
      • Myoclonic tonic
    • Clonic
    • Tonic
    • Atonic
• Focal seizures
• Unknown
  • Epileptic spasms

Descriptors of focal seizures according to degree of impairment during seizure

• Without impairment of consciousness/responsiveness
  • With observable motor or autonomic components. This roughly corresponds to the concept of “simple partial seizure."Focal motor" and "autonomic" are terms that may adequately convey this convept depending on the seizure manifestations.
  • Involving subjective sensory or psychic phenomena only. This corresponds to the concept of an aura, a term endorsed in the 2001 Glossary.
• With impairment of consciousness/responsiveness. This roughly corresponds to the concept of complex partial seizure. "Dyscognitive" is a term that has been proposed for this concept
• Evolving to a bilateral, convulsive seizure (involving tonic, clonic or tonic and clonic components). This expression replaces the term "secondarily generalized seizure." The term convulsive was considered a lay term in the Glossary;however it is it is used throughout medicine in various forms and translates well across many languages. Its use is, therefore, endorsed.

Electroclinical syndromes and other epilepsies

Note: The arrangement of electroclinical syndromes does not reflect etiology

• Electroclinical syndromes arranged by age at onset
  • Neonatal period
    • Benign familial neonatal epilepsy (BFNE)
    • Early myoclonic encephalopathy (EME)
    • Ohtahara syndrome
  • Infancy
    • Epilepsy of infancy with migrating focal seizures
    • West syndrome
    • Myoclonic epilepsy in infancy (MEI)
    • Benign infantile epilepsy
    • Benign Infantile Focal Epilepsy with Midline Spikes and Waves during Sleep (BIMSE)^??
    • Benign familial infantile epilepsy
    • Dravet syndrome
    • Myoclonic encephalopathy in nonprogressive disorders
  • Childhood
    • Febrile seizures plus(FS+)(Can start in infancy)
    • Panayitopoulos syndrome
    • Epilepsy with myoclonic atonic(previously astatic)seizures
    • Benign epilepsy with centrotemporal spikes(BECTS)
    • Autosomal-dominant nocturnal frontal lobe epilepsy(ADNLFE)
    • Late onset childhood occipital epilepsy(Gastaut type)
    • Epilepsy with myoclonic absences
    • Lennox-Gastaut syndrome
    • Epileptic encephalopathy with continous spike-and-wave during sleep(CSWS).(sometimes referred to as Electrical Status Epilepticus during Slow Sleep (ESES))
    • Landau-Kleffner syndrome(LKS)
    • Childhood absence epilepsy(CAE)
  • Adolescence-Adult
    • Juvenile absence epilepsy(JAE)
    • Juvenile myoclonic epilepsy(JME)
    • Epilepsy with generalized tonic-clonic seizures alone
    • Progressive myoclonus epilepsies(PME)
    • Autosomal doinant epilepsy with auditory features(ADEAF)
    • 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)
  • Rasmussen syndrome
  • Gelastic seizures with hypothalamic hamartoma
  • Hemiconvulsion-hemiplegia-epilepsy
  • Epilepsis that do not fit into any of these diagnostic categories can be distinguished first on the basis of the preence or absence of a known structural or metabolic condition (presumed cause) and then on the basis of the primary mode of seizures onset (generalized vs. focal)
• Epilepsies attributed to and organized by structural-metabolic causes
  • Malformations of cortical development(hemimegalencephaly,heterotopias, etc.)
  • Neurocutaneous syndromes(tuberous sclerosis complex,Sturge-Weber, etc)
  • Tumour
  • Infection
  • Trauma
• Angioma
  • Perinatal insults
  • Stroke, Etc.
• Epilepsis of unknown cause
• Conditions with epileptic seizures that are traditionally diagnosed as a form of epilepsy per se
  • Benign neonatal seizures (BNS)
  • Febrile seizures

^?? : indicates where there are published reports suggesting these conditions are separate syndromes, but were not included in the 2009 ILAE Classification

References

Contributors to this page

Drhameed, Icnapedia