A definition and classification of status epilepticus – Report of the ILAE Task Force on Classification of Status Epilepticus
Abstract
Summary: The Commission on Classification and Terminology and the Commission on Epidemiology of the International League Against Epilepsy (ILAE) have charged a Task Force to revise concepts, definition, and classification of status epilepticus ( SE ). The proposed new definition of SE is as follows: Status epilepticus is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t 1 ). It is a condition, which can have long‐term consequences (after time point t 2 ), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures . This definition is conceptual, with two operational dimensions: the first is the length of the seizure and the time point (t 1 ) beyond which the seizure should be regarded as “continuous seizure activity.” The second time point (t 2 ) is the time of ongoing seizure activity after which there is a risk of long‐term consequences. In the case of convulsive (tonic–clonic) SE , both time points (t 1 at 5 min and t 2 at 30 min) are based on animal experiments and clinical research. This evidence is incomplete, and there is furthermore considerable variation, so these time points should be considered as the best estimates currently available. Data are not yet available for other forms of SE , but as knowledge and understanding increase, time points can be defined for specific forms of SE based on scientific evidence and incorporated into the definition, without changing the underlying concepts. A new diagnostic classification system of SE is proposed, which will provide a framework for clinical diagnosis, investigation, and therapeutic approaches for each patient. There are four axes: (1) semiology; (2) etiology; (3) electroencephalography ( EEG ) correlates; and (4) age. Axis 1 (semiology) lists different forms of SE divided into those with prominent motor systems, those without prominent motor systems, and currently indeterminate conditions (such as acute confusional states with epileptiform EEG patterns). Axis 2 (etiology) is divided into subcategories of known and unknown causes. Axis 3 ( EEG correlates) adopts the latest recommendations by consensus panels to use the following descriptors for the EEG : name of pattern, morphology, location, time‐related features, modulation, and effect of intervention. Finally, axis 4 divides age groups into neonatal, infancy, childhood, adolescent and adulthood, and elderly.
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“…information, with the scale developed based on established epilepsy clinical evidence, classification criteria, and treatment guidelines 3,7,8,31,32 as well as emerging literature on health misinformation on social media, and reviewed by two senior neurologists with specialized expertise…”
- Authors
- Trinka, E., Cock, H., Hesdorffer, D., Rossetti, A. O., Scheffer, I. E., Shinnar, S., Shorvon, S., & Lowenstein, D. H.
- Affiliations
- Paracelsus Medical University (AT)
- St George's Hospital (GB)
- Columbia University (US)
- Centre Hospitalier Universitaire Vaudois (CH)
- Royal Children's Hospital (AU)
- Albert Einstein College of Medicine (US)
- National Hospital for Neurology and Neurosurgery (GB)
- University of California, San Francisco (US)
- Corresponding author
- Trinka, Eugen
- ORCID
- Venue
- Epilepsia
- Publisher
- Wiley
- Published
- 2015-09-04
- Volume
- 56
- Issue
- 10
- Pages
- 1515-1523
- ISSN
- 0013-9580 (ISSN-L)
- 1528-1167
- OpenAlex
- W1856414226
- Cited by
- 2,494
- References
- 40
- Citations by year
- 2026: 250 · 2025: 265 · 2024: 301 · 2023: 265 · 2022: 242 · 2021: 259 · 2020: 225 · 2019: 209 · 2018: 189 · 2017: 174 · 2016: 101 · 2015: 10 · 2014: 1 · 2013: 2
- FWCI
- 21.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Epilepsia (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Funders
- Merck
- Eisai
- Viropharma
- Takeda Pharmaceuticals U.S.A.
- Pfizer
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Keywords
- status epilepticus, seizure termination, prolonged seizures, convulsive status epilepticus, EEG correlates, age groups, neuronal injury
- MeSH terms
- Electroencephalography, Humans, International Cooperation, Status Epilepticus, Time Factors, Advisory Committees, History, 20th Century
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