Updated classification of epileptic seizures (2025)

Updated classification of epileptic seizures: Position paper of the International League Against Epilepsy
Beniczky S, Trinka E, Wirrell E, Abdulla F, Al Baradie R, Alonso Vanegas M, et al. Epilepsia. First published: 23 April 2025. DOI: 10.1111/epi.18338
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Translations: German | Spanish | Russian

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Commentaries:
Updating the ILAE seizure classification
Beniczky S, Trinka E, Wirrell E, Specchio N, Cendes F, Helen Cross J. Epilepsia. First published: 23 April 2025. DOI: 10.1111/epi.18399
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Revision der ILAE (International League Against Epilepsy) — Anfallsklassifikation 2025: Ein internationales multisprachliches Unterfangen
Trinka, E., Hamer, H., Rüegg, S. et al. Revision der ILAE(International League Against Epilepsy)-Anfallsklassifikation 2025. Clinical Epileptology. Published: 15 October 2025. DOI: 10.1007/s10309-025-00790-0
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Seminar in epileptology:
A practical guide to the updated seizure classification 2025
Beniczky S, Trinka E, Wirrell E, Singh MB, Blumenfeld H, Bogacz Fressola A, et al. Epileptic Disorders. First published: 13 October 2025. DOI: 10.1002/epd2.70110

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The International League Against Epilepsy (ILAE) has updated the operational classification of epileptic seizures, building upon the framework established in 2017.

The taxonomic hierarchy of epileptic seizure classification 1. Focal (F) 2. Unknown whether focal or generalized (U) 3. Generalized (G) 4. Unclassified Expanded classifications of focal (F) and unknown (U) seizures include semiology descriptors defined and explained in the ILAE glossary. Adapted from Beniczky S., Trinka E., Wirrell E., et al. Updated classification of epileptic seizures: A position paper by the International League Against Epilepsy. Epilepsia. 2025; online ahead of print.

This revision, informed by the implementation experience, involved a working group appointed by the ILAE Executive Committee. Comprising 37 members from all ILAE regions, the group utilized a modified Delphi process, requiring a consensus threshold of more than two thirds for any proposal. Following public comments, 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 four main seizure classes: Focal, Generalized, Unknown (whether focal or generalized), and Unclassified — and it comprises 21 seizure types, in contrast to 63 seizure types in the 2017 classification.

Six key changes were made:

  1. “Onset” is removed from the names of the four main seizure classes.
  2. A distinction is made between classifiers and descriptors. Classifiers reflect biological classes and directly impact clinical management, while descriptors characterize specific features within a seizure type.
  3. “Consciousness” replaces “awareness” as a classifier. Consciousness is operationally defined by both awareness and responsiveness.
  4. The motor vs. non-motor dichotomy is replaced by observable manifestations vs. non-observable manifestations.
  5. Seizures are described by the chronological sequence of signs and symptoms, rather than by relying solely on the first sign.
  6. Epileptic negative myoclonus is recognized as a seizure type.

Seizures in neonates are not included in the updated classification. They are addressed in a separate position paper.