癫痫杂志

癫痫杂志

癫痫持续状态的定义与分类——ILAE工作组关于癫痫持续状态分类的报告

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国际抗癫痫联盟(ILAE)分类与术语委员会和流行病学委员会组织了一个工作组来修订癫痫持续状态(Status epilepticus, SE)的概念、定义和分类。提出SE的新定义如下:癫痫持续状态是一种由于癫痫发作终止机制的失败或者导致异常的、延长的(在时间点t1之后)癫痫发作机制的启动而导致的情况。这是一种产生长期后果(在时间点t2之后), 包括神经元死亡、神经元损伤及神经元网络改变的情况, 具体取决于癫痫发作的类型和持续时间。该定义是概念性的, 包括两个操作维度:第一是癫痫发作的时长以及时间点(t1), 超过该时间点的发作应当被认为是"持续的发作活动"; 第二时间点(t2)正在进行的发作活动的时间, 在该时间点之后存在造成长期后果的风险。在抽搐性(强直-阵挛)SE的病例中, 2个时间点(t1为5 min, t2为30 min)是基于动物试验和临床研究的。此证据不完整, 并且有待进一步证实, 所以这些时间点应被认为是目前可用的最佳时间点。其它形式的SE数据尚不可用, 但对它们的了解正在增加, 可以基于科学证据为特定形式的SE定义时间点并整合到定义当中而不改变基本的概念。一个新的SE诊断性分类系统被提出, 将为每个患者的临床诊断、研究、治疗方法提供框架。共有4个轴:①症状学; ②病因学; ③脑电图(EEG)相关; ④年龄。轴1(症状学)列出了SE的不同形式, 分为具有显著运动系统症状、无显著运动系统症状和目前尚不确定的情况(如急性意识障碍伴癫痫样EEG图形)。轴2(病因学)分为已知病因和未知病因。轴3(EEG相关)采用了最新的专家共识推荐, 应用以下EEG指标:图形的名称、形态、部位、时间相关特点、调节和干预的影响。轴4将年龄组分为新生儿、婴幼儿、儿童、青少年、成年和老年。

关键词: 癫痫持续状态; 癫痫发作; 定义; 分类; 发作持续时间

引用本文: TrinkaE, CockH, HesdorfferD, RossettiAO, SchefferIE, ShinnarS, ShorvonS, LowensteinDH, 杨华俊, 王群. 癫痫持续状态的定义与分类——ILAE工作组关于癫痫持续状态分类的报告. 癫痫杂志, 2016, 2(5): 437-445. doi: 10.7507/2096-0247.20160079 复制

