Revidierte Klassifikation epileptischer Anfälle: Positionspapier der Internationalen Liga gegen Epilepsie

Beniczky S, Trinka E, Wirrell E, Abdulla F, Al Baradie R, Alonso Vanegas M, Auvin S, Singh MB, Blumenfeld H, Bogacz Fressola A, Caraballo R, Carreno M, Cendes F, Charway A, Cook M, Craiu D, Ezeala-Adikaibe B, Frauscher B, French J, Gule MV, Higurashi N, Ikeda A, Jansen FE, Jobst B, Kahane P, Kishk N, Khoo CS, Vinayan KP, Lagae L, Lim KS, Lizcano A, McGonigal A, Perez-Gosiengfiao KT, Ryvlin P, Specchio N, Sperling M, Stefan H, Tatum W, Tripathi M, Yacubian EM, Wiebe S, Wilmshurst J, Zhou D, Cross JH (2025)

Publication Type: Journal article, Review article

Publication year: 2025

Journal

DOI: 10.1007/s10309-025-00789-7

Abstract

The International League Against Epilepsy (ILAE) has updated the operational classification of epileptic seizures, building upon the framework established in 2017. This revision included the published experiences with the implementation of the classification from 2017. A working group involving 37 members of the ILAE was convened by the ILEA Executive Committee. The international experts from all ILEA regions utilized a modified Delphi process, requiring a consensus threshold of more than two thirds for any proposal. Following public comments on the ILEA homepage, 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 the 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 during the seizure and retained memory (recall) after a seizure. If the state of consciousness cannot be determined, the seizure is classified under the parent term, i.e., 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 4 main classes and 21 seizure types (and no longer 63 as in the 2017 classification, comment of the translator). Special emphasis was placed on ensuring translatability into languages other than English. The aim is to establish a common language for all healthcare professionals involved in the field of epilepsy, from resource-limited areas to highly specialized centers and to provide easily accessible terms for patients and caregivers.

Authors with CRIS profile

Involved external institutions

Aarhus University Hospital / Aarhus Universitetshospital Denmark (DK) Christian Doppler Klinik Austria (AT) Universidade Estadual de Campinas (UNICAMP) / University of Campinas Brazil (BR) The University of Melbourne Australia (AU) Carol Davila University of Medicine and Pharmacy / Universitatea de Medicină și Farmacie „Carol Davila” (UMF București) Romania (RO) University of Nigeria Nigeria (NG) Duke University United States (USA) (US) Ministry of Health Bahrain (BH) King Fahad Specialist Hospital (KFSHD) / Gulf Hospital / مستشفى الملك فهد التخصصي Saudi Arabia (SA) HMG Hospital Coyoacán Mexico (MX) Hôpital Universitaire Robert-Debré France (FR) All India Institute of Medical Sciences India (IN) Yale University United States (USA) (US) University of the Republic / Universidad de la República (UdelaR) Uruguay (UY) Hospital Garrahan / El Hospital Garrahan Argentina (AR) Hospital Clínic de Barcelona Spain (ES) New York University (NYU) United States (USA) (US) Groote Schuur Hospital South Africa (ZA) Jikei University School of Medicine / 東京慈恵会医科大学 Japan (JP) University Medical Centre Utrecht (UMC Utrecht) Netherlands (NL) Geisel School of Medicine United States (USA) (US) Grenoble Institute of Neurosciences (GIN) / Institut des Neurosciences de Grenoble France (FR) Cairo University / جامعة القاهرة Egypt (EG) Amrita University / Amrita Vishwa Vidyapeetham India (IN) Katholieke Universiteit Leuven (KUL) / Catholic University of Leuven Belgium (BE) University of Malaya (UM) / Universiti Malaya Malaysia (MY) University of Queensland Australia (AU) University of the Philippines Manila (UPM) Philippines (PH) Mayo Clinic Hospital United States (USA) (US) Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV) Switzerland (CH) Ospedale Pediatrico Bambino Gesu Italy (IT) Thomas Jefferson University Hospitals United States (USA) (US) University of Calgary Canada (CA) Red Cross War Memorial Children’s Hospital South Africa (ZA) West China Medical Center of Sichuan University / 四川大学华西医学中心 China (CN) University College London (UCL) United Kingdom (GB) Mayo Clinic United States (USA) (US) Federal University of São Paulo / Universidade Federal de São Paulo (UNIFESP) Brazil (BR)

How to cite

APA:

Beniczky, S., Trinka, E., Wirrell, E., Abdulla, F., Al Baradie, R., Alonso Vanegas, M.,... Cross, J.H. (2025). Revidierte Klassifikation epileptischer Anfälle: Positionspapier der Internationalen Liga gegen Epilepsie. Clinical Epileptology. https://doi.org/10.1007/s10309-025-00789-7

MLA:

Beniczky, Sándor, et al. "Revidierte Klassifikation epileptischer Anfälle: Positionspapier der Internationalen Liga gegen Epilepsie." Clinical Epileptology (2025).

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