癲癇型別

癲癇發作型別最常使用國際抗癲癇聯盟在1981年提出2017年更新的分類。區分癲癇發作的型別很重要，因為不同型別的癲癇發作可能有不同的原因、結果和治療方法。國際抗癲癇聯盟的分類.已隱藏部分未翻譯內容，歡迎參與[ 翻譯]。This classification is based on observation (clinical and EEG) rather than the underlying pathophysiology or anatomy.In terms of their origin within the brain, seizures may be described as either "partial" (focal) or "generalized". Partial seizures only involve a localized part of the brain, whereas generalized seizures involve the whole of both hemispheres. The term 'secondary generalisation' may be used to describe a partial seizure that later spreads to the whole of the cortex and becomes generalized.Whilst most seizures can be neatly split into partial and generalized, there exists some that don't fit. For example: the seizure may be generalized only within one hemisphere. Alternatively there may be many focal points ("multifocal seizures") that are distributed in a symmetrical or asymmetrical pattern.局灶性癲癇發作.Partial seizures may be further subdivided into both "simple" and "complex" seizures. This refers to the effect of such a seizure on consciousness; simple seizures cause no interruption to consciousness (although they may cause sensory distortions or other sensations), whereas complex seizures interrupt consciousness to varying degrees. This does not necessarily mean that the person experiencing this sort of seizure will lose consciousness (like fainting). For example, a complex partial seizure may involve the unconscious repetition of simple actions, gestures or verbal utterances, or simply a blank stare and apparent unawareness of the occurrence of the seizure, followed by no memory of the seizure. Other patients may report a feeling of tunnel vision or dissociation, which represents a diminishment of awareness without full loss of consciousness. Still other patients can perform complicated actions, such as travel or shopping, while in the midst of a complex partial seizure.The effects of partial seizures can be quite dependent on the area of the brain in which they are active. For example, a partial seizure in areas involved in perception may cause a particular sensory experience (for example, the perception of a scent, music or flashes of light) whereas, when centred in the motor cortex, a partial seizure might cause movement in particular groups of muscles. This type of seizure may also produce particular thoughts or internal visual images or even experiences which may be distinct but not easily described. Seizures affecting the anterior insular cortex may produce brief mystical or ecstatic experiences in some people; these are known as ecstatic seizures. They may result in a misdiagnosis of psychosis or schizophrenia, if other symptoms of seizure are disregarded and other tests are not performed. Unfortunately for those with epilepsy, anti-psychotic medications prescribed without anticonvulsants in this case can actually lower the seizure threshold further and worsen the symptoms.When the effects of a partial seizure appear as a 'warning sign' before a larger seizure, they are known as an aura: frequently, a partial seizure will spread to other parts of the brain and eventually become generalized, resulting in a tonic-clonic convulsion. The subjective experience of an aura, like other partial seizures, will tend to reflect the function of the affected part of the brain.全身性癲癇發作.Primarily generalized seizures can be sub-classified into a number of categories, depending on their behavioural effects:連續癲癇發作."Status epilepticus" refers to continuous seizure activity with no recovery between successive seizures. A tonic-clonic seizure lasting longer than 5 minutes (or two minutes longer than a given person's usual seizures) is considered a medical emergency. Benzodiazepines are most commonly used to relieve the seizure activity. Lorazepam is drug of choice in status epilepticus. Diazepam is 2nd priority to treat status epilepticus."Epilepsia partialis continua" is a rare type of focal motor seizure (hands and face) which recurs every few seconds or minutes for extended periods (days or years). It is usually due to strokes in adults and focal cortical inflammatory processes in children (Rasmussen's encephalitis), possibly caused by chronic viral infections or autoimmune processes.亞臨床發作.Subclinical seizures are defined as seizures which can only be detected by reading an electroencephalogram (EEG) and cause no overt, specific changes in an affected person's behavior, whether the person is awake or asleep. One study in the "Journal of Neurosurgery" described the pattern on EEG as appearing like "rhythmic spik[es] showing intrinsic evolution".未來分類.In 1997, the ILAE began work on revising the classification of seizures, epilepsies and epileptic syndromes. This revision remains in gestation and has not superseded the 1981 classification.Proposed changes to terminology include:The hierarchy presented has the structure:Self limiting seizure typesGeneralized seizuresTonic-clonic seizures (includes variations beginning with a clonic or myoclonic phase)Clonic seizures (with and without tonic features)Typical absence seizuresAtypical absence seizuresMyoclonic absence seizuresTonic seizuresSpasmsMyoclonic seizuresMassive bilateral myoclonusEyelid myoclonia (with and without absences)Myoclonic atonic seizuresNegative myoclonusAtonic seizuresReflex seizures in generalized epilepsy syndromesSeizures of the posterior neocortexNeocortical temporal lobe seizuresFocal seizuresFocal sensory seizuresFocal motor seizuresGelastic seizuresHemiclonic seizuresSecondarily generalized seizuresReflex seizures in focal epilepsy syndromesContinuous seizure typesGeneralized status epilepticusGeneralized tonic-clonic status epilepticusClonic status epilepticusAbsence status epilepticusTonic status epilepticusMyoclonic status epilepticusFocal status epilepticusEpilepsia partialis continua of KojevnikovAura continuaLimbic status epilepticus (psychomotor status)Hemiconvulsive status with hemiparesis早期分類.The 1981 classification revised the 1970 ILAE system devised by Henri Gastaut. A significant difference was the distinction between simple and complex partial seizures. In the 1970 classification, the distinction was whether the symptoms involved elementary sensory or motor functions (simple) or whether "higher functions" were involved (complex).This was changed to consider whether consciousness was fully retained or not. As a result, studies that group patients according to these classifications are not directly comparable from one generation to another. The 1970 classification was important for standardising the modern terms for many seizure types. Prior to this, terms such as "petit mal", "grand mal", "Jacksonian", "psychomotor" and "temporal-lobe" seizures were used.#重定向The earliest classification of seizures can be attributed to Babylonian scholars who inscribed their medical knowledge into stone tablets known as the "Sakikku" (meaning "All Diseases"). This dates from the reign of the Babylonian king Adad-apla-iddina of the Second Dynasty of Isin - estimated to be between 1067 and 1046 BC. Many types of seizures are described, each attributed to a certain demon or departed spirit and given a prognosis.中醫的分類.中醫可按不同的病邪引發的症候分為：風癇、驚癇、食癇、痰癇、蟲癇、瘀癇、寒癇、熱癇等。 或者按照陰陽分類法分為實熱型陽癇、虛寒型陰癇。