ILAE 2025 Classification of Epileptic Seizures: Key Revisions and Clinical Implications

The International League Against Epilepsy released an updated seizure classification in 2025 with six main revisions to improve clinical clarity, including replacing 'onset' in seizure class names, substituting 'consciousness' for 'awareness' to encompass both awareness and responsiveness, and replacing 'motor' with 'observable' features. The update also emphasizes chronological seizure semiology patterns, recognizes epileptic negative myoclonus as a new seizure type, and expands the use of epileptic spasms as a descriptor across focal and unknown seizures.