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Epilepsia. 2017 Apr;58(4):531-542. doi: 10.1111/epi.13671. Epub 2017 Mar 8.

Instruction manual for the ILAE 2017 operational classification of seizure types.

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Stanford Department of Neurology & Neurological Sciences, Stanford, California, U.S.A.
UCL-Institute of Child Health, Great Ormond Street Hospital for Children, London, United Kingdom.
Bombay Epilepsy Society, Mumbai, India.
Department of Neurology, NYU Langone School of Medicine, New York, New York, U.S.A.
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, New York, U.S.A.
Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan.
Unite Francis Rohmer, Strasbourg, France.
Department of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, The Netherlands.
Pediatric Neurology, University Hospitals KU Leuven, Leuven, Belgium.
Saul R. Korey Department of Neurology, Department of Pediatrics and Dominick P. Purpura Department Neuroscience, Montefiore Medical Center, Bronx, New York, U.S.A.
Department of Neurology, Tampere University Hospital, Tampere, Finland.
Pediatric Neurorehabilitation Unit, CHUV, Lausanne, Switzerland.
Florey Institute and University of Melbourne, Austin Health and Royal Children's Hospital, Melbourne, Victoria, Australia.
Epilepsy Center, University Medical Center Freiburg, Freiburg, Germany.
Faculty of Medicine, Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
Department of Neurology and Neurosurgery, Epilepsy Research and Treatment Unit, São Paulo, Brazil.
The Paediatric Neurosciences Research Group, Royal Hospital for Children, Glasgow, United Kingdom.
College of Medicine, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom.


This companion paper to the introduction of the International League Against Epilepsy (ILAE) 2017 classification of seizure types provides guidance on how to employ the classification. Illustration of the classification is enacted by tables, a glossary of relevant terms, mapping of old to new terms, suggested abbreviations, and examples. Basic and extended versions of the classification are available, depending on the desired degree of detail. Key signs and symptoms of seizures (semiology) are used as a basis for categories of seizures that are focal or generalized from onset or with unknown onset. Any focal seizure can further be optionally characterized by whether awareness is retained or impaired. Impaired awareness during any segment of the seizure renders it a focal impaired awareness seizure. Focal seizures are further optionally characterized by motor onset signs and symptoms: atonic, automatisms, clonic, epileptic spasms, or hyperkinetic, myoclonic, or tonic activity. Nonmotor-onset seizures can manifest as autonomic, behavior arrest, cognitive, emotional, or sensory dysfunction. The earliest prominent manifestation defines the seizure type, which might then progress to other signs and symptoms. Focal seizures can become bilateral tonic-clonic. Generalized seizures engage bilateral networks from onset. Generalized motor seizure characteristics comprise atonic, clonic, epileptic spasms, myoclonic, myoclonic-atonic, myoclonic-tonic-clonic, tonic, or tonic-clonic. Nonmotor (absence) seizures are typical or atypical, or seizures that present prominent myoclonic activity or eyelid myoclonia. Seizures of unknown onset may have features that can still be classified as motor, nonmotor, tonic-clonic, epileptic spasms, or behavior arrest. This "users' manual" for the ILAE 2017 seizure classification will assist the adoption of the new system.


Classification; Epilepsy (taxonomy); Focal; Generalized; Seizures

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