The document discusses updates to the ILAE classification of seizures and epilepsies from 2017. The classification aims to better organize seizure types and include new types based on supporting information like videos, EEGs, and genetic testing. It clarifies definitions of consciousness impairment and reclassifies some seizures as focal or generalized onset. New terms were also introduced for some older seizure types. The goal of the updated classification is to improve diagnosis and guide targeted therapies for patients.

1. ILAE Classification
of Seizures and
Epilepsies
Moderator
Dr. Sudhir
An update for
the
Pediatrician
Presenter
Dr. Vinaykumar S Appannavar
R Dhinakaran and Devendra Mishra
INDIAN PEDIATRICS JOURNAL – Volume 56 ; Jan 15, 2019

2. Why to classify ?
• It is the cornerstone in the evaluation and management of seizures
• It helps in understanding the types of seizure, identifying and labeling
the type of epilepsy, and grouping similar entities into specific
syndromes
• it is also critical for research, communication among clinicians and
researchers, and development of antiepileptic therapies

3. ILEA - International League Against Epilepsy
• The 1981 and 1989 ILAE classifications were a major breakthrough in
understanding the types and classification of seizures and epilepsy
• In 2017 - updated classifications of both seizures and epilepsies
• The “first new official papers on classification from the ILAE since
1989”
• The stated purpose of revisions is to include new seizure types, have a
better organized classification

4. • Supporting information viz., Video record, Electro-encephalography
(EEG), neuroimaging, gene mutations and autoimmune panel, if available,
are to be utilized in classifying epilepsy type and/or epilepsy syndrome
Classification :

5. • Inclusion of new seizure types[BOX 1]
• Clarification of impairment of
consciousness: Awareness- knowledge
of self and environment
• Re-classification of certain seizure
types into either focal or generalized
onset
• Classification of seizure of unknown
onset - the term ‘unknown onset’ is a
placeholder – not a characteristic of
the seizure

6. • New terms for old ones
• Updated glossary of seizure terms

7. Conclusion :
• These new classifications of seizures and the epilepsies are likely to
lead to improved understanding of seizure etiology, making
appropriate diagnosis and will guide targeted therapies to the patient
• Helps in greater ease of communication about seizure types among
clinicians, the non-medical community, and researchers
• A companion piece to present these concepts for people with
epilepsy and their caregivers is also available