Definisi-Klasifikasi Epilepsi
Definisi-Klasifikasi Epilepsi
Definisi-Klasifikasi Epilepsi
TERBARU EPILEPSI
Bangkitan Non
Status Epileptikus
Epilepsi
ILAE OFFICIAL RE
PORT
Conclusion:
Adults with an unprovoked first seizure should be informed
that seizure recurrence risk is greatest early within the first 2
years (21%–45%) (Level A), and
clinical variables associated with increased risk may include:
– a prior brain insult (Level A),
– an epileptiform EEG (Level A),
– an abnormal CT/MRI(Level B)
– a nocturnal seizure (Level B).
• Alcohol-withdrawal seizures
• Metabolic seizures (sodium, calcium, magnesium, glucose, oxygen)
• Convulsive syncope
• Acute concussive convulsion
Gangguan kesadaran
•
• Gerakan Motorik
Area otak yan
• Sensoris g mengalami
• Emosi gangguan
• Perilaku atau persepsi
Purpose of ILAE Classification of Seizures and
Epilepsies
Manifestasi motorik
Manifestasi sensorik Bangkitan
Manifestasi autonomik mioklonik
Manifestasi psikik
Bangkitan
Bangkitan Parsial klonik
Kompleks
Bangkitan
Parsial sederhana diikuti gangguan tonik
kesadaran
Dari awal dgn gangguan kesadaran Bangkitan
atonik / astatik
Bangkitan Parsial yang menjadi Bangkitan
Umum Sekunder tonik – klonik
www.t
Classification by ILAE 1989 heme
Epilepsy Syndrome galler
y.com
Unsclassified
Replace old “secondarily
“Generalized tonic-clonic seizure”
Fisher R et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia, **(*):1–12, 2017
Classification not hierarchical
• Can skip level
• Arrows intentionally omitted
Fisher R et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia, **(*):1–12, 2017
Note : when a seizure begins with
“focal, generalized or absence then th
e word “onset” can be presumed
Fisher R et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia, **(*):1–12, 2017
ILAE 2017 Classification Of Seizure Type Expanded Version
• Cognitive seizures
– Impaired language
– Other cognitive domains
– Positive features : Déjà vu,
hallucination, perceptual
distortions
• Emotional seizures
– Ansiety, fear, joy, etc
ILAE 2017 Classification Of Seizure Type Expanded Version
Secondarily
Psychic Dyscognitive generalized tonic-
clonic
Old Term : “Benign”
• Many epilepsies are not benign
- Childhood absence epilepsy : psychosocial impact
- RoLandic epilepsy (BECTS) : learning concerns
• Replace by term :
- Self-limited
- Pharmacoresponsive
• No Longer in use :
- Malignant
- Catastrophic
Words that don’t mean what the say Word that mean what they say
Partial Seizures
• Complex
– Means complicated
– Does not mean ”altered
awareness” Focal Seizure
• Simple
– Straightforward
– Does not mean “ retained
awareness”
Etiology
Seizure type
Structural
Focal impaired awareness automatism seizure
Genetic
Immune
Autosomal dominant nocturnal frontal
Unknown
Lobe epilepsy
Impact on Clinical Care and Practice
New
definition
No longer How
Old definition
present Big ?
Epilepsy Resolved