Could the 2017 ILAE and the four-dimensional epilepsy classifications be merged to a new “Integrated Epilepsy Classification”?

Rosenow F, Akamatsu N, Bast T, Bauer S, Baumgartner C, Benbadis S, Bermeo-Ovalle A, Beyenburg S, Bleasel A, Bozorgi A, Brázdil M, Carreño M, Delanty N, Devereaux M, Duncan J, Fernandez-Baca Vaca G, Francione S, García Losarcos N, Ghanma L, Gil-Nagel A, Hamer H, Holthausen H, Omidi SJ, Kahane P, Kalamangalam G, Kanner A, Knake S, Kovac S, Krakow K, Krämer G, Kurlemann G, Lacuey N, Landazuri P, Lim SH, Londoño LV, LoRusso G, Luders H, Mani J, Matsumoto R, Miller J, Noachtar S, O'Dwyer R, Palmini A, Park J, Reif PS, Remi J, Sakamoto AC, Schmitz B, Schubert-Bast S, Schuele S, Shahid A, Steinhoff B, Strzelczyk A, Szabo CA, Tandon N, Terada K, Toledo M, van Emde Boas W, Walker M, Widdess-Walsh P (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Book Volume: 78

Pages Range: 31-37

DOI: 10.1016/j.seizure.2020.02.018

Abstract

Over the last few decades the ILAE classifications for seizures and epilepsies (ILAE-EC) have been updated repeatedly to reflect the substantial progress that has been made in diagnosis and understanding of the etiology of epilepsies and seizures and to correct some of the shortcomings of the terminology used by the original taxonomy from the 1980s. However, these proposals have not been universally accepted or used in routine clinical practice. During the same period, a separate classification known as the “Four-dimensional epilepsy classification” (4D-EC) was developed which includes a seizure classification based exclusively on ictal symptomatology, which has been tested and adapted over the years. The extensive arguments for and against these two classification systems made in the past have mainly focused on the shortcomings of each system, presuming that they are incompatible. As a further more detailed discussion of the differences seemed relatively unproductive, we here review and assess the concordance between these two approaches that has evolved over time, to consider whether a classification incorporating the best aspects of the two approaches is feasible. To facilitate further discussion in this direction we outline a concrete proposal showing how such a compromise could be accomplished, the “Integrated Epilepsy Classification”. This consists of five categories derived to different degrees from both of the classification systems: 1) a “Headline” summarizing localization and etiology for the less specialized users, 2) “Seizure type(s)”, 3) “Epilepsy type” (focal, generalized or unknown allowing to add the epilepsy syndrome if available), 4) “Etiology”, and 5) “Comorbidities & patient preferences”.

Authors with CRIS profile

Involved external institutions

International University of Health and Welfare (IUHW) / 国際医療福祉大学 Japan (JP) University Hospitals of Cleveland / Case Western Reserve University Hospital United States (USA) (US) University of Texas Health Science Center at Houston (UTHealth) United States (USA) (US) Schön Kliniken Germany (DE) St. Bonifatius Hospital Germany (DE) Neurozentrum Bellevue Switzerland (CH) Case Western Reserve University United States (USA) (US) Beaumont Hospital Ireland (IE) Ruber International Hospital Spain (ES) UT Health San Antonio United States (USA) (US) Rainbow Babies & Children's Hospital United States (USA) (US) Memorial Hermann Northwest Hospital United States (USA) (US) University Hospital Brno Czech Republic (CZ) Hospital Clínic de Barcelona Spain (ES) St. Elizabeth Youngstown Hospital (Mercy Health) United States (USA) (US) Northwestern University United States (USA) (US) Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Brazil (BR) University of Sydney (USYD) Australia (AU) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE) University of São Paulo / Universidade de São Paulo (USP) Brazil (BR) Kokilaben Dhirubhai Ambani Hospital India (IN) Rush University United States (USA) (US) Sigmund-Freud-Privatuniversität Wien (SFU) / Sigmund Freud University Austria (AT) Ludwig-Maximilians-Universität (LMU) Germany (DE) Epilepsiezentrum Kork Germany (DE) Luxembourg Hospital Center / Centre Hospitalier de Luxembourg (CHL) Luxembourg (LU) Ospedale Niguarda Ca' Granda / ASST Grande Ospedale Metropolitano Niguarda Italy (IT) University of Miami United States (USA) (US) Goethe-Universität Frankfurt am Main Germany (DE) University of Florida United States (USA) (US) National University of Singapore (NUS) Singapore (SG) Vivantes - Netzwerk für Gesundheit GmbH Germany (DE) Westfälische Wilhelms-Universität (WWU) Münster Germany (DE) Asklepios Kliniken Germany (DE) Philipps-Universität Marburg Germany (DE) University College London (UCL) United Kingdom (GB) Kobe University / 神戸大学 Japan (JP) Shizuoka Institute of Epilepsy and Neurological Disorders Japan (JP) University of Grenoble Alpes (UGA) / Université de Grenoble France (FR) University of South Florida (USF) United States (USA) (US) University of Kansas Medical Center United States (USA) (US) Stichting Epilepsie Instellingen Nederland (SEIN) Netherlands (NL) Vall d'Hebron University Hospital / Hospital Universitari Vall d'Hebron Spain (ES)

How to cite

APA:

Rosenow, F., Akamatsu, N., Bast, T., Bauer, S., Baumgartner, C., Benbadis, S.,... Widdess-Walsh, P. (2020). Could the 2017 ILAE and the four-dimensional epilepsy classifications be merged to a new “Integrated Epilepsy Classification”? Seizure-European Journal of Epilepsy, 78, 31-37. https://doi.org/10.1016/j.seizure.2020.02.018

MLA:

Rosenow, Felix, et al. "Could the 2017 ILAE and the four-dimensional epilepsy classifications be merged to a new “Integrated Epilepsy Classification”?" Seizure-European Journal of Epilepsy 78 (2020): 31-37.

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