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1. Gastaut H. Clinical and electroencephalographical classification of epileptic seizures. Epilepsia, 1970, 11(7):102-113.
2. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. From the Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia, 1981, 22(5):489-501.
3. Gastaut H. Clinical and electroencephalographical classification of epileptic seizures. Epilepsia, 1969, 10(Suppl.1):2-13.
4. Engel J Jr. International League Against Epilepsy (ILAE). A proposed diagnostic scheme for people with epileptic seizures and with epilepsy:report of the ILAE Task Force on Classification and Terminology. Epilepsia, 2001, 42(9):796-803.
5. Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies:report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia, 2010, 51(11):676-685.
6. Bauer G, Trinka E. Seizures, syndromes and classifications. Epileptic Disord, 2006, 8(4):162-163.
7. Gastaut H. Dictionary of epilepsy, part 1 definitions. Geneva:World Health Organisation; 1973.
8. Roger J, Lob H, Tassinari CA. Status epilepticus. In Magnus O, de Lorentz Haas AM (Ed) Handbook of clinicalneurology, Vol. 15. The epilepsies. Amsterdam:North Holland Publishing Company, 1974:145-188.
9. Meldrum BS, Horton RW. Physiology of status epilepticus in primates. Arch Neurol, 1973, 28(7):1-9.
10. Treatment of convulsive status epilepticus. Recommendations of the Epilepsy Foundation of America's Working Group on Status Epilepticus. JAMA, 1993, 270(6):854-859.
11. Guidelines for epidemiologic studies on epilepsy. Commission on Epidemiology and Prognosis, International League Against Epilepsy. Epilepsia, 1993, 34(6):592-596.
12. Towne AR, Pellock JM, Ko D, et al. Determinants of mortality in status epilepticus. Epilepsia, 1994, 35(5):27-34.
13. DeLorenzo RJ, Garnett LK, Towne AR, et al. Comparison of status epilepticus with prolonged seizure episodes lasting from 10 to 29 minutes. Epilepsia, 1999, 40(10):164-169.
14. Lowenstein DH, Bleck T, Macdonald RL. It's time to revise the definition of status epilepticus. Epilepsia, 1999, 40(5):120-122.
15. Engel J Jr. Report of the ILAE classification core group. Epilepsia, 2006, 47(11):1558-1568.
16. Gastaut H, Broughton R. Epileptic seizures:clinical and electrographic features, diagnosis and treatment. Springfield, IL:Charles C Thomas, 1972:25-90.
17. Theodore WH, Porter RJ, Albert P, et al. The secondarily generalized tonic-clonic seizure:a videotape analysis. Neurology, 1994, 44(1):1403-1407.
18. Jenssen S, Gracely EJ, Sperling MR. How long do most seizures last? A systematic comparison of seizures recorded in the epilepsy monitoring unit. Epilepsia, 2006, 47(4):1499-1503.
19. Dobesberger J, Risti' Ac'G AJ, Walser G, et al. Duration of focal complex, secondarily generalized tonic-clonic, and primarily generalized tonic-clonic seizures-a video-EEG analysis. Epilepsy Behav, 2015, 49(8):111-117.
20. Shinnar S, Berg AT, Moshe SL, et al. How long do new-onset seizures in children last?. Ann Neurol, 2001, 49(3):659-664.
21. Hauser WA, Rich SS, Annegers JF, et al. Seizure recurrence after a 1st unprovoked seizure:an extended follow-up. Neurology, 1990, 40(6):1163-1170.
22. Hesdorffer DC, Benn EK, Bagiella E, et al. Distribution of febrile seizure duration and associations with development. Ann Neurol, 2011, 70(5):93-100.
23. Bauer G, Trinka E. Nonconvulsive status epilepticus and coma. Epilepsia, 2010, 51(3):177-190.
24. Calmeil LF. De l'èpilepsieètudèe sous le rapport de son siège et de son influence sur la production de l'aliènation mentale. Paris:Thèse de Université de Paris; 1824.
25. Blume WT, Lüders HO, Mizrahi E, et al. Glossary of descriptive terminology for ictal semiology:report of the ILAE task force on classification and terminology. Epilepsia, 2001, 42(7):1212-1218.
26. Beniczky S, Hirsch LJ, Kaplan PW, et al. Unified EEG terminology and criteria for nonconvulsive status epilepticus. Epilepsia, 2013, 54(Suppl. 6):28-29.
27. Hirsch LJ, LaRoche SM, Gaspard N, et al. American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology:2012 version. J ClinNeurophysiol, 2013, 30(11):1-27.
28. Proposal for revised classification of epilepsies and epileptic syndromes. Commission on classification and terminology of the international league against epilepsy. Epilepsia, 1989, 30(7):389-399.
29. Shorvon S. Clinical forms of status epilepticus. In Shorvon S (Ed) Status epilepticus. Ist clinical features and treatment in children and adults. Cambridge, United Kingdom:Cambridge University Press, 1994:34-137.
30. Sutter R, Kaplan PW. The neurophysiologic types of nonconvulsive status epilepticus:EEG patterns of different phenotypes. Epilepsia, 2013, 54(Suppl. 6):23-27.
31. Sutter R, Kaplan PW. Electroencephalographic criteria for nonconvulsive status epilepticus:synopsis and comprehensive survey. Epilepsia, 2012, 53(Suppl. 3):1-51.
32. Kaplan PW. EEG criteria for nonconvulsive status epilepticus. Epilepsia, 2007, 48(Suppl. 8):39-41. Erratum in:Epilepsia, 2007, 48(Suppl.1):2383.
33. Genton P, Gelisse P, Crespel A. Lack of efficacy and potential aggravation of myoclonus with lamotrigine in Unverricht-Lundborg disease. Epilepsia, 2006, 47(5):2083-2085.
34. Larch J, Unterberger I, Bauer G, et al. Myoclonic status epilepticus in juvenile myoclonic epilepsy. Epileptic Disord, 2009, 11(5):309-314.
35. Thomas P, Valton L, Genton P. Absence and myoclonic status epilepticus precipitated by antiepileptic drugs in idiopathic generalized epilepsy. Brain, 2006, 129(Pt 5):1281-1292.
36. Osorio I, Reed RC, Peltzer JN. Refractory idiopathic absence status epilepticus:a probable paradoxical effect of phenytoin and carbamazepine. Epilepsia, 2000, 41(4):887-894.
37. Genton P, Ferlazzo E, Thomas P. Absence status epilepsy:delineation of a distinct idiopathic generalized epilepsy syndrome. Epilepsia, 2008, 49(8):642-649.