Experience with the International League Against Epilepsy Proposals for Classification of Epileptic Seizures and the Epilepsies and Epileptic Syndromes in a Pediatric Outpatient Epilepsy Clinic

Eslava-Cobos, Jorge; Nariño, Daniel

doi:10.1111/j.1528-1157.1989.tb05291.x

Cited by 182 publications

(24 citation statements)

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“…Many of the patients included in such studies performed thus far have epilepsies which have been presumed to be symptomatic, although, frequently, no exact cause has been identified. The ICEES can be successfully applied in studies in developing countries, as several authors have shown [11, 15, 18, 21, 22], but whether the high classifiable proportions have amounted to clinically or epidemiologically useful information is debatable. A less detailed epilepsy classification based upon risk factors for epilepsy would surely be preferable for such studies [6].…”

Section: Use Of the Icees In Population-based Studies Of Epilepsymentioning

confidence: 99%

“…Some studies relying on EEG departments for case ascertainment [10, 20]may have underrepresented or even excluded patients in whom EEG was considered inappropriate or technically difficult (e.g., the elderly or patients with severe learning difficulty) or those with seizures associated with an important co-existent pathology (e.g., stroke, brain tumour). Clearly, the reason that so many of these studies have been performed in hospital settings [11, 12, 14, 15, 16, 18, 19, 21, 22, 23, 24, 25, 26]is that this environment confers better access to those investigations facilitating successful classification, hence reducing the proportion with cryptogenic or unclassifiable epilepsies. Additionally, many of these studies have been retrospective in design, resulting in incomplete case ascertainment and data collection and a large interpatient variation in the extent of investigation [27].…”

Section: Use Of the Icees In Population-based Studies Of Epilepsymentioning

confidence: 99%

“…Studies in developing countries have consistently found higher proportions of localization-related (50–75%) than generalized syndromes (20–25%) [11, 15, 18, 21, 22], whereas those from developed countries have yielded more equivalent proportions, occasionally with a slight excess of localization-related syndromes [10, 12, 16, 17, 23, 26]. The most commonly reported explanation for this trend [11, 18, 22, 31, 32, 33]has been the higher prevalence of perinatal cerebral hypoxia, CNS infection, and parasitic infection in the developing world, all of which are more likely to lead to localization-related epilepsies.…”

Section: Use Of the Icees In Population-based Studies Of Epilepsymentioning

confidence: 99%

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Classification of the Epilepsies: Time for a Change?

Everitt

Sander²

1999

Eur Neurol

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The Commission on Classification and Terminology of the International League against Epilepsy (ILAE) first devised a comprehensive classification for the epilepsies and epileptic syndromes nearly 30 years ago. Despite subsequent revisions, the classification remains too complicated to be of utility in clinical practice and epidemiological research. Recent developments in neuro-imaging and neurogenetics have also contributed to the limited usefulness of the current International Classification of the Epilepsies and Epileptic Syndromes (ICEES). This review examines the evolution, advantages, and notable disadvantages of the ICEES and assesses its previous application in several population-based studies of epilepsy. The important need for a new, simplified, and aetiologically orientated classification which is amenable to use outside of the tertiary epilepsy centre is discussed.

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Section: Use Of the Icees In Population-based Studies Of Epilepsymentioning

confidence: 99%

Section: Use Of the Icees In Population-based Studies Of Epilepsymentioning

confidence: 99%

Section: Use Of the Icees In Population-based Studies Of Epilepsymentioning

confidence: 99%

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Classification of the Epilepsies: Time for a Change?

Everitt

Sander²

1999

Eur Neurol

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“…In the absence of other underlying structural lesions or metabolic anomalies, the International Classification of Epilepsies and Epileptic Syndromes, approved in 1989 by the International League Against Epilepsy, distinguished between idiopathic and cryptogenic epilepsy [Eslava-Cobos and Nariño, 1989]. Within idiopathic epilepsies, the idiopathic generalized epilepsies are characterized by recurrent unprovoked generalized seizures with synchronous alterations detected by EEG, encompassing ∼ 30% of all epilepsies .…”

mentioning

confidence: 99%

Deletion 18p11.32p11.31 in a Child with Global Developmental Delay and Atypical, Drug-Resistant Absence Seizures

