Kollar Branislav, Klobucnikova Katarina, Fecikova Anna, Borovska Jana
1st Department of Neurology, University Hospital, Comenius University, Bratislava, Slovakia.
Neuro Endocrinol Lett. 2010;31(6):814-7.
Authors warn of difficulties in diagnostic of solitary epileptic seizure and epilepsy.
Our groups have been made up of patients, who have been dismissed from our clinic in the period from January 1997 to January 2007 with diagnosis of solitary unprovoked epileptic seizure (n=84) and epilepsy with sporadic epileptic seizure (n=179). We have evaluated the clinical typology of epileptic seizure, EEG findings and results of imaging methods and we determined the part of patients with complete diagnostic concordance between clinical image of epileptic seizure and results of auxiliary diagnostic methods.
We have denoted the complete diagnostic concordance among the clinical image, EEG findings and results of imaging methods only in 13.1% of patients after solitary unprovoked epileptic seizure and in 24.02% of patients with diagnosis of epilepsy with sporadic epileptic seizures. The receiving diagnosis of unclear seizure status was determined at 49.14% of patients dismissed with diagnosis of solitary epileptic seizure and at 40.78% of patients dismissed with diagnosis of epilepsy with sporadic epileptic seizures in 10 year time period.
Our results repeat the confirmation that the diagnostic of seizure disorders, with and without disturbance of consciousness, belong to the difficult part in the clinical praxis.
作者警示孤立性癫痫发作和癫痫诊断存在困难。
我们的研究组由1997年1月至2007年1月期间从我们诊所出院的患者组成,这些患者被诊断为孤立性特发性癫痫发作(n = 84)和伴有散发性癫痫发作的癫痫(n = 179)。我们评估了癫痫发作的临床类型、脑电图结果和影像学检查结果,并确定了癫痫发作临床图像与辅助诊断方法结果完全诊断一致的患者比例。
我们发现,在孤立性特发性癫痫发作后的患者中,仅13.1%的患者临床图像、脑电图结果和影像学检查结果完全诊断一致;在诊断为伴有散发性癫痫发作的癫痫患者中,这一比例为24.02%。在10年期间,诊断为癫痫发作状态不明的患者比例在诊断为孤立性癫痫发作出院的患者中为49.14%,在诊断为伴有散发性癫痫发作的癫痫出院的患者中为40.78%。
我们的结果再次证实,无论有无意识障碍,癫痫发作疾病的诊断都是临床实践中的难点。