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Related Concept Videos

Epilepsy ll: Types01:22

Epilepsy ll: Types

Recurrent seizures, stemming from abnormal electrical activity in the brain, are the defining characteristic of epilepsy, a chronic neurological condition. Because seizure features vary greatly, epilepsy is classified using two systems: by seizure type and by epilepsy syndromes. These classifications enable clinicians to describe seizure patterns and select suitable treatment strategies.I. Classification by Seizure Type1. Focal EpilepsyFocal epilepsy begins in one hemisphere of the brain.
Seizures: Classification01:13

Seizures: Classification

Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:

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Comparing normative and ipsative methods of IC-CoDE phenotype classification in frontal lobe epilepsy.

Sofia Lesica1, Kayela Arrotta2, Nicolas R Thompson3

  • 1Department of Neurology and Epilepsy Center Neurological Institute, Cleveland Clinic, Cleveland, OH, United States.

Epilepsy & Behavior : E&B
|May 28, 2026
PubMed
Summary

Classifying cognitive phenotypes in frontal lobe epilepsy (FLE) differs between normative and ipsative methods. The normative approach identifies more impairment, especially in those with lower education, while the ipsative method may better suit highly educated individuals.

Keywords:
Cognitive impairmentCognitive phenotypeFrontal lobe epilepsyIC-CoDEPremorbid functioning

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Area of Science:

  • Neuroscience
  • Epilepsy Research
  • Cognitive Assessment

Background:

  • Frontal lobe epilepsy (FLE) significantly impacts cognitive function.
  • Accurate classification of cognitive phenotypes is crucial for effective management.
  • Existing classification methods, normative and ipsative, have distinct approaches to defining impairment.

Purpose of the Study:

  • To compare the utility of normative versus ipsative methods for classifying cognitive phenotypes in adults with FLE.
  • To evaluate classifications using the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE).
  • To determine how demographic and clinical factors influence phenotype classification by each method.

Main Methods:

  • One hundred adults with FLE underwent neuropsychological evaluations.
  • Cognitive phenotypes were classified using both normative (peer-based) and ipsative (baseline-based) approaches.
  • Agreement between methods was assessed using quadratic weighted kappa; logistic regressions explored variable associations.

Main Results:

  • Cognitive phenotype distributions varied significantly between the normative and ipsative methods.
  • The ipsative method classified more patients as having intact cognitive function, with poor agreement (κ = 0.085) between methods.
  • Normative classification identified associations between impairment and higher anti-seizure medication burden, younger age, female sex, and lower education; ipsative classification linked impairment to higher education.

Conclusions:

  • Normative IC-CoDE classifications in FLE are more sensitive to clinical/demographic risk factors and identify impairment in individuals with lower premorbid functioning.
  • Ipsative approaches may help reduce misclassification in highly educated individuals with FLE.
  • Method selection for cognitive phenotyping in FLE requires careful consideration of the research question, clinical context, and patient population.