Academic Neurology Unit, The University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, United Kingdom; Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, United Kingdom.
Seizure. 2023 Dec;113:48-53. doi: 10.1016/j.seizure.2023.11.008. Epub 2023 Nov 11.
The typical adult patient presenting with a first seizure has a normal clinical examination, uninformative investigations, and often has no witness to their episode. The assessing clinician, therefore, has one primary source of information to guide their assessment; the patient's experience. However, seizure phenomenology - the subjective seizure experience - has received relatively less attention by researchers than objective semiology or investigations. This essay reviews the clinical importance of seizure phenomenology, and the challenges clinicians face in eliciting accurate and clinically relevant descriptions of ictal experience. I conclude by discussing tools that clinicians may use to support the clinical application of seizure phenomenology, and exploring the subjectivity of epilepsy more broadly.
典型的首次发作的成年患者临床检查正常，检查结果无提示，且发作时通常没有目击者。因此，评估临床医生主要依靠患者的体验这一单一信息来源来进行评估。然而，与客观症状或检查相比，发作现象学（主观发作体验）在研究中受到的关注相对较少。本文回顾了发作现象学的临床重要性，以及临床医生在获取准确和具有临床相关性的发作体验描述方面所面临的挑战。最后，我讨论了临床医生可能用于支持发作现象学临床应用的工具，并更广泛地探讨了癫痫的主观性。
