New Epilepsy Nomenclature-_10 points

What has changed in terminology for seizure and epilepsy as per International League against epilepsy (ILAE)?

1. Partial seizures are now called as focal seizures
2. The terms like simple partial seizure and complex partial seizure are no longer used. We use focal seizure with preserved awareness or focal seizure with impaired awareness.  
3. Partial seizure with secondary generalization is better described as focal seizure evolving to bilateral convulsive seizure.
4. Seizures can be focal, generalized, unknown onset or unclassified onset. We call it unclassified when the seizure was not witnessed or it is not clear whether the onset was focal or not.
5. Seizures like epileptic spasm, tonic, clonic seizures can be focal as well as generalized
6. Etiology can be genetic, structural or  unknown etiology instead of idiopathic, symptomatic or cryptogenic
7. New seizure types that are now included in the classification include absence with eyelid myoclonia, myoclonic atonic, behavioural arrest, emotional
8. Seizures types that are not used anymore include dyscognitive or psychic seizures type
9. The term “benign” as in “benign rolandic epilepsy” is replaced with “self-limiting” or “pharmacoresponsive”.
10. The term “catastrophic” is no longer used to depict drug resistant epilepsy as in children with west syndrome, Lennox Gestaut syndrome

 Visit website of ILAE at URL: https://www.ilae.org/guidelines/definition-and-classification for further details

References

1. Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE Classification of the Epilepsies: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58:512–21.
2. Fisher RS, Cross JH, French JA, Higurashi N, Hirsch E, Jansen FE, et al. Operational Classification of Seizure Types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58:522–530
3. Fisher RS, Cross JH, Souza CD, Higurashi N, Hirsch E, Jansen FE, et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia. 2017;58:531-42.
4. Brodie MJ, Zuberi SM, Scheffer IE, Fisher RS. The 2017 ILAE classification of seizure types and the epilepsies: what do people with epilepsy and their caregivers need to know? Epileptic Disord. 2018;20:77-87

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