癫痫杂志

癫痫杂志

癫痫的 ILAE 分类:ILAE 委员会关于分类和术语的意见书

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自从 1989 年国际抗癫痫联盟(ILAE)最后批准的分类以来,ILAE 已经更新了癫痫的分类,以反映我们在获得巨大科学进步后对癫痫及其基本机制理解方面的收获。作为执业医师的重要工具,在我们的思想中癫痫分类必须有恰当和动态的变化,并且应全面的翻译到全球所有地区。癫痫分类最初的目的是对患者进行诊断,但是对于癫痫研究、抗癫痫治疗的发展和全世界的交流也非常重要。这次新分类起源于 2013 年提交以供公开评论的一份草拟文件,该草拟文件在经过国际癫痫界几轮讨论广泛反馈后得以修订。此分类呈现了 3 个层次,首先是发作类型,假设患者已经有最新的 2017 年 ILAE 癫痫发作分类所确定的发作类型;诊断了发作类型后,下一步就是诊断癫痫类型,包括局灶性癫痫、全面性癫痫、全面性及局灶性癫痫两者兼有,以及分类不明的癫痫;第三层次是癫痫综合征,此处可以做出特定综合征的诊断。这一新分类在每一层次均包含了病因,强调在每一步诊断时都要考虑病因,因为病因将会对治疗产生重要影响。选择将病因分为 6 个亚组是基于其潜在的治疗因果关系。该分类引入了新的术语如“发育性和癫痫性脑病”等。“自限性”和“药物有效性”取代“良性”一词。希望这一新的框架将有助于提高 21 世纪癫痫的关爱和研究。

关键词: 分类; 癫痫综合征; 术语; 病因

引用本文: Ingrid EScheffer, SamuelBerkovic, GiuseppeCapovilla, 张静 张月华 译, 刘晓燕 吴逊 审. 癫痫的 ILAE 分类:ILAE 委员会关于分类和术语的意见书. 癫痫杂志, 2018, 4(6): 517-525. doi: 10.7507/2096-0247.20180084 复制

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