title: [Suggestion for a new, patient-oriented epilepsy classification].
abstract: The recent proposal by the ILAE Task Force for Epilepsy Classification is a multiaxial, syndrome-oriented approach. Epilepsy syndromes--at least as defined by the ILAE Task Force--group patients according to multiple, usually poorly defined parameters. As a result, these syndromes frequently show significant overlap and may change with patient age. We propose a five-dimensional and patient-oriented approach to epilepsy classification. This approach shifts away from syndrome orientation, using independent criteria in each of the five dimensions similarly to the diagnostic process in general neurology. The main dimensions of this new classification consist of (1) localizing the epileptogenic zone, (2) semiology of the seizure, (3) etiology, (4) seizure frequency, and (5) related medical conditions. These dimensions characterize all information necessary for patient management, are independent parameters, and include information more pertinent than the ILAE axes with regard to patient management. All cases can be classified according to this five-dimensional system, even at initial encounter when no detailed test results are available. Information from clinical tests such as MRI and EEG are translated into the best possible working hypothesis at the time of classification, allowing increased precision of the classification as additional information becomes available.
authors.affiliation: Department of Neurology, The Cleveland Clinic Foundation, Cleveland, OH, USA. kelling@uni-muenster.de
authors.forename: C
authors.initials: C
authors.lastname: Kellinghaus
authors.forename: T
authors.initials: T
authors.lastname: Loddenkemper
authors.forename: E
authors.initials: E
authors.lastname: Wyllie
authors.forename: I
authors.initials: I
authors.lastname: Najm
authors.forename: A
authors.initials: A
authors.lastname: Gupta
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authors.initials: F
authors.lastname: Rosenow
authors.forename: C
authors.initials: C
authors.lastname: Baumgartner
authors.forename: F
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authors.lastname: Boesebeck
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authors.lastname: Diehl
authors.forename: C
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authors.lastname: Drees
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authors.lastname: Ebner
authors.forename: H
authors.initials: H
authors.lastname: Hamer
authors.forename: S
authors.initials: S
authors.lastname: Knake
authors.forename: J H
authors.initials: JH
authors.lastname: Meencke
authors.forename: M
authors.initials: M
authors.lastname: Merschhemke
authors.forename: G
authors.initials: G
authors.lastname: Möddel
authors.forename: S
authors.initials: S
authors.lastname: Noachtar
authors.forename: S
authors.initials: S
authors.lastname: Rona
authors.forename: S U
authors.initials: SU
authors.lastname: Schuele
authors.forename: B J
authors.initials: BJ
authors.lastname: Steinhoff
authors.forename: I
authors.initials: I
authors.lastname: Tuxhorn
authors.forename: K
authors.initials: K
authors.lastname: Werhahn
authors.forename: H O
authors.initials: HO
authors.lastname: Lüders
mesh_terms: D004827:Epilepsy / Q000145:classification* / Q000175:diagnosis*; D006801:Humans; D007390:International Agencies; D009626:Terminology as Topic