Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, California, U.S.A.
Epilepsia. 2014 Apr;55(4):475-82. doi: 10.1111/epi.12550. Epub 2014 Apr 14.
Epilepsy was defined conceptually in 2005 as a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures. This definition is usually practically applied as having two unprovoked seizures >24 h apart. The International League Against Epilepsy (ILAE) accepted recommendations of a task force altering the practical definition for special circumstances that do not meet the two unprovoked seizures criteria. The task force proposed that epilepsy be considered to be a disease of the brain defined by any of the following conditions: (1) At least two unprovoked (or reflex) seizures occurring >24 h apart; (2) one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years; (3) diagnosis of an epilepsy syndrome. Epilepsy is considered to be resolved for individuals who either had an age-dependent epilepsy syndrome but are now past the applicable age or who have remained seizure-free for the last 10 years and off antiseizure medicines for at least the last 5 years. "Resolved" is not necessarily identical to the conventional view of "remission or "cure." Different practical definitions may be formed and used for various specific purposes. This revised definition of epilepsy brings the term in concordance with common use. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
癫痫于 2005 年被概念化为一种大脑疾病,其特征为存在持久的产生癫痫发作倾向。该定义通常实际应用为出现两次无诱因发作,且两次发作之间相隔超过 24 小时。国际抗癫痫联盟(ILAE)接受了一个特别工作组的建议,对不符合两次无诱因发作标准的特殊情况的实用定义进行了修改。该工作组提出,可以将癫痫视为一种脑部疾病,其定义如下:(1)至少两次无诱因(或反射性)发作,发作之间相隔超过 24 小时;(2)一次无诱因(或反射性)发作和进一步发作的概率与两次无诱因发作后 10 年内的一般复发风险(至少 60%)相似;(3)癫痫综合征的诊断。对于那些曾经患有年龄相关的癫痫综合征但现已过适用年龄的个体,或在过去 10 年内无发作且已停止抗癫痫药物治疗至少 5 年的个体,可认为癫痫已得到解决。“解决”不一定与“缓解”或“治愈”的传统观点相同。可能会形成和使用不同的实用定义来满足各种特定目的。本修订后的癫痫定义使该术语与常见用法保持一致。本文的幻灯片摘要可在此处的支持信息部分下载。