van Donselaar C A, Geerts A T, Schimsheimer R J
Department of Neurology, University Hospital Rotterdam-Dijkzigt, The Netherlands.
Epilepsia. 1990 Sep-Oct;31(5):529-35. doi: 10.1111/j.1528-1157.1990.tb06102.x.
In 67 of 149 patients with a generalized first seizure, the occurrence of some kind of sensation immediately preceding the loss of consciousness was the only clue that possibly indicated focal onset of the seizure. We studied the interobserver agreement between six neurologists regarding the interpretation of these preceding feelings as either a nonspecific symptom or an aura implicating a focal onset of the seizure. The observers also classified the seizures as generalized from onset, undetermined, or partial secondarily generalized. To assess the accuracy of the classification, we obtained a standard EEG, an EEG after partial sleep deprivation, a computed tomography (CT) scan, and a follow-up report after 1 year. The subclassification on clinical grounds of a generalized first seizure is too unreliable and probably too invalid as well to be useful in clinical practice or in epidemiologic research.
在149例首次发生全身性癫痫发作的患者中，有67例在意识丧失前立即出现某种感觉，这是可能提示癫痫发作灶性起始的唯一线索。我们研究了六位神经科医生之间关于将这些发作前感觉解释为非特异性症状或提示癫痫发作灶性起始的先兆的观察者间一致性。观察者还将癫痫发作分类为从发作开始即为全身性、无法确定或继发性全身性部分性发作。为评估分类的准确性，我们进行了标准脑电图、部分睡眠剥夺后的脑电图、计算机断层扫描（CT）以及1年后的随访报告。基于临床依据对首次全身性癫痫发作进行亚分类在临床实践或流行病学研究中太不可靠，可能也太无效而无法使用。
