国际癫痫诊断分类课程.ppt

局灶性发作 发作起始方式的说明与解释：起源并局限于一侧半球的网络；这个网络可是局部或更广泛的分布；局灶性发作可起源于皮质下结构；对于每一种发作类型而言，每次发作的起始部位固定，易于扩散，可累及对侧皮质。但在有些病例，不止存在一个起源网络，可有多种发作类型，但每种发作类型有其恒定的起源部位。 Focal seizures  不再将局灶性发作分为不同类型（如复杂部分性与简单部分性发作）。 对意识或觉醒度的降低或其他认知障碍特点、部位及发作性事件进展的认识，对于评估个体患者和特殊目的（如区别癫痫发作与非癫痫事件、随机对照试验及手术）很重要。本建议并不反对依据这些特点或其他特征对局灶性发作进行描述 * * * * So new concepts and terminology for organizing the epilepsies have been recommended. This is an ORGANIZATION rather than a Classification as we are not realistically at the point at which we can classify according to the biology of these disorders in a scientific way. In this presentation we will discuss what we have done in the new organization. * * Changes in the new organization are structural and in general do not affect diagnostic entities. Here are the key items we will work through. * * * * * * Here is a diagram that shows a conceptual network for generalized seizures involving the corticothalamic circuitry. Theoretically a generalized seizure could start at different points in the network and engage bilaterally distributed networks. Thus a seizure could start frontally or even parietally.The key point is that a generalized seizure can start from a focal point. * * Here is a diagram that shows a conceptual network for generalized seizures involving the corticothalamic circuitry. Theoretically a generalized seizure could start at different points in the network and engage bilaterally distributed networks. Thus a seizure could start frontally or even parietally. Here the conceptual diagram of the network is superimposed on a functional MRI of generalized spike wave activity. * * The organization of generalized seizures has actually been simplified from 1981 and 2006 * * * * Syndrome names retain the word “benign” eg. benign familial neonatal seizures, benign childhood epilepsy with centro temporal spikes * * 2010年国际癫痫诊断分 类  2010 Proposal for Revised Terminology for Organization of Seizures and Epilepsies 北京大学第一医院儿科 秦 炯 昆明军海脑科医院 兰州癫痫病医院 沈阳羊癫疯医院广州癫痫病医院