A proposed diagnostic scheme for people with epileptic seizures and with epilepsy. Report of the ILAE task force on classification and terminology

`A diagnostic scheme for epileptic seizures and epilepsies with five levels or Axes is proposed (1, ictal semiology; 2, seizure type[s]; 3, epilepsy syndrome; 4, etiology, and 5, resulting impairment). A standardized Glossary of Descriptive Terminology is used for the description of the ictal semiology and the description of seizure types is derived from a list of accepted seizure types constructed by the Task Force. If possible, the syndromic diagnosis follows according to a list of accepted epilepsy syndromes as well as syndromes in development provided by the Task Force. Regarding etiology another list or classification of diseases frequently associated with epileptic seizures or syndromes is provided. The (optional) designation of a resulting impairment will be derived from the WHO International Classification of Functioning and Disability. In addition, the use of some diagnostic terms is discouraged or they are replaced by others (e.g. "simple and complex partial seizures", "Partial" and "localization related syndromes", "convulsive" and "convulsion"), the meaning of other terms is clarified ("cryptogenic" = "probably symptomatic") and some new concepts are proposed (e.g. "epileptic disease" with a single, specific etiology or "epileptic encephalopathy" as condition, in which the epileptic processes themselves lead to cerebral dysfunction). It is emphasized that this proposal is not a new classification of seizures and epilepsies or epilepsy syndromes. The proposed scheme should lead to an updated and uniformed use of the diagnostic vocabulary in the preparation of a future new classification or rather multiple classifications for different purposes (e.g. for teaching and research purposes or clinical trials). It is flexible and will be periodically changed and updated in the future as needed.