癫痫病史采集及体格检查课件.ppt

癫痫病史采集及体格检查 重庆医科大学儿童医院神经内科 梁锦平 痫性发作Epileptic Seizure 因大脑神经元过度或同步性放电所引起的暂时性的体征和/或症状; A transient occurrence of signs /or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. 癫痫发作的临床特征之一:明确的起病和结束过程 Mode of onset termination 暂时性或一过性意味着清楚的开始与结束,但前者通常较后者更加明确 ”transient”is demarcated in time, with a clear start finish, the later is often less evident than the onset; 癫痫持续状态是一种持续或反复发作的特殊情况SE is a special circumstance with prolonged or recurrent Sz. 癫痫发作的临床特征之二:典型的临床表现Clinical manifestation 取决于发作起始的部位,传播的形式,大脑的成熟度,复杂的疾病过程,清醒与睡眠周期,医疗过程和其他因素; Seizure presentation depends on location of onset in the brain, patterns of propagation, confounding disease processes, sleep-wake cycle, medications other factors. 癫痫发作的临床特征之二:典型的临床表现Clinical manifestation 痫性发作可影响感觉、运动、自主神经功能、意识、情感状态、记忆、认知和行为功能。 Seizures can affect sensory, motor, autonomic function, consciousness, emotional state, memory, cognition or behavior. 癫痫发作的临床特征之二:典型的临床表现Clinical manifestation 感觉性发作包括躯体感觉、听觉、视觉、嗅觉、味觉、前庭觉和复杂性感知觉。 Sensory manifestations include somatosensory, auditory, visual, olfactory, gustatory, vestibular senses complex perceptual distortions (psychic) 癫痫发作的临床特征之二:典型的临床表现Clinical manifestation 发作中的认知缺陷主要表现为感知、注意力、情感（畏惧、兴奋、满足、焦虑和其他）、记忆（阳性与阴性）、执行、实践和语言功能障碍 Cognitive deficits during seizures can appear as problems with perception, attention, emotion (fear, elation, satisfaction, anxiety others), memory (positive negative), execution, praxis or speech 脑电图特征：异常强化的神经元同步Abnormal enhanced synchrony 癫痫发作常见的脑电图特征主要表现为异常强化的神经元同步，无论这种放电是抑制性或是兴奋性的。 EEG discharges featured more common to epileptic seizures is abnormal enhanced synchrony of neurons regardless of firing of neurons involving inhibition or excitation。 临床下发作Subclinical seizures 具有类似于某些痫性发作的脑电图,但没有患者的临床表现或被旁人所观察,不能诊断为痫性发作;然而,微小发作和意识水平下降应值得警惕; EEG patterns that resemble those seen during some epileptic seizures, but are perceived neither by patient ore by the observer are not defined as epileptic seizures; however, subt