ILAE 2025 Classification of Epileptic Seizures: Key Revisions and Implications for Clinical Practice.

The International League Against Epilepsy (ILAE) published an updated epileptic seizure classification in April 2025. While the core framework of the 2017 version is retained, the revised classification introduces six main changes aimed at improving clarity for clinical practice. The term "onset" is removed from the names of main seizure classes. The word "awareness" is now replaced with "consciousness" as a classifier, which is now defined by both awareness and responsiveness. The term "motor" seizures have been replaced with seizures with "observable" features to better reflect what can be witnessed during a seizure. The chronological sequence of seizure semiology is given more importance, rather than just relying on the first-noticed symptomatology. The update also recognizes epileptic negative myoclonus as a new seizure type. Epileptic spasms are now used as a descriptor in focal and unknown seizures, and retained as a seizure type for generalized seizures. This article aims to summarize the key changes and new recommendations for pediatricians.