JLE

Epileptic Disorders

MENU

Applicability and contribution of the new ILAE 2017 classification of epileptic seizures and epilepsies Volume 21, numéro 6, December 2019

TEST YOURSELF

(1) What is gained and what is missing in the reclassification of a seizure described as a forced deviation of the head to the left without disturbance of consciousness, according to the 2017 versus 1981 seizure classification system?

 

(2) Why do the authors state that the application of the 2017 classification would lead to better management regarding diagnostic uncertainty?

 

(3) What is the main consequence of the addition of “structural” as an option among the aetiological categories offered in the 2017 classification of epilepsies?

 

 

 

 

See answers

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Answers

(1) According to the 1981 classification, these are simple partial seizures with motor and versive signs; in the 2017 classification, they would turn to focal aware (motor) tonic seizures. In the new classification, we gain information on the type of movement (tonic), excluding its origin in the primary motor area, for example. On the other hand, we need to add a further description to make sense of it, otherwise we do not know which part of the body is "tonic". In both cases, detailed and sequenced descriptions are needed to maximize the accuracy of the localization hypothesis based on ictal semiology.

 

(2) The new classification of seizures and epilepsies (2017) includes specific boxes for the identification and labelling of seizures of unknown onset (whether focal or generalized), seizures of unknown type or unclassified, epilepsies of unknown type (whether focal or generalized), and epilepsies of any type but with unknown aetiology. Thus, health care providers can more accurately record their thoughts on diagnosis for individual patients, while using a classification system that also allows standardized communication among professionals.

 

(3) Regardless of an underlying tumoral, vascular, traumatic or even genetic aetiology, the addition of the “structural” category may highlight the existence of a focal brain lesion that could be the target of surgical treatment.

 

 

 Back to questions