Classification of The Epilepsies

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Abstract
Efforts to classify epilepsy and epileptic seizures have been made for centuries. The objects of modern-day classifications have been to aid research, treatment, and teaching, and to facilitate communication. From the mid-19th century, epilepsies have been classified into two major groups. One group of syndromes, independent of any cerebral lesion, appears related principally to a functional disturbance, i.e., a predisposition of the brain to produce seizures. These syndromes have collectively been called functional, idiopathic, primary, etc; or with an assumed pathophysiology, centrencephalic. The second group includes those epilepsies believed to be symptoms of cerebral lesions, and has been known at various times as lesional, organic, structural, secondary, etc. This simple classification was used for a century from the time of Delasiauve 1 to that of Penfield and Jasper. 2 During that time, idiopathic or primary epilepsies were distinguished from symptomatic or secondary epilepsies on the basis of seizure type alone. The first were believed to be manifested only by seizures which were generalized from their onset, including absences, myoclonic seizures, and generalized convulsions, correlating with the diffuse nature of the epileptic predisposition. In contrast, the seizures of symptomatic or secondary epilepsies were all thought to begin locally as the result of a localized epileptogenic brain lesion.

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