ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology.
ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology.
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DOI：
10.1111/epi.13709
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发表时间：
2017-04
期刊：
影响因子：
5.6
通讯作者：
Zuberi SM
中科院分区：
文献类型：
--
作者：
Scheffer IE;Berkovic S;Capovilla G;Connolly MB;French J;Guilhoto L;Hirsch E;Jain S;Mathern GW;Moshé SL;Nordli DR;Perucca E;Tomson T;Wiebe S;Zhang YH;Zuberi SM
ILAE的癫痫分类已经更新，以反映我们对癫痫及其潜在机制的理解，这是自1989年最后一次批准分类以来取得的重大科学进展。作为执业临床医生的一项重要工具，癫痫分类必须与思维的变化相关且动态，但必须稳健并可转化为全球所有地区。它的主要目的是对患者进行诊断，但它对癫痫研究、抗癫痫疗法的开发以及世界各地的交流也至关重要。新的分类源自2013年提交的一份征求公众意见的文件草案，该文件经过修订，纳入了国际癫痫界在几轮磋商中获得的广泛反馈。它呈现三个级别，从癫痫类型开始，它假设患者患有新的2017年ILAE癫痫发作分类定义的癫痫发作。在诊断出癫痫类型后，下一步是癫痫类型的诊断，包括局灶性癫痫、全面性癫痫、全面性和局灶性癫痫合并，以及未知的癫痫组。第三个层次是癫痫综合征，可以作出具体的综合征诊断。新的分类纳入了每个阶段的病因学，强调在诊断的每个步骤都需要考虑病因学，因为它通常具有重要的治疗意义。病因学分为六个亚组，因为它们的潜在治疗效果而被选择。介绍了发展性脑病和癫痫性脑病等新术语。“良性”一词由“自我限制”和“药物反应性”两词代替，将在适当情况下使用。希望这一新的框架将有助于改善21世纪的癫痫护理和研究。
The ILAE Classification of the Epilepsies has been updated to reflect our gain in understanding of the epilepsies and their underlying mechanisms following the major scientific advances which have taken place since the last ratified classification in 1989. As a critical tool for the practising clinician, epilepsy classification must be relevant and dynamic to changes in thinking, yet robust and translatable to all areas of the globe. Its primary purpose is for diagnosis of patients, but it is also critical for epilepsy research, development of antiepileptic therapies and communication around the world. The new classification originates from a draft document submitted for public comments in 2013 which was revised to incorporate extensive feedback from the international epilepsy community over several rounds of consultation. It presents three levels, starting with seizure type where it assumes that the patient is having epileptic seizures as defined by the new 2017 ILAE Seizure Classification. After diagnosis of the seizure type, the next step is diagnosis of epilepsy type, including focal epilepsy, generalized epilepsy, combined generalized and focal epilepsy, and also an unknown epilepsy group. The third level is that of epilepsy syndrome where a specific syndromic diagnosis can be made. The new classification incorporates etiology along each stage, emphasizing the need to consider etiology at each step of diagnosis as it often carries significant treatment implications. Etiology is broken into six subgroups, selected because of their potential therapeutic consequences. New terminology is introduced such as developmental and epileptic encephalopathy. The term benign is replaced by the terms self-limited and pharmacoresponsive, to be used where appropriate. It is hoped that this new framework will assist in improving epilepsy care and research in the 21st century.