Background and purposeThe International League against Epilepsy (ILAE) updated the classifications of seizures and epilepsies in 2017. The 2017 classifications were compared with the 1980s classifications in rural China. MethodsPeople with epilepsy receiving treatment under the National Epilepsy Control Programme were recruited from rural areas in China. Their seizures and epileptic syndrome were classified using the 1980s ILAE classification system and then re-classified according to the 2017 system. Differences in seizure, epilepsy and aetiology classifications were identified. ResultsA total of 597 individuals (58% males, aged 6-78 years) were included. Amongst them 535 (90%) had a single seizure type, 57 (9.55%) had two types and five (0.84%) had three. There was complete agreement between the 1981 and 2017 classifications for the 525 individuals with focal seizures. Seizures originally classified as generalized in 10 of 65 individuals were re-classified as unknown in the 2017 classification. Compared to the 1980s classifications, the proportion of individuals with unknown seizures and unknown epilepsy increased from 1.2% (7/597) to 2.8% (17/597, P = 0.002), and unknown aetiology increased from 32% (189/597: 182 cryptogenic and seven unclassified) to 39% (230/597; P < 0.001) in the 2017 classifications. ConclusionsThe 1980s and 2017 classifications had 100% agreement in classifying focal seizures and epilepsy in rural China. A small but significant proportion of generalized seizures and epilepsy and aetiologies classified in the old classifications were re-classified to unknown in the new classifications. These results highlight the need for improvement in clinical evaluation of people with epilepsy in resource-poor settings.
[1]Shanghai Jiao Tong Univ, Dept Neurol, Shanghai Gen Hosp, Shanghai, Peoples R China;
[2]Univ Melbourne, Dept Med, Royal Melbourne Hosp, Parkville, Vic, Australia;
[3]Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia;
[4]UCL Inst Neurol, Dept Brain Repair & Rehabil, Acad Dept Neuroradiol, London, England;
[5]Natl Hosp Neurol & Neurosurg, Lysholm Dept Neuroradiol, London, England;
[6]Fudan Univ, Shanghai, Peoples R China;
[7]Beijing Neurosurg Inst, Beijing, Peoples R China;
[8]Jiaozuo Peoples Hosp, Jiaozuo, Henan, Peoples R China;
[9]Ningxia Med Univ, Ningxia, Peoples R China;
[10]Jincheng Emergency Med Rescue Ctr, Jincheng, Peoples R China;
[11]Hebei Med Univ, Affiliated Hosp 2, Shijiazhuang, Hebei, Peoples R China;
[12]UCL Inst Neurol, Biomed Res Ctr, NIHR Univ Coll London Hosp, London, England;
[13]Chalfont Ctr Epilepsy, Gerrards Cross, England;
[14]Stichting Epilepsie Instellingen Nederland SEIN, Heemstede, Netherlands;
[15]Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Peoples R China;
[16]Monash Univ, Dept Neurosci, Cent Clin Sch, Melbourne, Vic, Australia
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