Epilepsy is not resolved.

Commentary The ILAE has redefined epilepsy: epilepsy is a disease of the brain causing at least two unprovoked or reflex seizures occurring more than 24 hours apart or after one seizure if risks of recurrence are " high " (>60%). Conversely—and making a change that carries significant implications—they also now define epilepsy as " resolved " if an individual has outgrown their age-dependent syndrome or if they are seizure free for 10 years and off AEDs for 5 years. Overall, the ILAE committee report is a useful and sophisticated practical definition of epilepsy that helps guide the clinical evaluation of patients with seizures: epilepsy implies a risk for seizure recurrence and may require treatment while clinical monitoring and safety restrictions can end when epilepsy is resolved. Their definition incorporates a number of points that are clearly reviewed and justified in the ILAE report. It is important, however, to note what this " practical clinical " definition of epilepsy " is " and " is not " and to note controversial aspects of the report. First, unlike the 2005 conceptual definition of epilepsy, this is a clinical and not a neurobiological definition. The 2005 conceptual definition of epilepsy is " a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the neurobiologic, cognitive, psychological and social consequences of this condition. " While the new " practical clinical " definition of epilepsy is not intended to replace the 2005 conceptual definition, its use may de-emphasize important links between brain disorders, epilepsy and associated emotional, cognitive and neurologic symptoms that are important to assess in patients with epilepsy (1, 2). Secondly, the new definition of epilepsy incorporates several controversies: 1) Epilepsy is defined as a disease. Although epilepsy meets the broad definition of disease as any condition that impairs normal function, it is more precisely a " disorder " with seizures representing functional disturbances caused by multiple diseases. The practical elements of a broad definition for epilepsy won out; similar to " heart disease, " advocacy for epilepsy research funding and epilepsy awareness may be enhanced by terming epilepsy a disease. It may be less stigmatizing; however, to call epilepsy a " disorder " than a " disease " if this helps distinguish patients with benign and disabling etiologies for epilepsy; 2) patients diagnosed with an epilepsy syndrome are defined as having epilepsy, since " it makes …