Department of Neurosurgery, Mattel Children's Hospital, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
Epilepsia. 2012 Jul;53 Suppl 2(Suppl 2):22-7. doi: 10.1111/j.1528-1167.2012.03555.x.
Neuroimaging significantly affects the diagnosis and treatment of patients with patients. Despite its importance, magnetic resonance imaging (MRI) has been marginally incorporated into concepts used to define epilepsy etiologies by the International League Against Epilepsy (ILAE) Classification Commission. We propose that Structural etiology be defined as positive neuroimaging abnormalities likely causing the seizures. This would contrast with Genetic and Unknown etiologies, where imaging shows no overt structural abnormality that explains the seizures. It is further recommended that Structural and Metabolic be separated into individual categories, as the outcomes and therapies are different. It is advocated that Structural etiology be subdivided into subgroups based on MRI and surgical syndromes. With this approach, the ILAE should acknowledge that both MRI and electroencephalography (EEG) are necessary diagnostic tools in the classification of epilepsy syndromes and etiologies in the modern era. Promoting the use of neuroimaging into concepts that determine terminology will promote the notion that epilepsy classification should consider structural etiology of the seizures, along with the frequency of the most common epilepsy syndromes, and prognosis for spontaneous and treated remission and cure.
神经影像学对患者的诊断和治疗有重大影响。尽管它很重要，但磁共振成像（MRI）在国际抗癫痫联盟（ILAE）分类委员会用来定义癫痫病因的概念中只是略有涉及。我们建议将结构性病因定义为可能导致癫痫发作的阳性神经影像学异常。这与遗传和未知病因形成对比，在这些病因中，影像学检查没有明显的结构异常来解释癫痫发作。进一步建议将结构性和代谢性病因分开为单独的类别，因为它们的结果和治疗方法不同。提倡根据 MRI 和手术综合征将结构性病因进一步细分为亚组。通过这种方法，ILAE 应该承认 MRI 和脑电图（EEG）都是现代癫痫综合征和病因分类中必要的诊断工具。将神经影像学应用于确定术语的概念中，可以促进这样一种观念，即癫痫分类应该考虑癫痫发作的结构性病因，以及最常见的癫痫综合征的频率，以及自发性和治疗缓解和治愈的预后。
