ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology
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Summary: The International League Against Epilepsy ( ILAE ) Classification of the Epilepsies has been updated to reflect our gain in understanding of the epilepsies and their underlying mechanisms following the major scientific advances that have taken place since the last ratified classification in 1989. As a critical tool for the practicing clinician, epilepsy classification must be relevant and dynamic to changes in thinking, yet robust and translatable to all areas of the globe. Its primary purpose is for diagnosis of patients, but it is also critical for epilepsy research, development of antiepileptic therapies, and communication around the world. The new classification originates from a draft document submitted for public comments in 2013, which was revised to incorporate extensive feedback from the international epilepsy community over several rounds of consultation. It presents three levels, starting with seizure type , where it assumes that the patient is having epileptic seizures as defined by the new 2017 ILAE Seizure Classification. After diagnosis of the seizure type , the next step is diagnosis of epilepsy type , including focal epilepsy, generalized epilepsy, combined generalized, and focal epilepsy, and also an unknown epilepsy group. The third level is that of epilepsy syndrome , where a specific syndromic diagnosis can be made. The new classification incorporates etiology along each stage, emphasizing the need to consider etiology at each step of diagnosis, as it often carries significant treatment implications. Etiology is broken into six subgroups, selected because of their potential therapeutic consequences. New terminology is introduced such as developmental and epileptic encephalopathy. The term benign is replaced by the terms self‐limited and pharmacoresponsive, to be used where appropriate. It is hoped that this new framework will assist in improving epilepsy care and research in the 21st century.
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In 2017, the ILAE expanded the concept to a 'developmental and epileptic encephalopathy' owing to a growing recognition that the aetiology, whether genetic, structural or otherwise, often causes developmental impairment in its own right.
“In 2017, the ILAE expanded this concept to a 'developmental and epileptic encephalopathy', owing to a growing recognition that the aetiology, whether genetic, structural or otherwise, often causes developmental impairment in its own right 2 .”
From Developmental and epileptic encephalopathies (2024) · cites this paper as [2]
The ‘Developmental and epileptic encephalopathies’ section (page unavailable) explicitly broadens the term because many severe genetic disorders cause developmental consequences independently of epileptic activity. It also mentions cortical malformations and acquired causes, but does not establish that structural or other aetiologies often cause developmental impairment in their own right. (LLM, conf=0.82)
Experimental — accuracy not yet measuredApproximately 70% of patients with epilepsy can achieve seizure freedom with appropriate antiepileptic drug (AED) therapy.
“While approximately 70% of patients can achieve seizure freedom with appropriate antiepileptic drug (AED) therapy”
From Quality, reliability, and treatment misinformation risk of epilepsy content on Chinese short-video platforms TikTok (Douyin) and Bilibili: a cross-sectional analysis (2026) · cites this paper as [7]
The ‘Self-limited and pharmacoresponsive’ section says that some epilepsy syndromes are likely to be controlled with appropriate antiepileptic therapy. It does not give a 70% figure or extend that likelihood to patients with epilepsy generally (searched: ‘70%’ and ‘seizure freedom’). The indexed passages provide no page numbers. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe remaining 30% of patients have drug-resistant epilepsy requiring consideration of surgical intervention, ketogenic dietary therapy, vagus nerve stimulation, or other neuromodulatory approaches.
“the remaining 30% have drug-resistant epilepsy requiring consideration of surgical intervention, ketogenic dietary therapy, vagus nerve stimulation, or other neuromodulatory approaches6,7”
From Quality, reliability, and treatment misinformation risk of epilepsy content on Chinese short-video platforms TikTok (Douyin) and Bilibili: a cross-sectional analysis (2026) · cites this paper as [7]
In Classification of the Epilepsies > Etiology (page unavailable), the paper says epilepsy surgery should be considered for certain structural epilepsies if medical therapy fails. It does not give the claimed 30% figure or recommend ketogenic therapy, vagus nerve stimulation, or other neuromodulation for that group. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe Treatment Misinformation Risk Scale (TMRS) was developed based on established epilepsy clinical evidence, classification criteria, treatment guidelines, and emerging literature on health misinformation on social media.
