Special CommunicationReprint of: The new approach to classification: Rethinking cognition and behavior in epilepsy☆
Section snippets
The new approach to the classification of the epilepsies
In 2010, the ILAE Commission on Classification and Terminology (2005–2009) published a special report recommending a fundamental shift in our understanding of concepts, use of terminology, and approach to classifying seizures and the various forms of epilepsy [1]. The rationale for this shift was to produce a more flexible organization for classifying the epilepsies that could readily incorporate our rapidly advancing knowledge in basic and clinical neuroscience to facilitate its translation to
Rethinking cognition and behavior in epilepsy
From the perspectives of clinical neuropsychology and cognitive and behavioral neuroscience, perhaps the most profound impact of the new descriptive approach is the explicit reconceptualization of focal and generalized seizures as arising out of a disease of brain networks, the cause of which may be genetic, lesion-based, or unknown. Focal seizures are conceived as originating in a network confined to one hemisphere that may be cortical or subcortical, discrete, or more widely distributed. By
The benefits of aligning cognitive, behavioral, and neurological phenotypes
Within the field, it has been increasingly recognized that traditional clinical practice is becoming ‘out of step’ with the rapid advances in cognitive and behavioral neuroscience. For this reason, a special international workshop was convened in Toronto in 2010 under the auspices of the ILAE. The express purpose of this workshop was to review and advance evidence-based neuropsychological practice for pediatric and adult patients with epilepsy by bringing together a range of specialists with
Internalizing new perspectives: the psychology of change
An entire branch of occupational and behavioral psychology is dedicated to the study of resistance to change. The phenomenon is strong in both humans and animals and demonstrably impedes progress. People tend to have an innate preference to keep things as they are, and resistance to change is particularly strong in groups of people. When changes are proposed within a community, the community tends to respond with a low level of tolerance for any ambiguity in the new system and a focus on the
Moving forward: reframing existing findings and developing new research approaches
This Special Communication represents a call for papers that review and reframe cognitive and behavioral research through the prism of the new approach to classifying the epilepsies. It is designed to encourage the field to embrace change and move towards a more complete understanding of cognition and behavior in epilepsy by identifying the psychological, cognitive, and behavioral features that are most relevant to diagnostic classification and treatment. As one example of the type of work we
Acknowledgments
We would like to thank Professor Steven Schachter, Dr. Ennapadam Krishnamoorthy, and Professor Samuel Berkovic for their helpful discussions and comments on earlier drafts of this Special Communication.
Disclosure
The authors have no conflicts of interest to declare.
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The article is reprinted here for reader convenience and for the continuity of the special issue. For citation purposes, please use the original publication details; The new approach to classification: Rethinking cognition and behavior in epilepsy, 41, pp 307-310.