发作与癫痫课件.ppt

Status Epilepticus A Life-threatening Conditions Prolonged seizure (over up to 30 minutes or consciousness does not regained between attacks) 60% of people who develop this condition have no prior seizure history * * Seizure Epilepsy發作與癲癇 高雄醫學大學神經內科暨 行為科學研究所副教授 戴志達醫師 Seizure A seizure is a temporary involuntary disturbance of brain function that may be manifested as impaired consciousness, convulsions (or muscle spasms), sensory disturbances, or emotional, behavioral or autonomic changes Definitions 發作 ( Seizure ) 腦神經細胞活動不穩、過度放電所導致的各種臨床現象 抽搐 (Convulsion) : 肢體抽動 癲癇 ( Epilepsy ) : Repetitive Seizures 因腦細胞的不正常放電造成的各種症候群 A Common Misunderstanding * Superstition Being chosen or possessed ? * Stigma Caused by mental illness or retardation ? 歷史上罹患癲癇的名人 蘇格拉底、柏拉圖 亞歷山大大帝 凱撒大帝、拿破崙 杜斯妥也夫斯基 梵谷 海頓 Diagnosis of epilepsy Two spontaneous (unprovoked) seizures during the previous year Electroencephalography Causes of Epilepsy Symptomatic due to a recognizable brain insult Cryptogenic a symptomatic etiology is suspected but can not be demonstrated Idiopathic due to genetic defect (Epilepsy itself is the primary disorder) 66% 2% 6% 11% 4% 8% 3% 癲 癇 的 發 生 原 因 發生率： 0.5 - 0.8 %人口 ; 台灣 約 17 萬病患 Case 6 Genetic No clear susceptibility gene for idiopathic generalized epilepsy (IGE) (except opioid receptor μ-subunit gene in absence epilepsy ?) IGE may develop only with a much larger group of susceptibility genes 癲 癇 發 作 的 分 類  I. Partial Seizure (One Hemisphere) - 60% A. 單純性局部癲癇 simple partial seizure ( 仍有意識 ) B. 複雜性局部癲癇 complex partial seizure ( 失去意識 ) C. 局部癲癇發展為續發性全身性癲癇 secondarily generalized seizure ◎局部型癲癇 為一種局部放電之癲癇發作。 患者會有先兆，根據不同的的放電部位而有不同的症狀。 有時候會轉變成大發作。 癲 癇 發 作 的 分 類 II. Generalized Seizure (Both Hemispheres) - 36% A.失神發作 Absence seizures (petit mal) B. 肌抽躍發作 Myoclonic seizures C. 陣攣發作 Clonic seizures D. 強直發作 Tonic seizures E. 強直陣攣發作 Tonic-Clonic seizures (gr