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. 2017 Apr;58(4):531-542.
doi: 10.1111/epi.13671. Epub 2017 Mar 8.

Instruction Manual for the ILAE 2017 Operational Classification of Seizure Types

Free article

Instruction Manual for the ILAE 2017 Operational Classification of Seizure Types

Robert S Fisher et al. Epilepsia. .
Free article


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.

Keywords: Classification; Epilepsy (taxonomy); Focal; Generalized; Seizures.

Comment in

  • Response to the numbering of seizure types.
    Fisher RS, Helen Cross J, D'Souza C, French JA, Haut S, Higurashi N, Hirsch E, Jansen FE, Lagae L, Moshe SL, Korey SR, Purpura DP, Peltola J, Roulet Perez E, Scheffer IE, Schulze-Bonhage A, Somerville E, Sperling M, Yacubian EM, Zuberi SM. Fisher RS, et al. Epilepsia. 2017 Jul;58(7):1300-1301. doi: 10.1111/epi.13800. Epilepsia. 2017. PMID: 28677853 No abstract available.
  • The new ILAE seizure classification: 63 seizure types?
    Beniczky S, Rubboli G, Aurlien H, Hirsch LJ, Trinka E, Schomer DL; SCORE consortium. Beniczky S, et al. Epilepsia. 2017 Jul;58(7):1298-1300. doi: 10.1111/epi.13799. Epilepsia. 2017. PMID: 28677857 No abstract available.
  • How Have We Come This Far? Epilepsy Classification Through the Ages.
    Nickels K. Nickels K. Epilepsy Curr. 2017 Jul-Aug;17(4):229-231. doi: 10.5698/1535-7597.17.4.229. Epilepsy Curr. 2017. PMID: 29225528 Free PMC article. No abstract available.

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