Classification of the Epilepsies
Classification of the Epilepsies
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癫痫的分类
DOI：
10.1097/00004691-198510000-00001
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发表时间：
1985
影响因子：
2.4
通讯作者：
B. Zifkin
中科院分区：
文献类型：
--
作者：
H. Gastaut;B. Zifkin
综述癫痫分类的发展。原发性癫痫是相对良性的，通常是年龄限制的综合征，没有临床或放射学证据的脑病变，并与遗传体质易感性癫痫。他们通常对抗癫痫药物反应良好。原发性全身性癫痫的生化相关性已在动物和人类中得到证实，并与弥漫性皮质过度兴奋有关，这与这种疾病有关。原发性部分性或局灶性癫痫的病理生理学尚不清楚，但似乎并不依赖于局灶性脑病变。我们认为，这是由于相对局部地区的皮质过度兴奋局限于孤立的皮质丘脑部门，并依赖于宪法皮质过度兴奋和正常的皮质成熟之间的相互关系。继发性癫痫与脑病变的临床和放射学证据相关，并且通常对抗惊厥药具有耐药性。继发性全身性癫痫，伴有弥漫性脑病，以Lennox-Gastaut综合征为典型。继发性部分性癫痫的表现取决于病变部位。癫痫的发病机制是多因素的，预先存在的体质素质可以与获得性弥漫性或局灶性脑病相互作用，促进一种或另一种的临床表现。
Summary We review the development of the classfication of the epilepsies. Primary epilepsies are relatively benign, usually age-limited syndromes without clinical or radiologic evidence of brain lesions, and are related to a heritable constitutional predisposition to epilepsy. They usually respond well to antiepileptic drugs. The biochemical correlates of primary generalized epilepsy have been demonstrated in animals and man and have been related to diffuse cortical hyperexcitability, which has been linked to this disorder. The pathophysiology of the primary partial or focal epilepsies is poorly understood but does not appear to depend on focal brain lesions. We suggest that these are due to relatively localized areas of cortical hyperexcitability confined to isolated corticothalmic sectors and depend on interrelations between a constitutional cortical hyperexcitability and normal cortical maturation. The secondary epilepsies are associated with clinical and radiologic evidence of brain lesions and are often resistant to anticonvulsants. Secondary generalized epilepsies, with an associated diffuse encephalopathy, are typified by the Lennox-Gastaut syndrome. The presentation of the secondary partial epilepseis depends on the site of the lesion. The pathogenesis of epilepsy is multifactorial, and a preexisting constitutional predisposition can interact with an acquired diffuse or focal encephalopathy, facilitating the clinical expression of one or the other.