最后审阅: 25 九月 2021
最后更新: 17 十二月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 身体一侧或身体一个特定部位的运动症状
  • 先兆感觉或体验(害怕、上腹不适感、似曾相识、陌生感)
  • 自动症(撕扯衣服、咂口唇)
  • 短暂性失语
  • 目光呆滞并对周围环境无意识

其他诊断因素

  • 发作后局灶性神经系统功能损伤(Todd 麻痹、失语)
  • 持续性、局灶性神经系统功能损伤
  • 记忆力障碍
  • 神经皮肤综合征的皮肤红斑

危险因素

  • 热性惊厥
  • 外伤性脑损伤
  • 中枢神经系统 (CNS) 感染
  • 卒中
  • 脑肿瘤
  • 智力障碍和/或脑性瘫痪
  • 痴呆
  • 痫样发作家族史
  • 血管畸形
  • 男性

诊断性检查

首要检查

  • 血糖
  • 全血细胞计数 (FBC)
  • 电解质检查
  • 毒理学筛查
  • 腰椎穿刺术和脑脊液分析
  • 头部 CT
  • 颅脑 MRI 扫描
  • 脑电图 (EEG)

需考虑的检查

  • 视频/脑电图(EEG)长期监测(LTM)
  • PET 扫描
  • 单光子发射型计算机断层显像 (single photon emission computed tomography, SPECT)
  • 功能性 MRI 扫描
  • 脑磁图描记术(MEG)扫描
  • 神经心理测验
  • Wada 试验

治疗流程

撰稿人

作者

Ramses Ribot, MD

Assistant Professor of Clinical Neurology

Department of Neurology, Epilepsy Division

University of Miami, Miller School of Medicine

Miami

FL

利益声明

RR has received consultancy funds from Supernus Pharmaceuticals, Inc.

Andres M. Kanner, MD, FANA, FAES, FAAN

Professor of Clinical Neurology

Director, Comprehensive Epilepsy Center and Head, Section of Epilepsy

Department of Neurology

University of Miami, Miller School of Medicine

Miami

FL

利益声明

AMK has received honoraria from Eisai laboratories and Neuropace. AMK is an author of a number of references cited in this topic.

鸣谢

Dr Ramses Ribot and Dr Andres M. Kanner would like to gratefully acknowledge Dr Vikram R. Rao, Dr John D. Hixson, and Dr Jeffrey Cohen, previous contributors to this topic.

利益声明

VRR served as a paid consultant for Neuropace, Inc., manufacturer of the Responsive Neurostimulation (RNS) System. JDH has received research funding and consultancy funds from UCB, Inc. JC declares that he has no competing interests.

同行评议者

Edward Bromfield, MD

Chief

Epilepsy Division

Brigham and Women's Hospital

Associate Professor of Neurology

Harvard Medical School

Boston

MA

利益声明

At the time of review, EB declared that between 2004 and 2009, he received speaking honoraria from UCB Pharma, Novartis, Abbott Laboratories, GlaxoSmithKline, and Pfizer. He received consulting fees from UCB Pharma, Genzyme, and Spherics, and research funding from UCB Pharma. Unfortunately, we have since been made aware that EB is deceased.

Angus A. Wilfong, MD

Associate Professor

Pediatrics and Neurology

Baylor College of Medicine

Medical Director

Comprehensive Epilepsy Program

Texas Children's Hospital

Houston

TX

利益声明

AAW declares that he has no competing interests.

Cigdem I. Akman, MD

Assistant Professor

Division of Pediatric Neurology

Columbia University College of Physicians and Surgeons

New York

NY

利益声明

Not disclosed.

Pasquale Striano, MD, PhD

Consultant Neurologist

Muscular and Neurodegenerative Diseases Unit

G Gaslini" Institute

Genova

Epilepsy Centre

Federico II University

Napoli

Italy

利益声明

PS declares that he has no competing interests.

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