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本刊将全文发表以Engel教授为首的工作组于2001年5月在第24届国际癫癎学术会议上提出的癫癎发作和癫癎诊断的方案(Epilepsia,2001,46:796-803)。 近年来随着基因学、分子生物学、中枢神经递质、微电生理及临床电生理等方面的进步,加深了对癫癎的机制和临床的了解。在此基础上重新审视癫癎的分类是必然的。目前国际通用的分类为1981年国际抗癫癎联盟(ILAE)的《癫癎发作的临床及脑电图分类》和1989年ILAE的《癫癎综合征的分类》(中华神经科杂志,2001,34:197-189.)。在临床实践中的确有的癫癎病很难归入上述两个分类中的任何一种。有鉴于此,以Engel为首的工作组提出了这个新建议。新建议与1981和1989两个分类最大的不同是放弃了“部分性”发作的概念;再次使用“局灶”一词代替“部分”一词;不再应用“惊厥(convulsion)”;在分类中增加了与癫癎相关疾病的内容。这个方案虽然总结了近年癫癎学研究的进展,但是否适用于临床,还需在未来实践中验证;是否会出现新的问题,如1981年分类中有关高级皮质功能的症状在这个方案中完全消失了,是否会使某些患者的临床诊断无所适从,也有待今后在实践中才能确定。 全文翻译这个分类方案的目的是希望有助于读者了解癫癎分类学的新观点,而不是主张立即用于临床。希望有条件的学
This issue of the full publication of the Engel Professor led by the Working Group in May 2001 at the 24th International Conference on Epilepsy Epilepsy and epilepsy diagnosis program (Epilepsia, 2001, 46: 796-803). In recent years, along with advances in genetics, molecular biology, neurotransmitters, microelectrophysiology and clinical electrophysiology, the mechanism and clinical understanding of epilepsy have been deepened. On this basis, re-examine the classification of epilepsy is inevitable. The current international classification of the 1981 International Antiepileptic League (ILAE) “epilepsy clinical and electroencephalographic classification” and ILAE in 1989 “Epilepsy syndrome classification” (Journal of Neurology, 2001, 34: 197-189.). It is difficult to classify epilepsy in clinical practice into any of these two categories. In view of this, the Engel-led working group made this new proposal. The major difference between the new proposal and the two categories of 1981 and 1989 is the abandonment of the concept of “partial” attacks; the re-use of the term “focal” in place of “partial”; the “convulsion” no longer applied; In the increase with the epilepsy-related diseases. Although this program summarizes the recent progress in the study of epilepsy, but whether applicable to clinical, but also need to verify in the future practice; whether there will be new problems, such as the 1981 classification of symptoms of advanced cortical function in this program completely Disappear, whether it will make some patients clinical diagnosis know what to do, but also to be determined in practice in the future. The purpose of this classification scheme is to help readers understand the new viewpoints of epilepsy taxonomy rather than claim immediate clinical use. I hope conditional learning