Epilepsies classification

FIGURE 27-1. International League Against Epilepsy classification of epileptic seizures. Data from reference 16. 

Kanemoto K, Tsuji T, Kawasaki J. Reexamination of interictal psychoses based on DSM IV psychosis classification and international epilepsy classification. Epilepsia 2001 42(1) 98-103. 

Commission on Classification and Terminology of the International League Against Epilepsy, Epilepsia 22, 289—501 (1981). 

Classification of epilepsies and epilepsy syndromes is helpful in determining appropriate pharmacotherapy. This classification scheme is based on the type of seizures a patient has and an attempt to identify the etiology of the epilepsy or epilepsy syndrome. 

The ILAE is proposing a new classification system that improves the description of the seizure type and epilepsy.18,19 The proposed scheme revolves around five axes ... 

Once it is concluded that the patient has seizures, the type of seizure and epilepsy syndrome, if any, must be determined. Proper identification and classification of the seizure type is most helpful in selecting appropriate pharmacotherapy. Without an accurate classification of the seizure type, it is possible to select a medication that is ineffective or even harmful to the patient. 

Apart from this epileptic seizure classification, an additional classification specifies epileptic syndromes, which refer to a cluster of symptoms frequently occurring together and include seizure type, etiology, age of onset and other factors [2]. The epileptic syndromes have been categorized into partial versus generalized epilepsies. The partial... 

The International Classification of Epileptic Seizures (Table 52-1) classifies epilepsy on the basis of clinical description and electrophysiologic findings. 

Epilepsy is a chronic often progressive disorder of the central nervous system (CNS). Periodic and unpredictable epileptic seizures caused by the abnormal electrical discharge of neurones in various anatomic structures of the CNS is the characteristic feature. This is an approximate definition based on international classifications of seizures and syndromes which take into account the extremely variable clinical and electroencephalographic expression of the disease. The annual incidence of epilepsy is an estimated 20-70 cases per 100,000 inhabitants with a prevalence of 0.4-0.8%. Globally, incidence is higher during childhood, remaining rather stable... 

The antiseizure drugs described in this chapter are also used in patients with febrile seizures or with seizures occurring as part of an acute illness such as meningitis. The term "epilepsy" is not usually applied to such patients unless chronic seizures develop later. Seizures are occasionally caused by an acute underlying toxic or metabolic disorder, in which case appropriate therapy should be directed toward the specific abnormality, eg, hypocalcemia. In most cases of epilepsy, however, the choice of medication depends on the empiric seizure classification. 

Several types of drugs are currently available, and certain compounds work best in specific types of epilepsy. Consequently, the type of epilepsy must be determined by observing the patient and using diagnostic tests such as electroencephalography (EEG).21 The classification system most commonly used in characterizing epilepsy is discussed here. 

Riviello JJ. Classification of seizures and epilepsy. Curr Neurol Neurosci Rep. 2003 3 325-331. 

For the purpose of drug treatment, the epilepsies are classified according to the seizure type. The classification generally used is based on that proposed by the Commission on Classification and Terminology of the International League against Epilepsy. The main groups are ... 

Proposal for revised classification of epilepsies and epileptic syndromes (1989). Commission on classification and terminology of the International League against epilepsy. Epilepsia 30 389-399. 

Epidemiology and Classification of Epilepsy Gender Comparisons John C. McHugh and Norman Delanty... 

Seizures have been classified into two broad groups, partial (or focal), and generalized. Choice of drug treatment is based on the classification of the epilepsy being treated (Figure 15.2). 

The International Classification of Epileptic Seizures (Table 52-1) classifies epilepsy on the basis of clinical description and electrophysiologic findings. Partial (focal) seizures begin in one hemisphere of the brain and, unless they become secondarily generalized, result in an asymmetric seizure. Partial seizures manifest as alterations in motor functions, sensory or somatosensory symptoms, or automatisms. If there is no loss of consciousness, the seizures are called simple partial. If there is loss of consciousness, they are termed complex partial, and the patients may have automatisms, memory loss, or aberrations of behavior. 

Scheffer IE. Severe infantile epilepsies molecular genetics challenge clinical classification. Brain 2003 126 513-514. 

A cla.ssillculion of the types of epilepsy has been widely accepted because its accuracy facilitate.s diagno.sis, drug selection. and precise discussion of. seizure di.sorders. - The major classification types are (a) generali zed. seizures, which c.s.scntially involve the entire brain and do not have an apparent local on.sct (b) unilateral. sei /.urc.s. which involve one entire side of the body (i) partial (or focal) sci /.ures that have a focus (i.c.. begin locally) (d) erratic seizures of the newborn and (e) unclassified seizures (severe seizures associated with high mortality such that time does nut permit a precise categorization). 

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