癫痫诊疗热点概述PPT.ppt

癫痫诊疗热点概述 南京医科大学附属脑科医院 神经内科 余年 yn_doc@ 2015-04-22 概 述 更新的癫痫定义和终止 癫痫疾病负担的再认识 癫痫诊断的新方式与新分类 已有的抗癫痫药物治疗原则 正在研究中的癫痫治疗药物靶点 未来癫痫研究的方向 癫痫的定义 理论性（概念性）定义 conceptual (theorematic) definition 2001/2005 实用性（操作性）定义 practical (operational) definition Part1. 更新的癫痫定义和终止 概念定义-2005 Part 1. 更新的癫痫定义和终止 Fisher R S, Boas W E, Blume W, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE)[J]. Epilepsia, 2005, 46(4): 470-472. 癫痫的概念定义 癫痫发作（epileptic seizure）旧称痫性发作，是指大脑神经元异常和过度的超同步化放电所造成的临床现象。(诱发性和非诱发性) 对一般临床不易发现症状而仅在脑电图（EEG）上出现异常放电者，不称之为癫痫发作。 癫痫（epilepsy）是一种脑部疾患，特点是持续存在能产生痫性发作的易感性，并出现相应的神经生物学、认知、心理学以及社会等方面的后果。诊断癫痫至少需要一次以上的痫性发作。（2005年国际抗癫痫联盟 ） Part 1. 更新的癫痫定义和终止 Fisher R S, Boas W E, Blume W, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE)[J]. Epilepsia, 2005, 46(4): 470-472. 旧实用性定义一些不足和缺陷 (1)一次发作后不能诊断癫痫 (2)未涵盖反射性癫痫 (3)独立于“癫痫”的癫痫综合征 (4)未定义何时才能确定癫痫已不存在(resolved epilepsy) Part 1. 更新的癫痫定义和终止 Operational (Practical) Clinical Definition of Epilepsy Epilepsy is a disease of the brain defined by any of the following conditions: At least two unprovoked (or reflex) seizures occurring more than 24 hours apart; 2. One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years; 3. Diagnosis of an epilepsy syndrome. Epilepsy is considered to be resolved for individuals who had an age-dependent epilepsy syndrome but are now past the applicable age or those who have remained seizure-free for the last ten years, with no seizure medicines for the last five years. Fisher et al., 2014, DOI: 10.1111/epi.12550 This material is copyrighted by the author(s) and provided as a courtesy for non-commercial educational use Part 1. 更新的癫痫定义