Validation of the New International League Against Epilepsy 2017 Classification for Determining Seizure Type in Indian Patients

Abstract

Introduction Epilepsy is a common condition in neurology comprising several electroclinical syndromes and seizure disorders of varying known and unknown etiologies that require variable diagnostic workup, treatment, and have obviously different prognoses. Therefore, for appropriate patient management, the best possible classification system for epilepsy is required. The International League Against Epilepsy (ILAE) is continuously working on this with the latest classification provided in 2017. There is little knowledge about seizure type based on newer classification systems in Indian patients.

Aims and Objective To test the applicability of the newer ILAE 2017 classification of epilepsy in determining seizure type in Indian patients, with respect to right patient management, the best classification system for epilepsy is necessary.

Materials and Methods Prospective data of 310 consecutive patients with seizures presenting in neurology department was collected from December 2017 to June 2018 and analyzed according to the newer systems of classification of seizures proposed by ILAE in 2017.

Results All 310 patients in age ranging from one year to 72 years with seizures could be classified according to the ILAE 2017 classification system. Focal onset seizure was noted in 66 patients (21.3%), while 244 patients (78.7%) had generalized onset based on clinical onset of seizure. Awareness was impaired in 262 (84.5%) patients. Motor onset seizure was observed in 278 patients (89.6%), while nonmotor seizure included absence, sensory, cognitive, and autonomic seizures.

Conclusion The present study showed that all patients could be classified using ILAE 2017 classification system. Majority of seizure were generalized onset, predominantly motor type of seizure with impaired awareness using clinical description of classifying seizure, while focal onset seizure was the majority type of seizure when ancillary information was considered.

Keywords

seizures - epilepsy - classifications

Publication History

Article published online:
20 July 2021

• References

• 1 Giourou E, Stavropoulou-Deli A, Giannakopoulou A, Kostopoulos GK, Koutroumanidis M. Introduction to Epilepsy and Related Brain Disorders. Cyberphysical Systems for Epilepsy and Related Brain Disorders. Switzerland: Springer International Publishing 2015
• 2 Amudhan S, Gururaj G, Satishchandra P. Epilepsy in India I: epidemiology and public health. Ann Indian Acad Neurol 2015; 18 (03) 263-277
• 3 Fisher RS, Cross JH, French JA. et al Operational classification of seizure types by the international league against epilepsy: position paper of the ILAE commission for classification and terminology. Epilepsia 2017; 58 (04) 522-530
• 4 Fisher RS, Cross JH, D’Souza C. et al Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia 2017; 58 (04) 531-542
• 5 Scheffer IE, Berkovic S, Capovilla G. et al ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017; 58 (04) 512-521
• 6 Beretta S, Carone D, Zanchi C. et al PRO-LONG Study Group. Long-term applicability of the new ILAE definition of epilepsy. Results from the PRO-LONG study. Epilepsia 2017; 58 (09) 1518-1523
• 7 Uttam AK, Joshi R, Dwivedi R. et al Applicability of the new ILAE classification for epilepsies (2010) in persons with epilepsy at a tertiary care center in India. Epilepsia 2013; 54 (04) 751-756
• 8 Sinha S, Satishchandra P, Mahadevan A, Bhimani BC, Kovur JM, Shankar SK. Fatal status epilepticus: a clinico-pathological analysis among 100 patients: from a developing country perspective. Epilepsy Res 2010; 91 (2-3) 193-204
• 9 Singh G, Bawa J, Chinna D. et al Association between epilepsy and cysticercosis and toxocariasis: a population-based case-control study in a slum in India. Epilepsia 2012; 53 (12) 2203-2208