Clinical Neurophysiology Department, National Institute of Neurology, Mexico City, Mexico.
Epilepsy Behav. 2011 Jul;21(3):318-20. doi: 10.1016/j.yebeh.2011.04.010. Epub 2011 May 14.
The characterization of a seizure as generalized or focal onset depends on a basic knowledge of the underlying pathophysiology. Recently, an uncommon phenomenon in generalized epilepsy-evolution of seizures from generalized to focal followed by secondary generalization-was reported for the first time. We describe a 15-year-old boy, initially classified as having partial epilepsy, who had a typical absence seizure that became focal with second secondary generalization (double generalization). On the basis of these findings his epilepsy was classified as juvenile absence epilepsy and his treatment was changed, resulting in seizure freedom. This is the first report of this unusual electroclinical evolution in a patient with juvenile absence epilepsy. The recognition of this particular pattern allows correct classification and impacts both treatment and prognosis.
癫痫发作的全面性或局灶性起始取决于对潜在病理生理学的基本知识。最近，首次报道了一种在全面性癫痫中罕见的现象——发作从全面性发展为局灶性，然后继发全面性发作。我们描述了一名 15 岁男孩，最初被归类为部分性癫痫，他出现典型的失神发作，随后出现局灶性发作伴二次全面性发作（双重全面性发作）。基于这些发现，他的癫痫被归类为青少年失神癫痫，他的治疗方案进行了更改，结果癫痫发作得到了控制。这是首例青少年失神癫痫患者出现这种不常见的电临床演变的报告。这种特殊模式的识别可以进行正确的分类，并影响治疗和预后。
