Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA.
Epilepsia. 2013 Jun;54(6):1125-30. doi: 10.1111/epi.12157.
The ILAE 2010 report does not classify focal seizures and instead uses “descriptors” to distinguish focal seizures with versus without impaired consciousness. Below, we recall a recent informal conversation that took place while traveling a back road in Australia (true story), discussing problems with the old terms as well as new biological and practical evidence separating events formerly known as complex partial versus simple partial seizures. Impaired level of consciousness is a core distinguishing feature of focal seizures, which arises from established physiological mechanisms and can be readily determined based on behavior in most cases. After some debate, we arrive at succinct terms compatible with the old as well as the new ILAE classification report: Focal Impaired Consciousness Seizures (FICS), and Focal Aware Conscious Seizures (FACS). We hope that this discussion will bring impaired consciousness off the back roads of epilepsy classification, and provide useful names for these two very common seizure types.
ILAE 2010 报告并未对局灶性发作进行分类，而是使用“描述符”来区分意识障碍与无意识障碍的局灶性发作。下面，我们回忆一下在澳大利亚一条偏僻道路上旅行时进行的一次非正式对话（真实故事），讨论了旧术语以及新的生物学和实际证据所带来的问题，这些证据将以前被称为复杂部分性发作与简单部分性发作的事件区分开来。意识障碍是局灶性发作的核心鉴别特征，它源于既定的生理机制，并且在大多数情况下可以根据行为来确定。经过一番讨论，我们提出了与旧分类报告以及新 ILAE 分类报告都兼容的简洁术语：局灶性意识障碍性发作（Focal Impaired Consciousness Seizures，FICS）和局灶性意识清晰性发作（Focal Aware Conscious Seizures，FACS）。我们希望本次讨论能使意识障碍不再成为癫痫分类的一个边缘问题，并为这两种常见的发作类型提供有用的命名。
