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目的探讨国际抗癫联盟关于癫发作分类的建议(2001年)在部分性癫发作中的应用价值和特点。方法收集1996年6月至2004年10月在我院癫中心就诊,经过录像脑电监测捕捉到发作的128例部分性癫患者的发作情况,应用1981、2001年两种癫发作分类方案,由3位受过正规癫和脑电图训练的神经科医生进行分类。结果128例患者共检测到298次发作。按照1981年分类标准,97次(32%)属于简单部分性发作,105次(35%)为复杂部分发作,12次(4%)部分性发作难以准确划分为简单或者复杂性,81次(27%)为继发全面性发作,3次(1%)为部分性癫持续状态;应用2001年分类建议,有295次发作为自限性局灶性发作,其中67次(22%)为局灶性感觉性发作,140次(47%)为局灶性运动性发作,包括81次(27%)伴随颞叶自动症的局灶运动性发作,81次(27%)为继发全面性发作,3次为局灶性癫持续状态发作。2001年分类方案中,发作类型体现了特征性的临床症状,与发作期的癫性放电的解剖部位有紧密的对应,但是,高级皮层的发作症状在一定程度上受到了忽略。结论2001年国际癫发作分类体现了良好的发作症状、发作类型、解剖部位之间的联系,可以试用于临床,但需要进一步的完善。
Objective To explore the value and characteristics of the proposed application of the International League Against Seizures (FTI) on the classification of epilepsy (2001) in partial epilepsy. Methods A total of 128 patients with partial epilepsy who were caught in the epileptic center of our hospital from June 1996 to October 2004 were collected. The epileptic patients were captured by video-EEG monitoring. Three neurologists trained in formal epilepsy and electroencephalography were classified. Results A total of 298 seizures were detected in 128 patients. According to the 1981 classification criteria, 97 (32%) were simple partial seizures, 105 (35%) were complicated seizures and 12 (4%) seizures were difficult to accurately classify as simple or complex, 81 ( 27%) were secondary to full-blown episodes and 3 (1%) were partial-status epilepticus. According to the 2001 classification recommendation, there were 295 episodes of self-limiting focal episodes, of which 67 (22%) were Focal seizures, 140 episodes (47%) were focal motor episodes, including 81 (27%) focal motor episodes with temporal lobe autopsy and 81 (27%) were secondary Seizures, 3 times as focal episodes of epileptic seizures. In the 2001 classification scheme, the type of seizure manifested a characteristic clinical symptom that closely corresponded to the anatomic site of the epileptic discharge at the time of attack, however, the symptoms of the high-grade cortex were somewhat neglected. Conclusion The classification of international epileptic seizures in 2001 showed good seizure symptoms, the type of seizure and the relationship between the anatomical parts. It can be used clinically but needs further improvement.