Applicability and feasibility of the updated ILAE seizure classification in secondary referral centers

This prospective multicenter study aimed to evaluate the applicability and feasibility of the updated International League Against Epilepsy (ILAE) seizure classification (basic version) in secondary referral centers, using information from history-taking and basic investigations (routine or sleep electroencephalography, and computed tomography or magnetic resonance imaging when indicated). The primary outcome was the proportion of patients whose seizures could be classified. Secondary outcomes addressed the new elements introduced in the updated classification: ictal responsiveness and recall (awareness) for classifying the state of consciousness, and the basic seizure descriptors (with vs. without observable manifestations). Data from 458 consecutive patients (152 pediatric) across seven outpatient epilepsy clinics were analyzed. All seizures could be classified according to the basic version of the updated ILAE seizure classification. Information on awareness was available in 396 patients (86.5%) and on responsiveness in 380 (83.0%). In 11 patients (2.4%), the ictal state of consciousness could not be determined. Information on basic seizure descriptors was available for 452 patients (98.7%). These findings indicate that the basic version of the updated ILAE seizure classification is feasible and applicable at secondary referral centers. Moreover, state of consciousness and basic seizure descriptors can be inferred from history in nearly all patients.