国际抗癫痫联盟（ILAE）癫痫分类：不同诊断类别的适用性及实用价值。伦巴第大区癫痫观察站（OREp）

ILAE classification of epilepsies: its applicability and practical value of different diagnostic categories. Osservatorio Regionale per L'Epilessia (OREp), Lombardy.

出版信息

Epilepsia. 1996 Nov;37(11):1051-9. doi: 10.1111/j.1528-1157.1996.tb01024.x.

DOI:10.1111/j.1528-1157.1996.tb01024.x

Abstract

PURPOSE

The study was aimed at verifying the applicability of the ILAE classification and the appropriateness of the different diagnostic categories in a large series of patients with epilepsy observed by epilepsy centers.

METHODS

Data concerning 10,342 patients observed by a network of 14 epilepsy centers in the Lombardy region between June 1990 and June 1994 were collected by using a simple standard form and stored in a PC database.

RESULTS

The diagnosis of epilepsy was assessed in 8,570 patients; the remaining 1,772 cases were excluded from the analysis as being affected by nonepileptic ictal events or by isolated or situation-related seizures, including febrile and neonatal convulsions. A definite syndromic diagnosis, according to the ILAE Classification criteria, was made in 7,332 (85.5%) of 8,570 cases. Atypical features were found in 995 (11.6%) cases, who were therefore classified as uncertain; 198 (2.3%) cases remained unclassified; and in the remaining 45 patients, the diagnosis was not properly codified. The seizure-control profile was found to be highly related to the syndromic diagnosis. The highest percentage of drug-resistant cases was found among patients with generalized symptomatic or cryptogenic syndromes (32.3%) and among cases with partial symptomatic epilepsy (19.8%), whereas virtually no drug-resistant cases were found among patients with idiopathic epilepsies.

CONCLUSIONS

The ILAE classification was found satisfactory in the large majority of cases observed at tertiary centers; however, the appropriateness of its various items in identifying homogeneous subpopulations was uneven, being maximal for those syndromes defined by highly consistent electroclinical pictures. An early identification of the characteristic pictures of distinct epileptic syndromes appears to be a valuable prerequisite for diagnostic and therapeutic approaches.

摘要

目的

本研究旨在验证国际抗癫痫联盟（ILAE）分类在癫痫中心观察的大量癫痫患者中的适用性以及不同诊断类别的恰当性。

方法

1990年6月至1994年6月期间，通过使用简单的标准表格收集了伦巴第地区14个癫痫中心网络观察的10342例患者的数据，并存储在个人电脑数据库中。

结果

对8570例患者进行了癫痫诊断；其余1772例因受非癫痫性发作事件影响或因孤立性或情境相关性发作（包括热性惊厥和新生儿惊厥）而被排除在分析之外。根据ILAE分类标准，在8570例病例中有7332例（85.5%）做出了明确的综合征诊断。995例（11.6%）病例发现有非典型特征，因此被归类为不确定；198例（2.3%）病例仍未分类；在其余45例患者中，诊断编码不正确。发现癫痫控制情况与综合征诊断高度相关。耐药病例百分比最高的是全身性症状性或隐源性综合征患者（32.3%）以及部分症状性癫痫患者（19.8%），而特发性癫痫患者中几乎没有耐药病例。