Classification des crises épileptiques. Comparaison entre deux systèmes

Abstract

In spite of its universal acceptance, the international classification of epileptic seizures suffers from certain limitations. The fundamental divisions between partial and generalized seizures on the one hand, and between partial simple and complex seizures on the other, are not always practical, nor useful. The terminology is often cumbersome, and does not contain essential localizing information. Finally, the seizure classification is sometimes dependent on ancillary testing, particularly the EEG. We propose a different seizure classification, which answers the above shortcomings of the international classification, and which has been used for years in major epilepsy centers. In this system, the seizure classification is based exclusively on seizure symptomatology. The terms are generally more concise than those of the international classification, and yet convey more precise information. For example, the term left visual aura-->automotor seizure-->generalized tonic clonic seizure would be equivalent to simple partial seizure with visual symptom evolving into complex partial seizure evolving into generalized tonic clonic seizure. The international classification is longer and omits essential later-alizing information. This classification is easy to apply, and can be an extremely useful complement to the international seizure classification, especially for centers whose emphasis is on surgical treatment of epilepsy.