Karbowski K
Neurologische Universitätsklinik, Inselspital, Bern.
Schweiz Rundsch Med Prax. 1991 Sep 3;80(36):892-5.
There are many different causes for an alternate outbreak of different seizure manifestations in the same patient. According to Herpin's 'law of identity', this is more a question of differing degrees of intensity of the same seizure type. Subsequently, minor or partial seizures are to be interpreted as rudimentary forms of 'major' seizures. This may be true for some, but not for all cases. It would be daring to maintain that a typical absence is a rudimentary form of a 'grand mal' seizure. Their mutual pathogenetic relations are unknown. A series of other cases would likewise go beyond the scope of Herpin's law. A patient can show, even during a cerebral condition of the same etiology, several different localized epileptogenic foci which 'flame up' alternately and initiate different types of seizures. Progressive cerebral illnesses can lead to a change in the original seizure symptoms and can also trigger off additional seizure forms. This can occasionally occur during medication. Finally, it is necessary to consider the possibility of an alternate outbreak of epileptic and nonepileptic seizures in the same patient.
同一患者交替出现不同发作表现有许多不同原因。根据埃尔潘的“同一性法则”，这更多是同一发作类型不同强度程度的问题。随后，轻微或部分性发作应被解释为“全身性”发作的初级形式。这对某些情况可能是正确的，但并非对所有情况都如此。断言典型失神发作是“癫痫大发作”的初级形式是大胆的。它们相互的发病机制关系尚不清楚。一系列其他情况同样超出了埃尔潘法则的范围。即使在病因相同的脑部疾病期间，患者也可能表现出几个不同的局限性致痫灶，这些致痫灶交替“发作”并引发不同类型的发作。进行性脑部疾病可导致原始发作症状的改变，也可引发额外的发作形式。这偶尔会在用药期间发生。最后，有必要考虑同一患者癫痫发作和非癫痫发作交替出现的可能性。
