The new classification of seizures: an overview for the general physician

The International League Against Epilepsy Classification of the Epilepsies, first presented in 1981, has been widely adopted across the globe. In 2017 it was revised to allow for more robust, specific, flexible and logical classification of seizures. A number of new seizure types are recognised. Classification should be timely as it plays a vital role in the diagnosis and management of patients with epilepsy. Accurate classification also underpins epilepsy research from pathophysiology to public health. Here we review the basic and extended forms of the classification. Semiology (symptoms and signs) is used as the foundation for grouping seizures under focal, generalised or of unknown onset. Focal seizures can be further classified by the presence or absence of awareness and motor signs. Generalised seizures engage bilateral networks from the onset and these can be either motor or non-motor. Seizures of unknown onset can be classified as motor, non-motor, tonic–clonic, epileptic spasms, or behaviour arrest.