Epilepsieklassifikation – Vor- und Nachteile verschiedener Klassifikationssysteme – ein Review

 

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Zusammenfassung

Die Klassifikation von Epilepsien und epileptischen Syndromen und -eng verbunden- von epileptischen Anfällen unterliegt stetem Wandel. Ziel dieser Anpassungen ist es den aktuellen Erkenntnisstand und die Fortschritte in Diagnostik und im Krankheitsverständnis von Epilepsien abzubilden. In der aktuellen „Klassifikation der Epilepsien der International League Against Epilepsy (ILAE)“ von 2017 wird die Bedeutung von Ätiologie und Komorbidität hervorgehoben. Epilepsien werden vor allem in solche mit fokalen Anfällen, generalisierten Anfällen, fokalen und generalisierten Anfällen und unbekanntem Anfallstyp eingeteilt. Andere Befunde (z. B. aus EEG und MRT) gehen auf jeder Ebne ein. Auf der anderen Seite wurde von Lüders und Mitarbeitern eine „4-dimensionale Epilepsie Klassifikation“ vorgeschlagen, die diese Aspekte getrennt betrachtet und eine rein semiologische Anfallsklassifikation verwendet. In 2020 wurde mit der „Integrierten Epilepsie Klassifikation“ ein Vorschlag unterbreitet, der versucht die Vorteile dieser verschiedenen Systeme zu nutzen. In den hier vorliegenden Review werden diese Klassifikationssysteme vorgestellt und die jeweiligen Vor- und Nachteile diskutiert.

Abstract

The classification of epilepsies and epileptic syndromes and -closely related- of epileptic seizures is subject to constant change. The aim of these adaptations is to reflect the current state of knowledge and the progress in diagnostics and in the understanding of epilepsies. The current Classification of Epilepsies from the International League Against Epilepsy (ILAE) of 2017 emphasizes the importance of etiology and comorbidity. Epilepsies are primarily classified as those with focal seizures, generalized seizures, focal and generalized seizures, and unknown seizure type. Other findings (e. g., from EEG and MRI) are considered at each level. On the other hand, a "4-dimensional epilepsy classification” was proposed by Lüders and coworkers that considers these aspects separately and uses a purely semiological seizure classification. In 2020, the “Integrated Epilepsy Classification” was proposed, which tries to use the advantages of these different systems. In the review presented here, these classification systems are introduced and the advantages and disadvantages of each are discussed.

Publication History

Article published online:
07 September 2023

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