Objective: Test the applicability of the 2010 and 2017 ILAE classification of epilepsy and to compare it with the 1989 ILAE classification in a resource limited setting and to determine the electroclinical spectrum of pediatric epilepsy.

Methods: Children with epilepsy presenting to the Epilepsy Clinic of Lady Hardinge Medical College between November 2015 and March 2017 were analyzed and classified by the 1989, 2001, 2010 and 2017 ILAE classification.

Results: Both the 1989 and 2010 ILAE classification classified 82.7% cases. The 2001 diagnostic scheme (Axes 3&4) could classify 84.5% cases. All 480 cases could be classified by level 1(seizure type) of the 2017 ILAE classification. Level 2 (epilepsy type) classified 89.3% cases. Syndromes could be identified in 50.4% children. West syndrome was the most common electroclinical syndrome identified (10.4%). Rolandic Epilepsy and Epilepsy with GTCS alone were the most common syndromes amongst the focal and generalized epilepsies respectively. Etiology could be determined in 54.3% of cases of which structural causes due to perinatal insults were the most frequent followed by infection in older children.

Conclusion:

Both 1989 and 2010 ILAE classification classified same number of cases. The 2017 classification classified all children at level 1 and numerically more in level 2 although not statistically significant. A better delineation was also possible in the syndrome and etiology (level 3 & 4) thus achieving its aim to reflect current scientific understanding and provide a flexible framework in both developed and underdeveloped settings.