- 期刊
Another Seizure Classification-Semiological Seizure Classification
癲癇發作的「表徵」分類：另一種癲癇發作分類準則之介紹
摘要
「國際抗癲癇聯盟」（International League Against Epilepsy,ILAE） 在1981年以癲癇發作的現象、發作期間的腦波、與發作時的腦波為根據，提出了癲癇發作的分類。事實上，此分類倚類相當程度的「電生理－臨床」的相關變化，來做確實分類。在歷經二十多年的癲癇學發展，許多臨床醫師在面對一個癲癇個案的發作時，發現除非經過嚴密的電生理檢查，用1981年的分類，很難記錄診斷一個癲癇發作－特別是嬰兒的發作診斷。另外，有更多的發現，讓1981年的分類不敷使用。在1988年，H. Lüders 與其同僚在「國際抗癲聯盟」（ILAE）的官方雜誌 Epilepsia 上，發表了完全以「臨床症狀」為主的癲癇發作分類，稱為「表徵發作分類」（Semiological Seizure Classification,SSC）。此項分類標準，捨棄了原ILAE發作分類上對腦波的依賴，讓臨床醫師能以「所見即所得」的方式，來診斷癲癇發作類型，而將腦波、神經影像學、或其他實驗室的檢查結果，整合到癲癇症候群的診斷中，也引起了國際上對「新的癲癇發作分類需求」廣泛的討論。我們希望能以本文向國內有志從事癲癇治療診斷的醫師，提供國際上一癲癇發作的思考模式。
並列摘要
The International League Against Epilepsy (ILAE) introduced in 1981 a seizure classification based on clinical semiology, interictal EEG findings, and ictal EEG patterns. Such classification depends heavily on detailed electroclinical correlation. After 20 years’ progress in epileptology, many clinicians have found it difficult to make a “definite” seizure diagnosis clinically without a series of electrophysiological examinations, particularly in the infants, and further advancement in epileptology has findings have made the previous classification inefficient. Lüders and colleagues have proposed a classification, Semiological Seizure Classification (SSC), based exclusively on ictal semiology, which was published in the official journal of ILAE-EPILEPSIA in 1998. The EEG, neuroimaging and other laboratory results should be analyzed separately and then integrated to define the epileptic syndromes. The seizure diagnosis is thus made through a “what-you-see-is-what-you-get” way. It has also provoked an extensive discussion about the necessity of this new classification. In this review, we present the original guideline, which has been used at The Cleveland Clinic Foundation for years, to introduce another method of epileptic seizure classification.
延伸閱讀
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