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
<60 岁的成人
≥60 岁的成人
育龄期女性
孕妇
儿童
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.
鉴别诊断
- 晕厥
- 短暂性缺血发作 (TIA)
- 睡眠障碍
更多 鉴别诊断指南
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