UCL Institute of Neurology, Box 5, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
Epilepsy Behav. 2014 Mar;32:1-8. doi: 10.1016/j.yebeh.2013.12.025. Epub 2014 Jan 22.
The concept of symptomatic epilepsy and the difficulties in assigning cause in epilepsy are described. A historical review is given, emphasizing aspects of the history which are relevant today. The historical review is divided into three approximately semicentenial periods (1860-1910, 1910-1960, 1960-present). A definition of symptomatic epilepsy and this is followed by listing of causes of symptomatic epilepsy. The fact that not all the causes of idiopathic epilepsy are genetic is discussed. A category of provoked epilepsy is proposed. The complexities in assigning cause include the following: the multifactorial nature of epilepsy, the distinction between remote and proximate causes, the role of nongenetic factors in idiopathic epilepsy, the role of investigation in determining the range of causes, the fact that not all symptomatic epilepsy is acquired, the nosological position of provoked epilepsy and the view of epilepsy as a process, and the differentiation of new-onset and established epilepsy. The newly proposed ILAE classification of epilepsy and its changes in terminologies and the difficulties in the concept of acute symptomatic epilepsy are discussed, including the inconsistencies and gray areas and the distinction between idiopathic, symptomatic, and provoked epilepsies. Points to be considered in future work are listed.
描述了症状性癫痫的概念和在癫痫中确定病因的困难。本文进行了历史回顾，强调了与今天相关的历史方面。历史回顾分为三个大约半世纪的时期（1860-1910 年、1910-1960 年、1960 年至今）。给出了症状性癫痫的定义，并列出了症状性癫痫的病因。讨论了并非所有特发性癫痫的病因都是遗传的这一事实。提出了一种诱发性癫痫类别。确定病因的复杂性包括以下几点：癫痫的多因素性质、远因和近因的区别、非遗传因素在特发性癫痫中的作用、调查在确定病因范围中的作用、并非所有症状性癫痫都是获得性的、诱发性癫痫的分类位置以及将癫痫视为一种过程，以及新发和已确立的癫痫的区别。讨论了新提出的 ILAE 癫痫分类及其术语变化以及急性症状性癫痫概念中的困难，包括不一致和灰色区域以及特发性、症状性和诱发性癫痫之间的区别。列出了今后工作中需要考虑的要点。
