ICNC Abstracts, ICNC 2018

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Comparison of 1981, 1989 and 2017 International League Against Epilepsy classification (ILAE)
David Asish Manchala, Neelu Desai, Payal Shah, Vrajesh Udani

Last modified: 2018-09-09


Introduction:The ILAE introduced the classification of epileptic seizures (Gastaut,1969) which was later modified (Commission,1981). It also proposed a classification of epilepsies and epileptic syndromes (Commission, 1985) which was then revised (Commission,1989) and further after series of reiterations, a new classification  was proposed in 2017.

Methods: Prospective data of 200 children with epilepsy followed up in a tertiary pediatric epilepsy clinic in Mumbai was collected after the ethics approval. The patients were classified and ascertained into their respective categories with the expertise of two senior Pediatric Epileptologists conforming to the operational guidelines given out by the 2017 and 1981/1989 ILAE classification

Results: We were able to classify more seizure types using the 2017 classification (P value < 0.001) in comparison to 1981 classification. Focal seizures became more predominant with increasing age of onset.The 1989 ILAE classifies 89% of epilepsies at the broad syndromic level and 25% at specific syndromic level; whereas the 2017 ILAE classification classifies 93% of cases at epilepsy tier and 32.5% cases at specific Epilepsy syndrome level.

Conclusion/Discussion: We were able to classify more epilepsy syndromes with greater precision using 2017 ILAE at the expense of leaving a large number of epilepsy patients unclassified, which could be classified at a broader level using older classification. The newer classification can categorize more seizure types owing to the introduction of new descriptive terminology. With the introduction of etiology and comorbidities tagged at each level and greater clarity, the 2017 ILAE classification is quite comprehensive.



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