Application of the 2001 diagnostic scheme and the 2006 ILAE report of seizure and epilepsy: a feedback from the clinical practice of adult epilepsy.
Application of the 2001 diagnostic scheme and the 2006 ILAE report of seizure and epilepsy: a feedback from the clinical practice of adult epilepsy.
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DOI：
10.1684/epd.2008.0203
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发表时间：
2008-09
期刊：
影响因子：
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通讯作者：
M. Kinoshita;R. Takahashi;A. Ikeda
中科院分区：
文献类型：
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作者：
M. Kinoshita;R. Takahashi;A. Ikeda
目的探讨国际抗癫痫联盟（ILAE）2001年提出的癫痫发作和癫痫诊断方案（简称2001方案）和2006年ILAE分类核心组报告（简称2006报告）的临床有效性和可行性。方法：100例连续癫痫患者访问神经科诊所（组1）和100例顽固性癫痫患者接受了长期头皮视频脑电图监测（组2）在京都大学医院。2001年方案（轴1至4）和2006年报告（癫痫发作类型和癫痫综合征）适用于第1组。轴1应用于第2组，以评估癫痫发作症状学的多样性。结果根据1981年的分类，第1组共出现145次不同类型的癫痫发作（全身强直-阵挛发作：23%，复杂部分性发作（CPS）：29%，简单部分性发作：21%，继发全身强直-阵挛发作：21%）。在2001年方案的轴1（发作现象学）中，第1组和第2组分别列出了184项和333项，癫痫发作症状学独立于EEG结果进行描述。然而，各项目之间存在重复或不一致的情况。在第1组的轴2（癫痫发作类型）中，分别有62%和26%的CPS被进一步标记为局灶性运动或感觉癫痫发作;其余（24%）不符合任何类别的入选标准。在轴3（癫痫综合征）中，94%的患者被分类，并增加了家族性颞叶癫痫。轴4描述了详细的病因。应用2006年报告的癫痫发作类型需要考虑发作现象学，以确定传播模式。2006年报告的癫痫综合征可归因于70%的患者。结论在癫痫的诊断中，轴内和轴间的一致性对于建立一个更实用的诊断方案是非常重要的，这可能为癫痫不太明显的方面提供一个更有用的诊断工具。
PURPOSE To clarify the clinical validity and feasibility of the diagnostic scheme for seizures and epilepsy proposed by the International League Against Epilepsy (ILAE) in 2001 (the 2001 Scheme) and the report of the ILAE classification core group in 2006 (the 2006 Report). METHODS One hundred consecutive patients with epilepsy who visited the Neurology Clinic (Group 1) and 100 patients with intractable epilepsy who had undergone prolonged scalp video-EEG monitoring (Group 2) in Kyoto University Hospital were enrolled. The 2001 Scheme (Axis 1 to 4) and the 2006 Report (seizure types and epileptic syndromes) were applied to Group 1. Axis 1 was applied to Group 2 to evaluate the diversity of seizure semiology. RESULTS Group 1 demonstrated 145 seizures of different types (generalized tonic-clonic seizures: 23%, complex partial seizures (CPS): 29%, simple partial seizures: 21% and secondarily generalized tonic-clonic seizures: 21% according to the 1981 classification. In Axis 1 (ictal phenomenology) of the 2001 scheme, 184 and 333 items were listed in Groups 1 and 2, respectively, and seizure semiology was described independent of EEG findings. However, there was duplications or discordance among the items. In Axis 2 (seizure types) of Group 1, 62% and 26% of CPS were further labeled as focal motor or sensory seizures, respectively; the remainder (24%) did not meet inclusion criteria for any category. In Axis 3 (epilepsy syndromes), 94% of patients were sorted, and familial temporal lobe epilepsy was added. Axis 4 described detailed etiology. Application of seizure types of the 2006 Report required consideration of ictal phenomenology to determine spread patterns. Epileptic syndromes of the 2006 Report were assignable to 70% of patients. CONCLUSIONS It is important to achieve intra- and inter-axial accordance for the establishment of a more practical diagnostic scheme, which may provide a more useful tool for the diagnosis of less obvious aspects of epilepsy.