New clinical definition for epilepsy improves diagnosis accuracy

April 14, 2014

An expert task force has created a new definition for epilepsy that refines the scope of patients diagnosed with this brain disease. The study published in Epilepsia, a journal published by Wiley on behalf of the International League Against Epilepsy (ILAE), provides a greater level of detail to diagnose epilepsy by including individuals with two unprovoked seizures, and those with one unprovoked seizure and other factors that increase risk of seizure recurrence.

The 2005 report by the ILAE task force defined an epileptic seizure as "a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain" and epilepsy as "a disorder of the brain characterized by an enduring predisposition to generate , and by the neurobiologic, cognitive, psychological, and social consequences of this condition. The of epilepsy requires the occurrence of at least one epileptic seizure."

"Why change the definition of epilepsy?" asks task force lead author Dr. Robert Fisher from Stanford University School of Medicine. "The 2005 definition does not allow a patient to outgrow epilepsy, nor does it take into account some clinicians' views that epilepsy is present after a first unprovoked seizure when there is a high risk for another. The task force recommendation resolves these issues with the new, more practical, definition of epilepsy that is aimed at clinicians. However, some researchers might use criteria similar to those of the older definition to facilitate comparison with prior studies."

The task force suggests that epilepsy is a disease of the brain defined as:

1. At least two unprovoked (or reflex) occurring more than 24 hours apart; or

2. One unprovoked (or reflex) seizure and a probability of further seizures similar to the general (at least 60%) after two unprovoked seizures, occurring over the next 10 years; or

3. Diagnosis of an epilepsy syndrome.

"The burden of determining recurrence risk does not fall on the clinician. If information is not available on recurrence risk after a first seizure, then the definition defaults to the old definition," adds Dr. Fisher. According to the article epilepsy is "resolved" in individuals who are past the applicable age of an age-dependent epilepsy syndrome, or those that have been free of seizures for the last 10 years and off anti-epileptic drugs (AEDs) for 5 years or more. The authors note that, the meaning of "resolved" is not identical to that of "remission" or "cure."

"The published definitions were supported with factual data, but in some cases medical evidence did not exist and the used a "consensus" approach for these definitions," explains Drs. Gary Mathern and Astrid Nehlig, Editors-in-Chief of Epilepsia. In these instances, the editors are asking readers' opinions adding, "We encourage you to go to http://surveys.verticalresponse.com/a/show/1539433/ea840f4206/0 to share your feedback regarding the new definition of ."

Explore further: Can epileptic seizures be prevented or predicted?

More information: A Practical Clinical Definition of Epilepsy." Robert S. Fisher, Carlos Acevedo, Alexis Arzimanoglou, Alicia Bogacz, J. Helen Cross, Christian E. Elger, Jerome Engel Jr, Lars Forsgren, Jacqueline A. French, Mike Glynn, Dale C. Hesdorffer, B.-I. Lee, Gary W. Mathern, Solomon L. Moshé, Emilio Perucca, Ingrid E. Scheffer, Torbjörn Tomson, Masako Watanabe, and Samuel Wiebe. Epilepsia; Published Online: April 14, 2014 (DOI: 10.1111/epi.12550).

Editorial "From the Editors: Names Count—The New Operational Definition of Epilepsy and Epilepsia's Poll." Gary Mathern and Astrid Nehlig. Epilepsia; Published Online: April 14, 2014 (DOI: 10.1111/epi.12589).

Related Stories

Can epileptic seizures be prevented or predicted?

March 31, 2014
A biomedical engineering professor at the Institute of Biomaterials & Biomedical Engineering (IBBME) and the Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), Bardakjian works with a team of neurological ...

Surprising results from study of non-epileptic seizures

December 2, 2012
A Loyola University Medical Center neurologist is reporting surprising results of a study of patients who experience both epileptic and non-epileptic seizures.

Seizures late in life may be an early sign of Alzheimer's disease

July 8, 2013
Patients with epilepsy who had amnestic mild cognitive impairment (aMCI) or Alzheimer disease (AD) presented earlier with cognitive decline than patients who did not have epilepsy, according to a report published by JAMA ...

Adenosine therapy reduces seizures and progression of epilepsy

July 25, 2013
Epilepsy is characterized by recurrent seizures that present in many different ways. In some cases epileptic patients exhibit a progressive increase in both frequency and severity of seizures. Epigenetic changes such as DNA ...

Epilepsy sufferers will one day live without seizures, says expert

March 27, 2014
A leading epilepsy expert at Royal Holloway, University of London, has said there is a pressing need for new and more effective treatments that would make it possible for all sufferers to live seizure free.

Young people with epilepsy significantly more at risk of injury

April 14, 2014
Children and young adults with epilepsy are more likely to suffer broken bones, burns and poisonings compared to those without the neurological disorder, new research has found.

Recommended for you

Cognitive cross-training enhances learning, study finds

July 25, 2017
Just as athletes cross-train to improve physical skills, those wanting to enhance cognitive skills can benefit from multiple ways of exercising the brain, according to a comprehensive new study from University of Illinois ...

Lutein may counter cognitive aging, study finds

July 25, 2017
Spinach and kale are favorites of those looking to stay physically fit, but they also could keep consumers cognitively fit, according to a new study from University of Illinois researchers.

Zebrafish study reveals clues to healing spinal cord injuries

July 25, 2017
Fresh insights into how zebrafish repair their nerve connections could hold clues to new therapies for people with spinal cord injuries.

Brain stimulation may improve cognitive performance in people with schizophrenia

July 24, 2017
Brain stimulation could be used to treat cognitive deficits frequently associated with schizophrenia, according to a new study from King's College London.

New map may lead to drug development for complex brain disorders, researcher says

July 24, 2017
Just as parents are not the root of all their children's problems, a single gene mutation can't be blamed for complex brain disorders like autism, according to a Keck School of Medicine of USC neuroscientist.

Bird songs provide insight into how developing brain forms memories

July 24, 2017
Researchers at the University of Chicago have demonstrated, for the first time, that a key protein complex in the brain is linked to the ability of young animals to learn behavioral patterns from adults.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.