What are the criticisms of the ILAE 5-axis diagnostic scheme for epilepsy?

Updated: May 30, 2019
  • Author: David Y Ko, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Despite the fact that for many years psychiatrists have successfully used a somewhat similar 5-axis diagnostic scheme, critics indicate that this system is unnecessarily complex and its reliability, accuracy, and clinical use are uncertain. (For a more complete description of these controversies see Wolf [30] and the resultant discussions by Engel, Luders et al, Berg and Blackstone, and Avanzini. Similarly, see Fisher et al [1] and its resultant discussion.)

To increase the controversy on this subject, there is evidence that epilepsy syndromes are not static diagnoses but ones that may evolve over time. They also have poor prognostic predictivity, and the interobserver reliability of classifying epileptic syndromes is poor. [31]


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