Department of Neurology, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania Epilepsy Centre Kork, Kehl-Kork, Germany.
Epilepsia. 2011 Jun;52(6):1168-76. doi: 10.1111/j.1528-1167.2010.02974.x. Epub 2011 Feb 14.
To gain new insights into the clinical presentation, causes, treatment and prognosis of epilepsia partialis continua (EPC), and to develop hypotheses to be tested in a prospective investigation.
In this retrospective multicenter study, all cases were included that fulfilled these criteria: constantly repeated fragments of epileptic seizures, with preserved consciousness, lasting ≥ 1 h and representing locally restricted motor or sensory epileptic activity. Single episodes were included when they lasted for a minimum of 1 day. EPC with Rasmussen syndrome and acute stroke were excluded.
Three time courses with two subtypes each were distinguished, that is, EPC as a solitary event (de novo or in preexistent epilepsy); chronic repetitive nonprogressive EPC (with frequent or rare episodes); and chronic persistent nonprogressive EPC (primarily or evolving out of an episodic course). These were unrelated to etiologies (morphologic lesions 34%, inflammatory 29%, systemic disorders 9%, idiopathic 5%, unknown 23%). Precipitation and inhibition of seizures is a frequent feature of EPC. Levetiracetam and topiramate have improved the possibilities for pharmacotherapy. Topiramate seems to be particularly effective with dysontogenetic etiologies.
The existence of several clearly distinct courses of nonprogressive EPC is a new finding. These distinctions will be further investigated in a prospective study with precise protocols for electroencephalography (EEG), imaging, and other studies. This should better establish the relation of motor and somatosensory EPC; further clarify the relations, pathogenesis, and significance of the different types and their etiologies; and possibly identify more semiologic variants. It should also provide more precise knowledge about therapy and modification of ictogenesis by external stimuli.
深入了解部分连续性癫痫发作（EPC）的临床表现、病因、治疗和预后，并提出假设，以便在前瞻性研究中进行检验。
在这项回顾性多中心研究中，纳入符合以下标准的所有病例：持续重复的癫痫发作片段，意识保存，持续时间≥1 小时，代表局部局限性运动或感觉癫痫活动。单发性发作持续时间至少 1 天也包括在内。排除 Rasmussen 综合征和急性中风引起的 EPC。
区分出三个时间过程，每个过程都有两种亚型，即作为单一事件的 EPC（新发或既有癫痫）；慢性重复非进行性 EPC（发作频繁或罕见）；慢性持续性非进行性 EPC（主要或从发作性病程演变而来）。这些与病因无关（形态病变 34%、炎症 29%、系统性疾病 9%、特发性 5%、未知 23%）。癫痫发作的诱发和抑制是 EPC 的常见特征。左乙拉西坦和托吡酯改善了药物治疗的可能性。托吡酯对于发育不良病因似乎特别有效。
非进行性 EPC 存在几种明显不同的病程是一个新发现。这些区别将在一项前瞻性研究中进一步研究，该研究将为脑电图（EEG）、影像学和其他研究制定精确的方案。这将更好地确定运动和感觉 EPC 的关系；进一步阐明不同类型及其病因的关系、发病机制和意义；并可能确定更多的半影变体。它还应提供更精确的知识，了解外部刺激对治疗和癫痫发生的影响。
