Classification and Terminology

Task Force On Classification and Terminology  Commission Members

Aims

This task force was created to review the international classification for seizures and for epilepsies, and to recommend changes.

Achievements prior to July 2003

Blume WT, Lüders HO, Mizrahi E, Tassinari C, van Emde Boas W, Engel J Jr. Glossary of descriptive terminology for ictal semiology: Report of the ILAE Task Force on Classification and Terminology. Epilepsia 42:1212-1218, 2001.

Engel J Jr. Classifications of the International League Against Epilepsy: time for reappraisal. Epilepsia 39:1014-1017, 1998.

Engel J Jr. Classification of epileptic disorders. Epilepsia 42:316, 2001.

Engel J Jr. Commentary on: Blume WT, Lüders HO, Mizrahi E, Tassinari C, van Emde Boas W, Engel J Jr. Glossary of descriptive terminology for ictal semiology. Epilepsia 42:1211, 2001.

Engel J Jr. A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: Report of the ILAE Task Force on Classification and Terminology. Epilepsia 42:796-803, 2001.

Engel, J. Jr. Vorschlag für ein diagnostisches Schema für Menschen mit epileptischen Anfällen und Epilepsien. Aktuelle Neurologie 7:305-312, 2001.

Commission Activities July 31, 2003 to June 30, 2004

The core group has met several times and is evaluating the lists of epilepsy seizure types and epilepsy syndromes approved by the General Assembly in Buenos Aires in 2002. Although the group is considering possible alternative systems for classification, emphasis has been on validation of seizure types and epilepsy syndromes and no new classification has yet been proposed. Because the 1981 classification of epileptic seizure types, and the 1989 classification of epilepsy syndromes and epilepsies are generally acceptable and workable, they will not be discarded unless, and until, clearly better classifications have been devised, although an update and periodic modifications to the classifications will be recommended. At this time, however, the Core Group has focused on establishing scientifically rigorous criteria for identification of specific epilepsy seizure types and specific epilepsy syndromes as unique diagnostic entities, and is considering the use of an evidence-based approach.

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

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

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

Fisher RS. Editor’s introduction: Cabbages and kings in the classification of seizures and the epilepsies. Epilepsia 44:1, 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.

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

Upcoming Activities

A final list of seizure types and syndromes will be presented to the ILAE Executive Committee for approval as testable working hypotheses, subject to verification, falsification, and revision. If sufficient evidence subsequently becomes available to falsify any hypothesis, the seizure type or syndrome will be reevaluated and revised or discarded, with Executive Committee approval. The recognition of specific seizure types and syndromes, as well as any changes in the classification of seizure types and syndromes, therefore, will continue to be an ongoing dynamic process.

Jerome Engel, Jr.
Chair