New epilepsy-taxonomy based on the system epilepsy concept – A mini-review and proposal

In this review we propose a new epilepsy-taxonomy, based on recent sleep- and epilepsy research. It has been evidenced that sleep is a “cradle” of human cognitive development, and epileptogenesis – as an inbuilt risk - is underlined by the pathologic increase of the homeostatic NREM sleep regulation and the derailment of synaptic plasticity. Therefore, NREM sleep has an essential role in epileptogenesis and across the course of epilepsies. This approach goes hand in hand with the emerging system-concept abolishing the “Procrustean bed” of the now untenable focal-generalized epilepsy classification. Based on the system-approach, we briefly reinterpret the most frequent epilepsies each presenting with system-specific features both ictally and interictally while sharing the common mechanism of disfigured epileptic “learning”.