C. Classifying the seizure type and epilepsy.
ILAE Classification of Epilepsy and Epileptic Syndromes (1989)
1.Localization related epilepsy and syndromes
1.1 Idiopathic (with age related onset)
- benign childhood epilepsy with centrotemporal spikes.
- childhood epilepsy with occipital paroxysms .
- primary reading epilepsy
- chronic progressive epilepsia partialis continua of childhood (Kojewnikow’s syndrome)
- syndromes characterised by seizures with specific modes of precipitation
- temporal/frontal/parietal/occipital lobe epilepsies
2. Generalised epilepsies and syndromes
2.1 Idiopathic (with age related onset - listed inorder of age)
- benign neonatal familial convulsions
- benign neonatal convulsions
- benign myoclonic epilepsy of infancy
- childhood absence epilepsy
- juvenile absence epilepsy
- juvenile myoclonic epilepsy (impulsive petit)
- epilepsy with grand mal seizures on awakening
- epilepsies with seizures precipitated by specific modes of activation
- other generalised idiopathic epilepsies not defined above
2.2 Cryptogenic or symptomatic (in order of age)
- West syndrome (infantile spasms)
- Lennox Gastaut syndrome
- Epilepsy with myoclonic astatic seizures
- Epilepsy with myoclonic absences
2.3.1 Non Specific etiology
- Early myoclonic encephalopathy
- Early infantile epileptic encephalopathy with suppression burst
- Other symptomatic generalised epilepsies not defined above
2.3.2 Specific syndromes - diseases in which seizures are a predominant or presenting feature
3. Epilepsies and syndromes undetermined whether focal or generalised
3.1 With both generalised and focal seizures
- neonatal seizures
- severe myoclonic epilepsy of infancy
- epilepsy with continuous spike waves during slow wave sleep
- acquired epileptic aphasia
- other undetermined epilepsies not defined above
3.2 Without unequivocal generalised or focalfeatures
4. Special syndromes
4.1 Situation related seizures
D. Epileptic syndrome Diagnosis.
- Febrile convulsions
- Isolated seizures or isolated status epilepticus
- Seizures accompanying an acute toxic or metabolic event.
These are diagnosed based on the seizure type and semiology, age at onset, clinical course, family history and associated EEG Abnormalities. These constitute 10% of childhood epilepsies. The prognosis of these syndromes varies with the etiological group requiring no treatment (benign neonatal convulsions, benign Rolandic epilepsy).