“with the scale developed based on established epilepsy clinical evidence, classification criteria, and treatment guidelines3,7,8,31,32 as well as emerging literature on health misinformation on social media”
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- [10]Fisher RS Cross JH French JA Operational classification of seizure types by the International League Against Epilepsy Epilepsia 2017 3 8 10.1111/epi.13671 [Epub ahead of print] 28276060 · DOI
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Self-citationLi, M., Jancovski, N., Jafar-Nejad, P., Burbano, L. E., Rollo, B., Richards, K., Drew, L., Sedo, A., Heighway, J., Pachernegg, S., et al. (2021) · Journal of Clinical Investigation · doi:10.1172/jci152079 · Cited by 115 · see citing works
Preclinical Animal Models for Dravet Syndrome: Seizure Phenotypes, Comorbidities and Drug Screening
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Selective Neuromodulation of the Vagus Nerve
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Epilepsy in time of COVID-19: A survey-based study
Fonseca, E., Quintana, M., Lallana, S., Luis Restrepo, J., Abraira, L., Santamarina, E., Seijo‐Raposo, I., & Toledo, M. (2020) · Acta Neurologica Scandinavica · doi:10.1111/ane.13335 · Cited by 94 · see citing works
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“The definition of epilepsy has undergone some changes, so since 2014, the ILAE has proposed the inclusion of one of the following [4]:”
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Real-life survey of pitfalls and successes of precision medicine in genetic epilepsies
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“…treatment 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…”
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- Authors
- Scheffer, I. E., Berkovic, S., Capovilla, G., Connolly, M. B., French, J., Guilhoto, L., Hirsch, E., Jain, S., Mathern, G. W., Moshé, S. L., Nordli, D. R., Perucca, E., Tomson, T., Wiebe, S., Zhang, Y., & Zuberi, S. M.
- Affiliations
- Royal Children's Hospital (AU)
- The University of Melbourne (AU)
- Azienda Ospedaliera Carlo Poma (IT)
- University of British Columbia (CA)
- NYU Langone Health (US)
- Hospital Universitário da Universidade de São Paulo (BR)
- University Hospital INSERM U 964 Strasbourg France
- Indian Epilepsy Centre New Delhi India
- University of California, Los Angeles (US)
- Albert Einstein College of Medicine (US)
- Children's Hospital Los Angeles (US)
- University of Pavia (IT)
- Karolinska Institutet (SE)
- University of Calgary (CA)
- Peking University First Hospital (CN)
- Royal Hospital for Children (GB)
- Corresponding author
- Scheffer, Ingrid E.
- ORCID
- Venue
- Epilepsia
- Publisher
- Wiley
- Published
- 2017-03-08
- Volume
- 58
- Issue
- 4
- Pages
- 512-521
- ISSN
- 0013-9580 (ISSN-L)
- 1528-1167
- PMC
- PMC5386840
- OpenAlex
- W2592509339
- Cited by
- 5,054
- References
- 60
- Citations by year
- 2026: 450 · 2025: 615 · 2024: 627 · 2023: 612 · 2022: 653 · 2021: 701 · 2020: 582 · 2019: 425 · 2018: 278 · 2017: 97 · 2016: 3 · 2015: 1 · 2014: 1
- FWCI
- 310.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Epilepsia (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Funders
- Universidade Católica de Brasília
- Eisai
- GlaxoSmithKline
- Division of Arctic Sciences
- National Institutes of Health (NS43209, 1U54NS100064‐01, 1‐RO1‐NS43209)
- Humanities Research Center, Rice University
- CURE Childhood Cancer
- U.S. Department of Defense (W81XWH‐13‐1‐0180)
- March of Dimes Foundation
- Novartis
- Canadian Institutes of Health Research
- Lundbeckfonden
- Pfizer
- Vertex Pharmaceuticals
- National Institute of Neurological Disorders and Stroke
- Epilepsy Research UK
- University of California, Los Angeles
- Sanofi
- Takeda Pharmaceuticals U.S.A.
- Fundação Bial
- Stockholms Läns Landsting
- Sunovion
- Yorkhill Children’s Charity
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Life Sciences › Neuroscience › Neurology › Neurology and Historical Studies
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Keywords
- epilepsy classification, seizure types, epilepsy type, epilepsy etiology, developmental and epileptic encephalopathy, self-limited epilepsy, generalized epilepsy, focal epilepsy, epilepsy terminology
- MeSH terms
- Epilepsy, Humans, International Agencies, Terminology as Topic
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