癫痫课后思考题

癫痫课后思考题

癫痫课后思考题

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1。癫痫的分类:

采用2017年的癫痫分类,有局灶性癫痫,全面性癫痫,全面性合并局灶性癫痫,不明分类癫痫四大类;按癫痫发作分为局灶性起源、全面性起源、未知起源三大类;按病因分类有遗传性、结构性、感染性、免疫性、代谢性以及未知病因六大类。

部分性/局灶性发作:大脑半球某部分神经元首先被激活。包括单纯部分性发作、复杂部分性发作、继发全面性发作。

全面性发作:指发作起始症状及脑电图改变提示“双侧大脑半球同时受累”的发作。包括失神、肌阵挛、强直、阵挛、强直-阵挛、失张力发作。

2。癫痫的诊断:

首先根据起源部位诊断是局灶性发作、全面性发作、不明起源发作中的哪一类;

其次若为局灶性发作根据是否存在意识、运动性症状进一步分类诊断;若为全面性发作无需考虑意识,根据是否存在运动性症状进一步分类诊断;不明起源的发作可根据是否存在运动性症状进一步分类诊断

(1)询问患者基本信息,病史,家族史

(2)EcG是最重要的辅助诊断手法,CT和MRI可以确定大脑结构病变部位

3。难治性癫痫的定义;采用正规的药物治疗未能有效控制的癫痫

国内提出的有关难治性癫痫的定义为“频繁的癫痫发作至少每月4次以上,适当的AEDs正规治疗且药物浓度在有效范围以内,至少观察2年,仍不能控制并且影响日常生活,除外进行性中枢神经系统疾病或颅内占位性病变者。

 

1。 Classification of epilepsy:

According to the classification of epilepsy in 2017, there are four categories: focal epilepsy, generalized epilepsy, generalized combined with focal epilepsy and unknown epilepsy; According to seizures, they can be divided into three categories: focal origin, comprehensive origin and unknown origin; According to the etiology, there are six categories: hereditary, structural, infectious, immune, metabolic and unknown etiology.

Partial / focal seizures: neurons in a part of the cerebral hemisphere are activated first. Including simple partial seizures, complex partial seizures and secondary comprehensive seizures.

Comprehensive attack: refers to the attack in which the initial symptoms and EEG changes suggest that "both cerebral hemispheres are involved at the same time". Including absence, myoclonus, tonic, clonic, tonic clonic, atonic seizures.

2。 Diagnosis of epilepsy:

First, according to the location of origin, it is diagnosed which kind of attack is focal attack, comprehensive attack and attack of unknown origin;

Secondly, if it is focal attack, it is further classified and diagnosed according to the presence of consciousness and motor symptoms; If it is a comprehensive attack, it does not need to consider consciousness, and it is further classified and diagnosed according to the presence of motor symptoms; Seizures of unknown origin can be further classified and diagnosed according to the presence of motor symptoms

(1) Ask the patient for basic information, medical history and family history

(2) ECG is the most important auxiliary diagnostic technique. CT and MRI can determine the location of brain structural lesions

3。 Definition of intractable epilepsy; The use of regular drug treatment failed to effectively control epilepsy

The definition of intractable epilepsy proposed in China is "frequent seizures at least 4 times a month, appropriate AEDs regular treatment and drug concentration within the effective range, observation for at least 2 years, still unable to control and affect daily life, except those with progressive central nervous system diseases or intracranial space occupying lesions.