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New definition for epilepsy - tell us what you think!

New definition for epilepsy - tell us what you think!

Added: 17 April 2014, 15:53

The International League Against Epilepsy (ILAE) has published a new definition of epilepsy.  The purpose of this is to give practical help to doctors in making a clinical diagnosis and potentially starting treatment.  It also recognises that some people may ‘outgrow’ their epilepsy.

The ILAE considers that epilepsy is defined by any of the following:

1.    At least two unprovoked (or reflex) seizures occurring at least 24 hours apart
2.    One unprovoked seizure with at least a 60% chance of a further seizure within 10 years
3.    The diagnosis of an epilepsy syndrome

The ILAE also considers a person’s epilepsy to have resolved if they:

•    had a childhood or teenage epilepsy syndrome but are now past the applicable age (e.g. have grown out of it)
•    have remained seizure-free for the last 10 years, with no seizure medicines for the last 5 years

The new definition means that doctors might consider discussing and starting epilepsy treatment after a first seizure, if there is a high risk (60% or more) of the person having further seizures.  It is thought that this may improve access to epilepsy care after a first seizure, where appropriate.  However the decision to start epilepsy treatment should be made by the patient and an epilepsy specialist.

According to the new definition, a person’s epilepsy could be considered resolved if they have outgrown a childhood/teenage epilepsy syndrome or if they have been seizure-free for the last 10 years and taken no anti-epilepsy medication for the last 5 years.  This recognises the fact that children can grow out of their epilepsy and that in some people epilepsy ceases to be active – for example if the person has had a definitive treatment such as brain surgery, which has left them permanently seizure-free.

‘Resolved’ simply means that the person’s epilepsy is no longer active.  Although a person’s epilepsy may resolve, they are not cured and it does not guarantee that it will not return.  The person will probably always have a slightly raised risk of further seizures, compared to those with no history of epilepsy.

The new clinical definition also states that, in medical terms, epilepsy is a disease.  The term ‘disease’ was chosen because it covers a very wide range of health problems and implies that the person’s epilepsy can be present for a long time.  The ILAE feels that the previous word, ‘disorder’, was not very well understood by the general public and that it played down the serious nature of epilepsy. 

Like other epilepsy organisations, Epilepsy Scotland uses the terms ‘condition’ or ‘disorder’ when describing epilepsy.  We do not currently use the word ‘disease’ as people with epilepsy, their families and carers have told us that they perceive this to be a negative term which suggests that epilepsy is contagious or always progressive in nature. 

We would like to hear how you feel about this new definition.  If you would like to give us your views or if you would like to know more about any of these issues, please:

•    email us at
•    call our freephone helpline on 0808 800 2200
•    tweet us @epilepsy_scot
•    make contact with us on facebook
•    complete our online Enquiry Form