Seizure classification

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... 

Modified from the International Classification of Epileptic Seizures. Various methods of seizure classification are nsed by different anthers. 

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. 

CLINICAL PHARMACOLOGY OF ANTISEIZURE DRUGS SEIZURE CLASSIFICATION... 

Clinical Pharmacology of Antiseizure Drugs Seizure Classification... 

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

When the seizure begins in a localized area of the brain, it is defined as partial. There are three types of partial seizures in the current classification system. 

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. 

Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia 22 489-501,1981. 

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... 

There is a large body of literature on assessment of the therapeutic benefit of AEDs, mostly composed of comparative clinical trials. A few meta-analyses have been performed. For any given AED, it is sometimes difficult to formulate an opinion due to the different methodologies used for assessment tested alone or as an add-on drug, wide range of dosages, different types of seizures or epileptic syndromes. Classifications of indications and recommendations for use vary accordingly. 

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

This classification does not take into account the frequency, duration or causes of precipitation of the seizure. Any type of attack that is maintained for more than 1 hour is termed status epilepticus, which may be qualified as focal or generalized. 

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