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Classification and Terminology

Task Force On Classification and Terminology  Commission Members

Jerome Engel, Jr., Chair, Los Angeles, California, USA
Warren Blume, London, Ontario, Canada, Chair, Working Group on Glossary of Descriptive Ictal Terminology

Peter Williamson, Lebanon, New Hampshire, USA, Chair, Working Group on Seizures
Natalio Fejerman, Buenos Aires, Argentina, Chair, Working Group on Syndromes and Diseases
John Chaplin, Lund, Sweden, Chair, Working Group on Impairment
Jean Aicardi - Paris, France
Frederick Andermann - Montreal, Quebec, Canada
Alexis Arzimanoglou - Paris, France
Giuliano Avanzini - Milan, Italy
Anne Berg - DeKalb, Illinois, USA
Samuel Berkovic - Melbourne, Australia
Carol Camfield - Halifax, Nova Scotia, Canada
Bernardo Dalla Bernardina - Verona, Italy
Charlotte Dravet - Marseille, France
Francois Dubeau - Montreal, Quebec, Canada
Olivier Dulac - Paris, France
Orvar Eeg-Olofsson - Uppsala, Sweden
Robert Fraser - Seattle, Washington, USA
Renzo Guerrini - Pisa, Italy
Allen Hauser - New York, New York, USA
Matilde Leonardi - Geneva, Switzerland
Hans Lüders - Cleveland, Ohio, USA
Eli M. Mizrahi - Houston, Texas, USA
Jeffrey Noebels - Houston, Texas, USA
Perrine Plouin - Paris, France
Marieke Reuvekamp-Thuss - Groningen, Netherlands
Masakazu Seino - Shizuoka, Japan
Carlo Alberto Tassinari - Bologna, Italy
Rupprecht Thorbecke - Bielefeld, Germany
David Treiman - Phoenix, Arizona, USA
Walter van Emde Boas - Heemstede, Netherlands
Federico Vigevano - Rome, Italy
Heinz-Gregor Wieser - Zürich, Switzerland
Peter Wolf - Bielefeld, Germany
Benjamin Zifkin - Montreal, Quebec, Canada

Summary of Activities for 2002-2003

Following the commission report published in Epilepsia in 2001 proposing a diagnostic scheme for people with epileptic seizures and with epilepsy, and the approval of this report by the General Assembly in Buenos Aires, the Task Force has held several open meetings at various regional and national epilepsy conferences to discuss these concepts with our general membership. At the annual meeting of the American Epilepsy Society in Seattle, December 2002, Frederick Andermann and Peter Wolf debated whether there should continue to be three syndromes of juvenile myoclonic epilepsy, juvenile absence epilepsy, and epilepsy with generalized tonic clonic seizures only, or whether these should be combined into a single syndrome of generalized juvenile idiopathic epilepsy. A more formalized discussion of this issue will be published soon in Epilepsia. Questionnaires continue to come in commenting on this proposal and the material is included on our Website www.epilepsy.org/ctf.
The 2001 proposal was for a diagnostic scheme, and not for a new classification.

Consequently, the 1981 epileptic seizure classification and the 1989 epilepsy syndrome classification remain current. The Task Force has been actively discussing, at meetings and by email, the appropriateness of the list of epileptic seizure types and epilepsy syndromes included in the 2001 proposal, and how these seizure types and syndromes might be organised into one or more classifications. The debate was formalized with a series of articles published in Epilepsia intended to publicize the issues related to construction of a new classification.

Fisher, RF. Editor's introduction: Cabbages and kings in the classification of seizures and the epilepsies. Epilepsia 44:1, 2003.

Wolf P. Of cabbages and kings: Some considerations on classifications, diagnostic schemes, semiology, and concepts. Epilepsia 44:1-4, 2003.

Engel, J Jr. Reply to Of cabbages and kings: Some considerations on classifications, diagnostic schemes, semiology, and concepts. Epilepsia 44:4-6, 2003.

Lüders H, Najm I, Wyllie E. Reply to Of cabbages and kings: Some considerations on classifications, diagnostic schemes, semiology, and concepts. Epilepsia 44:6-8, 2003.

Berg AT, Blackstone NW. Of cabbages and kings: Perspectives on classification from the field of systematics. Epilepsia 44:8-12, 2003.

Avanzini G. Of cabbages and kings: Do we really need a systematic classification of epilepsies? Epilepsia 44:12-13, 2003.

Anne Berg was added to the task force because of her expertise in the concepts of biological classifications, and with her help, a meeting of Core Task Force members to discuss strategy for creating the new classification concepts was organised and will be held in Los Angeles in August 2003.

Natalio Fejerman instigated a collaborative effort with the Commission on Genetics to create a list of genetic defects associated with the idiopathic epilepsies. Ruth Ottman has represented the Commission on Genetics in this effort, and an extensive table has been constructed, which is currently being reviewed by members of both committees before submission to the Executive Committee for their approval to publish it in Epilepsia.

John Chaplin has replaced Harry Meinardi as chair of the Working Group on Impairment, which met in Holland in July 2002 to begin work for the 2002-2003 fiscal year. Their strategy for adapting the International Classification of Functioning and Disability (ICIDH-2) of the World Health Organisation for epilepsy consists of developing a subset of ICF codes relevant to epilepsy; a method to judge the impact of seizures on ICF domains based on severity, duration, and predictability; and a means to include an "episodic" modifier to the ICF coding. The intention is to eventually create this into an epilepsy-specific ICIDH booklet.

Date: 20 August 2003
Report by: Jerome Engel, Jr., Chair

 
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