AccScience Publishing / BH / Online First / DOI: 10.36922/BH026020002
REVIEW ARTICLE

The 2025 updated ILAE classification of epileptic seizures: Scope, challenges, recommendations, and clinical practice guidance

Abba Musa Abdullahi1* Usama Ishaq Abdulrazak2
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1 Department of Life Sciences, Faculty of Life Sciences and Education, University of South Wales, Newport, Wales, United Kingdom
2 Children’s Emergency Department, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
Brain & Heart, 026020002 https://doi.org/10.36922/BH026020002
Received: 9 January 2026 | Revised: 20 February 2026 | Accepted: 5 March 2026 | Published online: 8 May 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

The International League Against Epilepsy (ILAE) seizure classification has undergone progressive revisions to enhance its clinical relevance, culminating in the updated 2025 framework. This update builds upon the 2017 framework while further improving clinical and global applicability, as well as conceptual clarity. The 2017 ILAE seizure classification represented a major paradigm shift by simplifying terminology, introducing seizure onset as the central organizing principle, and promoting patient-centered communication. The 2025 ILAE classification retains this foundational structure and further refines terminology to enhance communication with patients and caregivers. It also expands recognition of seizures with uncertain or mixed onset, places greater emphasis on observable clinical manifestations, and provides a clearer distinction between seizure semiology and etiologic diagnosis. A central feature of the 2025 framework is its multidimensional approach, which integrates seizure semiology, neuroanatomical localization, etiology, and comorbidities. This approach supports timely diagnosis, rational treatment decisions, and improved outcomes, particularly in low- and middle-income countries where diagnostic resources may be limited. In this review, we critically examine the evolution of seizure classification from the 2017 ILAE framework to the 2025 update, highlighting its scope, core framework, and remaining challenges. We analyze terminology that has been retained, modified, or discontinued to clarify the transition between classification models and to promote consistent clinical use. Finally, we offer recommendations to inform future revisions of seizure classification and provide a practical guide for its application in clinical practice. 

Keywords
Seizures
Epilepsy
International League Against Epilepsy
Challenges
Scope
Recommendations
Funding
None.
Conflict of interest
The authors declare they have no competing interests.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing