The aetiologies of epilepsy
The aetiologies of epilepsy
复制标题
DOI：
10.1684/epd.2021.1255
复制
发表时间：
2021-02-01
影响因子：
2.3
通讯作者：
Walker, Matthew C.
中科院分区：
文献类型：
--
作者：
Balestrini, Simona;Arzimanoglou, Alexis;Walker, Matthew C.
癫痫病的病因学鉴定有助于癫痫病的诊断、预后咨询和管理。事实上，病因学对于确定单次癫痫发作的复发风险以及癫痫的诊断非常重要。在这里，我们将病因分为六类：结构性，遗传性，感染性，代谢性，免疫性（所有这些都是国际抗癫痫联盟[ILAE]分类系统的一部分）和神经退行性（我们单独考虑，因为它在癫痫中的重要性越来越大）。这些不是相互排斥的类别，许多病因属于一个以上的类别。事实上，遗传因素可能在不同程度上对所有癫痫患者的癫痫发作风险起作用。在每个类别中，我们讨论了我们认为最重要的病因;重要性不仅取决于患病率，还取决于临床意义。导言包含适合1级能力（入门级）的信息，而随后的部分包含针对2级能力（熟练程度）的信息，作为新的ILAE能力为基础的课程的一部分。随着我们向精准医学和靶向治疗迈进，病因学将在癫痫的管理中发挥更大的作用。
The identification of the aetiology of a patient's epilepsy is instrumental in the diagnosis, prognostic counselling and management of the epilepsies. Indeed, the aetiology can be important for determining the recurrence risk of single seizures and so for making a diagnosis of epilepsy. Here, we divide the aetiologies into six categories: structural, genetic, infectious, metabolic, immune (all of which are part of the International League Against Epilepsy [ILAE] classification system) and neurodegenerative (which we have considered separately because of its growing importance in epilepsy). These are not mutually exclusive categories and many aetiologies fall into more than one category. Indeed, genetic factors probably play a role, to varying degrees, in the risk of seizures in all people with epilepsy. In each of the categories, we discuss what we regard as the most important aetiologies; importance being determined not only by prevalence but also by clinical significance. The introduction contains information suitable for level 1 competency (entry level), whilst the subsequent sections contain information aimed at level 2 competency (proficiency level) as part of the new ILAE competency-based curriculum. As we move towards precision medicine and targeted therapies, so aetiologies will play an even greater role in the management of epilepsy.