汕头大学医学院儿科学课件 Epilepsy.pptVIP

Epilepsy Shi Xue Chuan General Considerations A seizure is a sudden, transient disturbance of brain function, manifested by involuntary motor, sensory, autonomic, or psychic phenomena, alone or in any combination, often accompanied by alteration or loss of consciousness. A seizure may occur after a metabolic, traumatic, anoxic, or infectious insult to the brain. Repeated seizures without evident cause justify the label of epilepsy. General Considerations Incidence is greatest in early and late life, with a prevalence of approximately 3～6 ‰. Chance of having a second seizure after an initial unprovoked episode is 30%. Chance of remission from epilepsy in childhood is 80%. General Considerations Recurrence rate after the withdrawal of drugs is about 30%. Idiopathic or genetic epilepsy most often appears between ages 4 and 16 yaers. General Considerations Factors adversely influencing recurrence include: Difficulty in getting the seizures under control Neurologic dysfunction or mental retardation Age at onset under 2 years Abnormal EEG at the time of discontinuing medication Type of epilepsy Etiology Genetic factor Brain damage and dysmetabolism Inborn Acquired Causative factor Classification Classified by etiology Idiopathic (essential) epilepsy Symptomatic (secondary) epilepsy Cryptogenic epilepsy Classification Classified by epileptic seizures Partial (foal, local) seizures Simple partial seizures, without impairment of consciousness With motor signs With somatosensory or special-sensory symptoms With autonomic symptoms or signs With psychic symptoms Classification Classified by epileptic seizures Complex partial seizures, with impairment of consciousness Partial seizures evolving to secondarily generalized seizures Classification Classified by epileptic seizures Generalized seizures Absence seizures Typical absence Atypical absence Myoclonic seizures Clonic seizures Tonic seizures Tonic-clonic seizures Atonic seizures Infant spasm, tonic-spasm Unclassified e