| Anne T Berg, Chair
Jerome Engel, Jr
| Perrine Plouin
|| Ingrid Scheffer
| Walter Van Emde Boas
This Taskforce was created to review the international classification for seizures and for epilepsies, and to recommend changes.
Commission Activities January 2006 through July 2007
The Commission members met at the Annual AES Meeting in San Diego, CA 5 December 2006.
I. Two main goals were discussed:
(1) Articulating explicit criteria and processes for developing a proposal concerning a syndrome, syndromic variant, or seizure type and methods for testing that proposal;
(2) Developing a new approach to organizing syndromes that better reflects our understanding of their causes, underlying mechanisms, presentation, prognosis, and so on.
A preliminary outline of the first goal will be presented at the parallel session on classification by Anne Berg at the Singapore International Epilepsy Congress. This will explicitly lay out the individual steps involved from initial observation to developing testable hypotheses regarding determinants of variation and their relative importance with respect to making syndrome or seizure-level distinctions.
A document has been circulating regarding the second goal and Commission members have been asked to provide input. The approach being contemplated reflects the components of classification articulated in the 2006 Task Force report (Engel, Epilepsia 2006) and will implement a suggestion made by Warren Blume regarding a multi-dimensional classification that can simultaneously reflect aspects of seizures and syndromes relevant to both scientific investigation and clinical management. The approach will also acknowledge gaps in knowledge and hence areas in need of further investigation. Once we reach a provisional final version, the intent is to enlist members of the epilepsy community to aid in completing information for individual seizures and syndromes, seek further input from others, and revise as further needed.
II. The MedLink, (an electronic medical textbook) contract has come to an end. Pete Engel has very kindly shouldered the task of recruiting authors to update chapters for a last time. As the relationship with MedLink is now terminated, syndrome and seizure updates on the ILAE Web site will no longer be MedLink chapters but stand-alone contributions to the Web site. The Executive Committee requested that Anne Berg develop a proposal for a format for future contributions to the ILAE Web site. That was submitted to the Executive Committee in March 2007.
III. A group affiliated with the US Centers for Disease Control is preparing a set of guidelines, definitions, and standards for epidemiologic studies of epilepsy with the intent that they be useful to investigators working in diverse settings across the world. David Thurman from the CDC is the chair of that committee. The committee met regularly by phone and then for a two-day meeting in Atlanta in May 2007. That committee would like to liaise with the ILAE and have its document reviewed and, it is hoped, ultimately endorsed by the ILAE. This possibility was discussed by Anne Berg with Nico Moshé and Peter Wolf in San Diego, and it was agreed that the CDC group could work through the Commission on Classification and Terminology. In the context of that work, a new organization for etiologies of epilepsy has been developed which should be of use for the Commission’s developing organization for syndromes. The etiologic classification has been sent to Commission members for comments which have been incorporated and shared with the CDC committee.
IV. The ILAE International Classification of Function Working Group chaired by John Chaplin submitted a report for consideration and ultimately posting on the ILAE Web site. At this point, the report is in the form of a checklist. This was considered of potentially important utility, but the document needed to be developed into more of a report format. Dr Chaplin was asked to revise the document accordingly. We have not heard back from him to date (last e-mailed June 2007).
V. The Commission will be meeting at the 2007 IEC meeting in Singapore. Specific plans are to flesh out the new organizational scheme for syndromes and seizures and to further articulate the preliminary proposal for establishing explicit and coherent criteria and processes for developing new proposals regarding seizures and syndromes types. In addition, we will discuss plans for a session at the 2008 AES Annual Meeting in Seattle or the IEC meeting in Budapest and begin development of a proposal to submit to the conference organizers. In addition, an issue regarding nomenclature for one of the idiopathic localization-related syndromes will be considered.
Anne T. Berg
Chair, Commission on
Classification and Technology