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Comparing two classification schemes for seizures and epilepsy in rural China

Wang, F; Chen, Z; Davagnanam, I; Hoskote, C; Ding, D; Wang, W; Yang, B; ... Kwan, P; + view all (2019) Comparing two classification schemes for seizures and epilepsy in rural China. European Journal of Neurology , 26 (3) pp. 422-427. 10.1111/ene.13857. (In press).

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Abstract

Background and purpose The 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. Methods People 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. Results A 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. Conclusions The 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.

Type: Article
Title: Comparing two classification schemes for seizures and epilepsy in rural China
Location: England
DOI: 10.1111/ene.13857
Publisher version: https://doi.org/10.1111/ene.13857
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: aetiology, classification, epilepsy syndromes, rural, terminology
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
URI: http://discovery.ucl.ac.uk/id/eprint/10065707
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