Beniczky Sándor, Trinka Eugen, Wirrell Elaine, Abdulla Fatema, Al Baradie Raidah, Alonso Vanegas Mario, Auvin Stéphane, Singh Mamta Bhushan, Blumenfeld Hal, Bogacz Fressola Alicia, Caraballo Roberto, Carreno Mar, Cendes Fernando, Charway Augustina, Cook Mark, Craiu Dana, Ezeala-Adikaibe Birinus, Frauscher Birgit, French Jacqueline, Gule M V, Higurashi Norimichi, Ikeda Akio, Jansen Floor E, Jobst Barbara, Kahane Philippe, Kishk Nirmeen, Khoo Ching Soong, Vinayan Kollencheri Puthenveettil, Lagae Lieven, Lim Kheng-Seang, Lizcano Angelica, McGonigal Aileen, Perez-Gosiengfiao Katerina Tanya, Ryvlin Philippe, Specchio Nicola, Sperling Michael R, Stefan Hermann, Tatum William, Tripathi Manjari, Yacubian Elza Márcia, Wiebe Samuel, Wilmshurst Jo, Zhou Dong, Cross J Helen
Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Epilepsia. 2025 Jun;66(6):1804-1823. doi: 10.1111/epi.18338. Epub 2025 Apr 23.
The International League Against Epilepsy (ILAE) has updated the operational classification of epileptic seizures, building upon the framework established in 2017. This revision, informed by the implementation experience, involved a working group appointed by the ILAE Executive Committee. Comprising 37 members from all ILAE regions, the group utilized a modified Delphi process, requiring a consensus threshold of more than two thirds for any proposal. Following public comments, the Executive Committee appointed seven additional experts to the revision task force to address and incorporate the issues raised, as appropriate. The updated classification maintains four main seizure classes: Focal, Generalized, Unknown (whether focal or generalized), and Unclassified. Taxonomic rules distinguish classifiers, which are considered to reflect biological classes and directly impact clinical management, from descriptors, which indicate other important seizure characteristics. Focal seizures and those of unknown origin are further classified by the patient's state of consciousness (impaired or preserved) during the seizure, defined operationally through clinical assessment of awareness and responsiveness. If the state of consciousness is undetermined, the seizure is classified under the parent term, that is, the main seizure class (focal seizure or seizure of unknown origin). Generalized seizures are grouped into absence seizures, generalized tonic-clonic seizures, and other generalized seizures, now including recognition of negative myoclonus as a seizure type. Seizures are described in the basic version as with or without observable manifestations, whereas an expanded version utilizes the chronological sequence of seizure semiology. This updated classification comprises four main classes and 21 seizure types. Special emphasis was placed on ensuring translatability into languages beyond English. Its aim is to establish a common language for all health care professionals involved in epilepsy care, from resource-limited areas to highly specialized centers, and to provide accessible terms for patients and caregivers.
国际抗癫痫联盟（ILAE）在2017年建立的框架基础上，更新了癫痫发作的操作性分类。此次修订参考了实施经验，由ILAE执行委员会任命的一个工作组进行。该小组由来自ILAE所有地区的37名成员组成，采用了改良的德尔菲法，任何提案需达到三分之二以上的共识阈值。在收到公众意见后，执行委员会又任命了七名专家加入修订特别工作组，以酌情处理和纳入所提出的问题。更新后的分类保留了四个主要发作类别：局灶性、全身性、不明（局灶性或全身性）和未分类。分类规则区分了分类器和描述符，分类器被认为反映生物学类别并直接影响临床管理，描述符则表明其他重要的发作特征。局灶性发作和不明起源的发作根据发作期间患者的意识状态（受损或保留）进一步分类，通过对意识和反应性的临床评估进行操作性定义。如果意识状态不确定，则发作归类于上级术语，即主要发作类别（局灶性发作或不明起源的发作）。全身性发作分为失神发作、全身强直阵挛发作和其他全身性发作，现在将负性肌阵挛确认为一种发作类型。在基本版本中，发作描述为有无可观察到的表现，而扩展版本则利用发作症状学的时间顺序。这个更新后的分类包括四个主要类别和21种发作类型。特别强调确保能够翻译成英语以外的语言。其目的是为所有参与癫痫护理的医疗保健专业人员建立一种通用语言，从资源有限地区到高度专业化的中心，并为患者和护理人员提供易懂的术语。
