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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Updated: Jan 15, 2026

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A practical guide to the updated seizure classification 2025.

Sándor Beniczky1,2,3, Eugen Trinka4,5,6, Elaine Wirrell7

  • 1Department of Neurology, Aarhus University Hospital, Member of European Reference Network EpiCARE, Aarhus, Denmark.

Epileptic Disorders : International Epilepsy Journal with Videotape
|October 13, 2025
PubMed
Summary
This summary is machine-generated.

This guide details the 2025 International League Against Epilepsy seizure classification. It improves clarity and consistency in diagnosing focal, generalized, and other seizure types for better epilepsy management.

Keywords:
2025 updateILAEclassificationepilepsyseizure

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Area of Science:

  • Neurology
  • Clinical Neuroscience
  • Epileptology

Background:

  • The 2017 operational classification for epilepsy has been updated by the International League Against Epilepsy (ILAE) in 2025.
  • Existing seizure classification systems require enhancement for improved clinical relevance and consistency.

Purpose of the Study:

  • To provide a practical guide for applying the updated 2025 ILAE seizure classification in diverse clinical settings.
  • To enhance clarity, clinical relevance, and consistency in seizure terminology.
  • To support healthcare professionals in managing patients with epilepsy.

Main Methods:

  • The updated classification categorizes seizures into four main classes: focal, generalized, unknown whether focal or generalized, and unclassified.
  • It incorporates consciousness (awareness and responsiveness) as a classifier.
  • The classification integrates semiology, distinguishing observable from non-observable features, and includes detailed temporal and somatotopic information.

Main Results:

  • A basic version is suitable for resource-limited settings, while an expanded version aids advanced diagnostics and surgical decisions.
  • Generalized seizures are categorized by impact on syndrome diagnosis and treatment.
  • Specific attention is given to epileptic spasms due to their unique presentation and need for urgent intervention.

Conclusions:

  • The updated ILAE classification offers a structured, adaptable approach to seizure diagnosis.
  • Implementation is supported by tables of semiological descriptors, generalized seizure type definitions, and case vignettes.
  • This guide aims to improve patient care by standardizing seizure classification across different healthcare environments.