全身发作性癫痫

最后审阅: 4 九月 2022
最后更新: 21 六月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 局灶性神经功能障碍
  • 局灶性神经症状(发作前或后)
  • 感觉先兆或体验(害怕、上腹不适感、似曾相识、陌生感)
  • 暂时性轻偏瘫
  • 短暂失语
  • 发热、颈强直、精神状态改变
更多 关键诊断因素

其他诊断因素

  • 神经性疾病的神经皮肤检查
其他诊断因素

危险因素

  • 全面发作性癫痫的家族史(扩展的或直系的)
  • 早期中枢神经系统 (CNS) 感染
  • 头部外伤
  • 既往发作事件或疑似发作事件
  • 物质使用史
  • 早产
  • 多次或复杂性热性惊厥
更多 危险因素

诊断性检查

首要检查

  • 脑电图 (EEG)
  • 血糖
  • 全血细胞计数 (FBC)
  • 电解质检查
  • 毒理学筛查
  • 头部 CT
更多 首要检查

需考虑的检查

  • 腰椎穿刺术:
  • 颅脑 MRI 扫描
  • 血清催乳素
  • 血清肌酸激酶 (CK)
更多 需考虑的检查

治疗流程

持续性治疗

≥2 次无诱因的全面强直阵挛发作 (GTCS) 且无综合征诊断

≥2 次无诱因 GTCS 伴局灶性癫痫发作

≥2 次的无诱因 GTCS 伴全面性癫痫发作

撰稿人

作者

Abdulrahman Alwaki, MD

Assistant Professor of Neurology

Emory University School of Medicine

Atlanta

GA

利益声明

AA is a Site Principal Investigator for an EPAS (Epilepsy Post Approval Study) for deep brain stimulation funded by Medtronic and receives 1% salary support.

Daniel Winkel, MD

Assistant Professor of Neurology

Emory University School of Medicine

Atlanta

GA

利益声明

DW receives consulting fees from NextSense, Inc.

鸣谢

Dr Abdulrahman Alwaki and Dr Daniel Winkel would like to gratefully acknowledge Dr Vikram R. Rao, Dr John D. Hixson, and Dr Daniel H. Lowenstein, previous contributors to this topic.

利益声明

VRR has served as a paid consultant for NeuroPace, Inc., manufacturer of the Responsive Neurostimulation (RNS) System. VRR is also an author of several references cited in this topic. JDH has received research funding and consultancy funds from UCB Inc. DHL declares that he has no competing interests.

同行评议者

Edward Barry Bromfield, MD

Chief

Division of Epilepsy and Sleep

Department of Neurology

Brigham and Women's Hospital

Associate Professor of Neurology

Harvard Medical School

Boston

MA

利益声明

EBB has received speaking fees from ICR Pharma, Novartis, Abbott Laboratories, GlaxoSmithKline, and Pfizer. He has received consulting fees from ICR Pharma, Genzyme, and Spherics, and research funding from UCB Pharma. Unfortunately we have since been made aware that EBB is deceased.

Roderick Duncan, MD, PhD, FRCP

Honorary Clinical Senior Lecturer

University of Glasgow

Institute of Neurological Sciences

Glasgow

UK

利益声明

Not disclosed.

  • 鉴别诊断

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    • 抽搐性晕厥
    • 心律失常
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  • 指南

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  • 患者教育信息

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    癫痫:如何有效治疗?

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