Engel J, Troupin A S, Crandall P H, Sterman M B, Wasterlain C G
Ann Intern Med. 1982 Oct;97(4):584-98. doi: 10.7326/0003-4819-97-4-584.
Recent advances in the diagnosis of epilepsy include the development of a clinically useful classification of epileptic seizures and the recognition of specific epileptic disorders. These advances have been aided by the advent of x-ray computed tomography, long-term electroencephalographic telemetry, and video monitoring. Techniques for functional imaging of the human brain promise even greater diagnostic capabilities. New antiepileptic drugs have improved medical management, and technical and theoretical advances in pharmacokinetics have permitted physicians to design balanced dosing for individual patients. Although currently underused, surgical treatment of partial complex epilepsy can be safe and effective when used appropriately. Operant conditioning of electroencephalography may become another practical alternative therapy. Contributions of basic research to understanding the complications of status epilepticus have influenced treatment protocols and greatly improved the prognosis of this potentially lethal condition.
癫痫诊断的最新进展包括制定了临床上有用的癫痫发作分类以及识别特定的癫痫疾病。X射线计算机断层扫描、长期脑电图遥测和视频监测的出现推动了这些进展。人脑功能成像技术有望带来更强的诊断能力。新型抗癫痫药物改善了药物治疗,药代动力学的技术和理论进展使医生能够为个体患者设计均衡的给药方案。尽管目前使用不足,但部分复杂性癫痫的手术治疗在适当使用时可以安全有效。脑电图的操作性条件反射可能成为另一种实用的替代疗法。基础研究对理解癫痫持续状态并发症的贡献影响了治疗方案,并大大改善了这种潜在致命疾病的预后。