Instruction manual for the ILAE 2017 operational classification of seizure types

Robert S. Fisher, J. Helen Cross, Carol D'Souza, Jacqueline A. French, Sheryl R. Haut, Norimichi Higurashi, Edouard Hirsch, Floor E. Jansen, Lieven Lagae, Solomon L. Moshe, Jukka Peltola, Eliane Roulet Perez, Ingrid E. Scheffer, Andreas Schulze-Bonhage, Ernest Somerville, Michael Sperling, Elza Márcia Yacubian, Sameer M. Zuberi

Research output: Contribution to journalArticle

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Abstract

This companion paper to the introduction of the International League Against Epilepsy (ILAE) 2017 classification of seizure types provides guidance on how to employ the classification. Illustration of the classification is enacted by tables, a glossary of relevant terms, mapping of old to new terms, suggested abbreviations, and examples. Basic and extended versions of the classification are available, depending on the desired degree of detail. Key signs and symptoms of seizures (semiology) are used as a basis for categories of seizures that are focal or generalized from onset or with unknown onset. Any focal seizure can further be optionally characterized by whether awareness is retained or impaired. Impaired awareness during any segment of the seizure renders it a focal impaired awareness seizure. Focal seizures are further optionally characterized by motor onset signs and symptoms: atonic, automatisms, clonic, epileptic spasms, or hyperkinetic, myoclonic, or tonic activity. Nonmotor-onset seizures can manifest as autonomic, behavior arrest, cognitive, emotional, or sensory dysfunction. The earliest prominent manifestation defines the seizure type, which might then progress to other signs and symptoms. Focal seizures can become bilateral tonic–clonic. Generalized seizures engage bilateral networks from onset. Generalized motor seizure characteristics comprise atonic, clonic, epileptic spasms, myoclonic, myoclonic–atonic, myoclonic–tonic–clonic, tonic, or tonic–clonic. Nonmotor (absence) seizures are typical or atypical, or seizures that present prominent myoclonic activity or eyelid myoclonia. Seizures of unknown onset may have features that can still be classified as motor, nonmotor, tonic–clonic, epileptic spasms, or behavior arrest. This “users’ manual” for the ILAE 2017 seizure classification will assist the adoption of the new system.

Original languageEnglish (US)
Pages (from-to)531-542
Number of pages12
JournalEpilepsia
Volume58
Issue number4
DOIs
StatePublished - Apr 1 2017

Fingerprint

Epilepsy
Seizures
Spasm
Signs and Symptoms
Automatism
Absence Epilepsy
Eyelids

Keywords

  • Classification
  • Epilepsy (taxonomy)
  • Focal
  • Generalized
  • Seizures

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Fisher, R. S., Cross, J. H., D'Souza, C., French, J. A., Haut, S. R., Higurashi, N., ... Zuberi, S. M. (2017). Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia, 58(4), 531-542. https://doi.org/10.1111/epi.13671

Instruction manual for the ILAE 2017 operational classification of seizure types. / Fisher, Robert S.; Cross, J. Helen; D'Souza, Carol; French, Jacqueline A.; Haut, Sheryl R.; Higurashi, Norimichi; Hirsch, Edouard; Jansen, Floor E.; Lagae, Lieven; Moshe, Solomon L.; Peltola, Jukka; Roulet Perez, Eliane; Scheffer, Ingrid E.; Schulze-Bonhage, Andreas; Somerville, Ernest; Sperling, Michael; Yacubian, Elza Márcia; Zuberi, Sameer M.

In: Epilepsia, Vol. 58, No. 4, 01.04.2017, p. 531-542.

Research output: Contribution to journalArticle

Fisher, RS, Cross, JH, D'Souza, C, French, JA, Haut, SR, Higurashi, N, Hirsch, E, Jansen, FE, Lagae, L, Moshe, SL, Peltola, J, Roulet Perez, E, Scheffer, IE, Schulze-Bonhage, A, Somerville, E, Sperling, M, Yacubian, EM & Zuberi, SM 2017, 'Instruction manual for the ILAE 2017 operational classification of seizure types', Epilepsia, vol. 58, no. 4, pp. 531-542. https://doi.org/10.1111/epi.13671
Fisher RS, Cross JH, D'Souza C, French JA, Haut SR, Higurashi N et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia. 2017 Apr 1;58(4):531-542. https://doi.org/10.1111/epi.13671
Fisher, Robert S. ; Cross, J. Helen ; D'Souza, Carol ; French, Jacqueline A. ; Haut, Sheryl R. ; Higurashi, Norimichi ; Hirsch, Edouard ; Jansen, Floor E. ; Lagae, Lieven ; Moshe, Solomon L. ; Peltola, Jukka ; Roulet Perez, Eliane ; Scheffer, Ingrid E. ; Schulze-Bonhage, Andreas ; Somerville, Ernest ; Sperling, Michael ; Yacubian, Elza Márcia ; Zuberi, Sameer M. / Instruction manual for the ILAE 2017 operational classification of seizure types. In: Epilepsia. 2017 ; Vol. 58, No. 4. pp. 531-542.
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