Updated classification of epileptic seizures: Position paper of the International League Against Epilepsy

The International League Against Epilepsy (ILAE) has updated the operational classification of epileptic seizures, building upon the framework established in 2017. This revision, informed by the implementation experience, involved a working group appointed by the ILAE Executive Committee. Comprising 37 members from all ILAE regions, the group utilized a modified Delphi process, requiring a consensus threshold of more than two thirds for any proposal. Following public comments, the Executive Committee appointed seven additional experts to the revision task force to address and incorporate the issues raised, as appropriate. The updated classification maintains four main seizure classes: Focal, Generalized, Unknown (whether focal or generalized), and Unclassified. Taxonomic rules distinguish classifiers, which are considered to reflect biological classes and directly impact clinical management, from descriptors, which indicate other important seizure characteristics. Focal seizures and those of unknown origin are further classified by the patient's state of consciousness (impaired or preserved) during the seizure, defined operationally through clinical assessment of awareness and responsiveness. If the state of consciousness is undetermined, the seizure is classified under the parent term, that is, the main seizure class (focal seizure or seizure of unknown origin). Generalized seizures are grouped into absence seizures, generalized tonic-clonic seizures, and other generalized seizures, now including recognition of negative myoclonus as a seizure type. Seizures are described in the basic version as with or without observable manifestations, whereas an expanded version utilizes the chronological sequence of seizure semiology. This updated classification comprises four main classes and 21 seizure types. Special emphasis was placed on ensuring translatability into languages beyond English. Its aim is to establish a common language for all health care professionals involved in epilepsy care, from resource-limited areas to highly specialized centers, and to provide accessible terms for patients and caregivers.

Authors

Institutions

Publication Details

Journal
Epilepsia
Published
2025-04-23
DOI
https://doi.org/10.1111/epi.18338
Citations
210
Primary Topic
Epilepsy research and treatment
Type
article
Field-Weighted Citation Impact
308.96

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Updated classification of epileptic seizures: Position paper of the International League Against Epilepsy

Judith Helen Cross, Jo M. Wilmshurst, Floor E. Jansen, Michael R. Sperling et al.
210 citations
Epilepsia
Epilepsy research and treatment
308.96
article

Updated classification of epileptic seizures: Position paper of the International League Against Epilepsy

Judith Helen Cross, Jo M. Wilmshurst, Floor E. Jansen, Michael R. Sperling, Mar Carreño, Alicia Bogacz Fressola, Kheng Seang Lim, Aileen McGonigal, Dana Craiu, Fatema Abdulla, Mario Alonso‐Vanegas, Birinus Ezeala‐Adikaibe, Katerina Tanya Perez‐Gosiengfiao, Philippe Ryvlin, Nirmeen A. Kishk, Samuel Wiebe, Hal Blumenfeld, William O. Tatum, Jacqueline A. French, Sándor Beniczky, Barbara C. Jobst, Roberto Caraballo, Fernando Cendes, Birgit Frauscher, Mark Cook, Augustina Charway‐Felli, Angélica Lizcano, Norimichi Higurashi, Dong Chi Zhou, Elza Márcia Targas Yacubian, Nicola Specchio, Elaine C. Wirrell, Ching Soong Khoo, H. Stefan, M. V. Gule, Stéphane Auvin, Akio Ikeda, Eugen Trinka, Mamta Bhushan Singh, Lieven G. Lagae, Philippe Kahane, Manjari Tripathi, Kollencheri Puthenveettil Vinayan, Raidah Albaradie
article en
210 citations