Verrotti

Palka

Prezioso

et al. 2015

Cytogenet Genome Res

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We report the first case of an 18p11.32 deletion, detected by array CGH, associated with a drug-resistant form of atypical absence epilepsy, global developmental delay and no signs of holoprosencephaly (HPE). In particular, this region encompasses 19 genes, and none of these genes have been strictly associated with epilepsy. Among these, TGIF1 is expressed in the fetal and adult nervous system, and its deletion has been related to central nervous system diseases. TGIF1 deletions have previously been reported in patients with a comparable phenotype as seen in our case and in children whose neurological signs and symptoms were considerable, but not epileptiform. Mutations and deletions involving the TGIF1 gene have been described in patients with HPE in an autosomal dominant model of inheritance. However, TGIF1 mutations have also been reported in normal individuals and in patients with mental retardation or showing a very mild phenotype, suggesting the characteristic of incomplete penetrance and variable expressivity. Therefore, a TGIF1 deletion may not be always related to HPE, and it may have a link to the development of epilepsy.

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“…The clinical application of ICEES had been tested by many investigators (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), and a majority of them approved its usefulness by demonstrating that they could classify almost all of their patients into the diagnostic categories of ICEES. Berg et al (13) also reported a good interrater agreement.…”

mentioning

confidence: 99%

Syndromic Diagnosis at the Epilepsy Clinic: Role of MRI in Lobar Epilepsies

Lee¹,

Heo²,

Kim

et al. 2002

Epilepsia

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Summary:Purpose: Magnetic resonance imaging (MRI) is an essential diagnostic tool for the management of epilepsy at modern epilepsy clinics. This study was conducted to incorporate MRI features into the international classification of epilepsies and epilepsy syndromes (ICEES) proposed by the International League Against Epilepsy (ILAE).Methods: Three hundred consecutive patients newly registered in the Yonsei Epilepsy Clinic underwent stepwise classifications based on clinical features, clinical EEG, and clinical EEG-MRI correlations. The patients were required to have epilepsy and have undergone both EEG and MRI for inclusion in the study. Interictal epileptiform discharges (IEDs) in the EEG were divided into lobar, multilobar, and generalized. MRI lesions were divided into lobar and multilobar lesions. Lobar epilepsies (LEs) were divided into temporal, frontal, parietal, occipital, rolandic, temporoparietooccipital junctional, multilobar, and nonlocalized LEs.Results: Two hundred forty-nine patients satisfied the inclusion criteria. In the first-step diagnosis, 190 patients were classified as having localization-related epilepsy; 24 patients, generalized epilepsy; 34 patients, undetermined epilepsy; and one patient, a special syndrome. EEG revealed IEDs in 124 (50%) patients, and the second-step diagnosis changed the diagnostic categories of 79 (32%) patients. MRI detected lesions in 106 (43%) patients, and the third-step diagnosis changed the diagnostic categories of 30 (12%) patients. The nonspecific diagnostic categories of ICEES decreased from 49% to 37% and then to 29%, as diagnosis progressed from steps one to three. In cases of LE, MRI was superior to EEG in its clinical correlation. Additionally, the diagnostic precision in temporal lobe epilepsy was far better than that for other LEs.Conclusions: The impact of MRI on ICEES was only modest in terms of changing diagnostic categories, although MRI provided a structural substrate for epilepsy in 38% of patients with negative EEGs. In LE, MRI was as sensitive as EEG, and its clinical correlation was superior to that of EEG, which strongly supports the rationale of incorporating MRI into ICEES.

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Experience with the International League Against Epilepsy Proposals for Classification of Epileptic Seizures and the Epilepsies and Epileptic Syndromes in a Pediatric Outpatient Epilepsy Clinic

Cited by 182 publications

References 13 publications

Classification of the Epilepsies: Time for a Change?

Classification of the Epilepsies: Time for a Change?

Deletion 18p11.32p11.31 in a Child with Global Developmental Delay and Atypical, Drug-Resistant Absence Seizures

Syndromic Diagnosis at the Epilepsy Clinic: Role of MRI in Lobar Epilepsies

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