Classifying Seizures and Epilepsies: Limits of Science and Semantics

Abstract

“If I wished to show a student the difficulties of getting at truth from medical experience, I would give him the history of epilepsy to read.” Oliver Wendell Holmes ( 1 ) If the medical experience of epilepsy is obscured by uncertainties, then its classification is mired in the mud of expert opinion. The newly revised terms and concepts for “organizing” (also known as “classifying”) seizures and epilepsy provide a humble and modern perspective, with many superb suggestions ( 2 ). The central points are well articulated and valid: 1) divorcing classification from “expert opinion” and marrying it to science; 2) acknowledging what is unknown; and 3) simplifying and clarifying terminology. Yet, the revision lacks the crisp clarity needed to educate students, patients, and colleagues. And some recommendations lack a clear scientific or semantic basis.