Abstract

The International League Against Epilepsy (ILAE) has updated the operational classification of epileptic seizures, building upon the framework established in 2017. This revision, informed by the implementation experience, involved a working group appointed by the ILAE Executive Committee. Comprising 37 members from all ILAE regions, the group utilized a modified Delphi process, requiring a consensus threshold of more than two thirds for any proposal. Following public comments, the Executive Committee appointed seven additional experts to the revision task force to address and incorporate the issues raised, as appropriate. The updated classification maintains four main seizure classes: Focal, Generalized, Unknown (whether focal or generalized), and Unclassified. Taxonomic rules distinguish classifiers, which are considered to reflect biological classes and directly impact clinical management, from descriptors, which indicate other important seizure characteristics. Focal seizures and those of unknown origin are further classified by the patient's state of consciousness (impaired or preserved) during the seizure, defined operationally through clinical assessment of awareness and responsiveness. If the state of consciousness is undetermined, the seizure is classified under the parent term, that is, the main seizure class (focal seizure or seizure of unknown origin). Generalized seizures are grouped into absence seizures, generalized tonic-clonic seizures, and other generalized seizures, now including recognition of negative myoclonus as a seizure type. Seizures are described in the basic version as with or without observable manifestations, whereas an expanded version utilizes the chronological sequence of seizure semiology. This updated classification comprises four main classes and 21 seizure types. Special emphasis was placed on ensuring translatability into languages beyond English. Its aim is to establish a common language for all health care professionals involved in epilepsy care, from resource-limited areas to highly specialized centers, and to provide accessible terms for patients and caregivers.

EpilepsiaVol. 66(6)
Jikei University School of Medicine (JP), Amrita Institute of Medical Sciences and Research Centre (IN), Dartmouth–Hitchcock Medical Center (US), Mayo Clinic (US), Cairo University (EG), Thomas Jefferson University (US), Inserm (FR), University of Cape Town (ZA), Carol Davila University of Medicine and Pharmacy (RO), The University of Queensland (AU), The University of Melbourne (AU), University of Calgary (CA), Duke University (US), Universidad de la República de Uruguay (UY), Universidade Estadual de Campinas (UNICAMP) (BR), Institut Universitaire de France (FR), Aarhus University (DK), Université Paris Cité (FR), Kyoto University (JP), Sichuan University (CN), Paracelsus Medical University (AT), Hospital Kuala Lumpur (MY), Clinical Emergency Hospital Bucharest (RO), Salmaniya Medical Complex (BH), Garrahan Hospital (AR), Great Ormond Street Hospital (GB), Centre Hospitalier Universitaire de Grenoble (FR), Jacksonville College (US), Philippine General Hospital (PH), Makati Medical Center (PH), Centre Hospitalier Universitaire Vaudois (CH), Groote Schuur Hospital (ZA), King Fahad Specialist Hospital (SA), Aarhus University Hospital (DK), WinnMed (US), University Medical Center Utrecht (NL), Yale University (US), University of Malaya (MY), University of Oxford (GB), Universitätsklinikum Erlangen (DE), West China Hospital of Sichuan University (CN), Instituto Neurológico de Colombia (CO), Assistance Publique – Hôpitaux de Paris (FR), Hospital Clínic de Barcelona (ES), St. Luke's Medical Center (PH), Bambino Gesù Children's Hospital (IT), Hôpital Robert-Debré (FR), Brazilian Institute of Neuroscience and Neurotechnology (BR), Mayo Clinic in Florida (US), Grenoble Institute of Neurosciences (FR), Red Cross War Memorial Children's Hospital (ZA), 37 Military Hospital (GH), Mater Adult Hospital (AU), University of Nigeria Teaching Hospital (NG), NeuroDiderot (FR), University College London (GB), New York University (US), All India Institute of Medical Sciences (IN), Universidade Federal de São Paulo (BR), National University of Malaysia (MY), Université Grenoble Alpes (FR), University of Lausanne (CH), KU Leuven (BE)
Sanofi, Vitaflo, Jazz Pharmaceuticals, LifeArc, Zogenix, Innovationsfonden, Ultragenyx Pharmaceutical, LivaNova, GW Pharmaceuticals, Sage Therapeutics, SK Life Science, National Institute for Health and Care Research, University of Cambridge, University of Oxford, European Commission, Great Ormond Street Hospital Charity, Ministero della Salute, Eisai, Angelini Pharma, Otsuka Pharmaceutical, Ono Pharmaceutical, H. Lundbeck A/S, Neuraxpharm, Genentech, HORIZON EUROPE Framework Programme, Engineering and Physical Sciences Research Council, Great Ormond Street Institute of Child Health, National Institute of Neurological Disorders and Stroke, UCB Pharma, Eurostars
Openalex Percentile: Top 0%
Epilepsy research and treatment
308.96
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.