Fisher Robert S, Bonner Anna M
a Department of Neurology and Neurological Sciences Stanford University School of Medicine , Stanford , California.
b ASET - The Neurodiagnostic Society , Cary , North Carolina.
Neurodiagn J. 2018;58(1):1-10. doi: 10.1080/21646821.2018.1428455.
The definition of who has epilepsy, classification of seizure types, and types of epilepsy have all recently been revised. The classical definition of epilepsy as a person having two or more unprovoked seizures more than 24 hours apart has been expanded also to include those with one seizure and a high likelihood (more than 60%) of having another. In the new definition, epilepsy is considered to be resolved when a person is seizure-free for 10 years, the terminal 5 being off seizure medicines, or when an age-dependent syndrome has been outgrown. The new seizure type classification revises the 1981 system but maintains the primary distinction of focal- versus generalized-onset seizures. Seizures also can be of unknown onset. Focal seizures may demonstrate retention or impairment of awareness, resulting in focal-aware or focal-impaired awareness seizures. Several new focal and generalized seizure types are introduced. Classification of the epilepsies is now by grouping of seizure types, etiologies, comorbidities, and epilepsy syndromes. The goal of the new terminology is greater clarity of communication and more accurate grouping of seizure types for research. Neurodiagnostic technologists can be of great help in observing clinical and electrographic features that will define the type of seizure.
癫痫患者的定义、发作类型分类以及癫痫类型最近均已修订。癫痫的经典定义是一个人出现两次或更多次间隔超过24小时的无诱因发作，现在这一定义也已扩展，将那些仅有一次发作且再次发作可能性很高（超过60%）的人纳入其中。在新定义中，如果一个人无癫痫发作达10年，最后5年未服用抗癫痫药物，或者某种年龄相关性综合征已不再出现，则认为癫痫已缓解。新的发作类型分类对1981年的系统进行了修订，但仍保留了局灶性发作与全面性发作的主要区分。发作起始也可能不明。局灶性发作可能表现为意识保留或受损，从而导致局灶性意识清醒发作或局灶性意识障碍发作。还引入了几种新的局灶性和全面性发作类型。癫痫的分类现在是根据发作类型、病因、合并症和癫痫综合征进行分组。新术语的目标是使交流更加清晰，并为研究更准确地对发作类型进行分组。神经诊断技术人员在观察能够确定发作类型的临床和脑电图特征方面会有很大帮助。
