Updated classification characteristics of seizures and epilepsy

A.S. Kotov, K.V. Firsov

Moscow Regional Clinical Research Institute named after M.F. Vladimirsky, Moscow

At present, the main classifications in Epileptology are ICD-10 and ILAE 2017. The ICD-10 does not meet the general scientific requirements for classification of epilepsy. This is due to several reasons: there is an intersection of concepts; the sum of the classification parts does not equal the generic concept volume; division into subclasses is not continuous; there are no classification bases, instead of which the non-operational terms «other», «special», «specified», «unspecified» are introduced. For a doctor, classification should be primarily practical. He should receive specific algorithms for diagnosis and treatment by using it. For a practitioner, it is necessary to classify epileptic seizures, forms of epilepsy, and epileptic syndromes. In turn, various specific grounds are highlighted in them, such as etiology, localization, and pathways of pathologic al activity. It leads to the establishment of detailed diagnosis, based on which the treatment algorithm is built. In some approximation, ILAE classification of 2017 is built on this principle. This classification of epilepsy is three-level (seizures type, epilepsy type, epileptic syndrome). The ideal way is to make a diagnosis at all levels and determine the etiology of epilepsy. Existing ILAE classifications are the result of a compromise obtained from various scientific and practical vectors. They do not meet the classical requirements for classification, but at the moment of Epileptology development, give the medical practitioner space to manoeuvre, and sometimes retreat.

Keywords: epilepsy, seizure, classification, terminology, ILAE 2017, ICD-10, syndrome, diagnosis, convulsions.

For citation: Kotov A.S., Firsov K.V. Updated classification characteristics of seizures and epilepsy. RMJ. 2020;8:5–7.