Informed acceptance and perceptions of the 2025 ILAE seizure classification following structured teaching

OBJECTIVE: To assess informed acceptance and perceptions of the 2025 update of the International League Against Epilepsy (ILAE) seizure classification-after participants had received a focused educational introduction to the updated classification.

METHODS: We analyzed anonymized live poll responses from two educational webinars dedicated to the updated seizure classification: an EpiCARE webinar held on March 26, 2026, and an ILAE e-Forum held on April 15, 2026. At the start of the webinars, participants reported their professional background and prior familiarity with the updated classification. Each webinar then included a 20-min teaching session, after which participants answered a poll question on their opinion of the updated classification. In the EpiCARE webinar, participants additionally classified 16 representative video-EEG cases using the updated classification. For the case exercise, we summarized question-level accuracy, the most frequent incorrect answer, the micro-average accuracy (total number of correct responses across all submitted answers divided by the total number of submitted answers), and the macro-average accuracy (mean of the 16 individual case accuracies).

RESULTS: A total of 323 participants actively engaged in the two webinars (185 in the EpiCARE webinar and 138 in the ILAE e-Forum). Most respondents were specialist neurologists or pediatric neurologists/pediatricians. Before the teaching session, most respondents had heard about the updated classification but had not read the full position paper and practical guide. The main post-teaching poll was completed by 295 participants (91.3%). The vast majority of the respondents (242; 82%) rated the updated classification as feasible and useful, 17 (5.8%) as feasible but not useful, and 2 (0.7%) as not feasible, and 34 (11.5%) respondents stated they were unsure / had no opinion. In the case-based exercise on applying the updated classification, the most frequently selected answer was correct in all 16 cases. The micro-average accuracy was 74.3%, the macro-average accuracy 74.5%, and the median question-level accuracy 81.5% (range 30.4%-94.0%).

SIGNIFICANCE: When neurologists and other professionals were surveyed after structured teaching, acceptance of the 2025 ILAE seizure classification was strongly favorable. These findings suggest that education is likely to influence how the update is perceived and may help explain part of the skepticism reported in earlier surveys conducted without a standardized teaching intervention.