Classification of epilepsies and seizures: Historical perspective and future directions

Anne T. Berg*, J. Helen Cross

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


The 1989 Classification of the Epilepsies has recently been abandoned and recommendations for new terminology, concepts, and organizational approaches have been made. Chief among the changes are: (1) generalized and focal, while retained for seizures, were abandoned as obligatory descriptors of epilepsies; (2) instead of idiopathic, symptomatic, and cryptogenic, terms such as genetic, structural-metabolic, and epilepsy of unknown cause were recommended and specifically defined; (3) no specific classification structure was proposed. Instead, epilepsies and information about them should be flexibly organized according to features that are most relevant to a specific purpose. The electroclinical diagnoses themselves remain unchanged. A simple clinically practical approach to use epilepsy syndromes in preliminary diagnosis, evaluation, and management of newly presenting epilepsy was proposed which utilizes guidelines and recommendations from various national and international organizations. For example, children under 2-3. years of age should be evaluated initially by a pediatric epilepsy specialist. Magnetic resonance imaging is an integral part of the early evaluation of anyone with newly presenting seizures, unless certain common and quite specific self-limited and pharmacoresponsive diagnoses can be made (e.g., childhood absence epilepsy). Any patient who fails trials of two or more medications should be evaluated thoroughly at an epilepsy center.

Original languageEnglish (US)
Pages (from-to)99-111
Number of pages13
JournalHandbook of Clinical Neurology
StatePublished - Sep 5 2012

ASJC Scopus subject areas

  • Medicine(all)
  • Neurology
  • Clinical Neurology

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