【正文】 Chapter 12. EpilepsyTHE FIRST AFFILIATED HOSPITAL, SUN YETSEN UNIVERSITYPROF. ZHOU LIE MINKEY WORDS :? Epilepsy(癲癇 )? Epileptic Seizure (癲癇發(fā)作 )? Electroencephalograph(EEG,腦電圖)? Epileptiform Discharge(癇性放電 )? Antiepileptic Drugs(抗癲癇藥 ) EPILEPSY The Stress on the Chapter:1. To prehend the epileptic definition.2. To understand and have a good mand of epilepsy with generalized tonicclonic seizure, absence seizure, plex partial seizure and Jacksonian epilepsy. West syndrome and LennoxGastaut syndrome. 3. To understand and have a good mand of epileptic diagnoses 4. To understand and have a good mand of distinguishing between generalized tonicclonic seizure and hysteria, absence seizure and syncope.5. To understand and have a good mand of definition and treatment principle on status epilepsy with generalized tonic clonic seizure.6. To prehend the principle in using antiepileptic drugs.RonaldoVincent van GoghSeizureEpilepsyEpileptic Seizure Epilepsy is characterized by which sudden recurrent and transient disturbances of mental function or movements and sense of the body are resulted from abnormal neuronal discharges in brain.(used to)Part 1. DEFINITIONEpilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the neurobiologic, cognitive, psychological, and social consequences of this condition. The definition of epilepsy requires the occurrence of at least one epileptic seizure. (new concept) OUTLINE:? Course: the recurrence of epileptic seizures? Location: usually arising from the cerebral cortex? Pathogenesis: abnormal neuronal discharges? Clinical signs: transient disturbances of cerebral functionPart 1. DEFINITIONPart 2. ATIOLOGY AND BASIC MECHANISMS OF EPILEPTOGENESIS, THE INDUCING ELEMENTSSymptomatic . Congenital diseases Structural Lesion of the Brain: Epilepsy . Brain trauma 1. Remarkable decrease in the . Infection of CN synaptic from GABA. . Brain tumor of bloodbrain barrier . Cerebrovascular D Biochemical Aspects: Decrease . Degenrative D in synthetic GABA and increase . Toxicosis in excitatory transmitter. . Nutritive and Electrophysiological Aspects: metabolic disturbance Paroxysmal depolarization . The others shift (PDS) discovered Atiology Pathogenesis Primary epilepsy Inheritance Mutation in Ion Channel (Idiopathic) (Usually no brain damage) cryptogenic ep unclear cannot be discoveried Mutation in Ion ChannelADNFLE The Elements of Interfering with EpilepsyInheritance: Be susceptible to epilepsy or epileptic predisposition ( abnormal EEG)Environmental Influences: Fatigue or hunger, Hyperventilation The Others: Age, Endocrinosis, Sleep Disturbance (Dysfunction) Part 2. ATIOLOGY AND BBASIC MECHANISMS OF EPILEPTOGENESIS, THE INDUCING ELEMENTSPart 2. BBASIC MECHANISMS OF EPILEPTOGENESIS Inheritance or acquired factorsAbnormal gene expressionNeurotransmitter and modulator dysfunction Structure and function disorder of Ionchannel Neuronal dischargeEpileptic seizure or epilepsy Part 3: Clinical Manifestations of Epileptic SeizuresClassification of Epileptic Seizures(The 1981 International Classification of Epileptic Seizures)I. Partial seizures(seizures beginning locally)II. Generalized Seizures Ⅲ . Unclassified epileptic seizuresPart 3: Clinical Manifestations of Epileptic SeizuresI. Partial seizures(seizures beginning locally)A. Simple partial seizures ( consciousness not impaired) ? With motor symptoms ? With somatosensory or special sensory symptoms ? With autonomic symptoms ? With psychic symptomsClassification of Epileptic Seizures(The 1981 International Classification of Epileptic Seizures)頂葉B. Complex partial seizures (with impairment of consciousness) ? Beginning as simple partial seizures and progressing to impairment of consciousness ? With no other features ? With features as in ? With automatisms ? impairment of consciousness at onset ? With no other features ? With features as in ? With automatisms C . Partial seizures secondarily generalized seizureClassification of Epileptic SeizuresII. Generalized Seizures (bilaterally symmetrical and without local onset) ? Absence seizures(Typical or Atypical AS) ? Myoclonic seizures ? Clonic seizures ? Tonic seizures ? Tonicclonic seizures ? Atonic seizuresⅢ . Unclassified epileptic seizures ( Inadequate or inplete data)Classification of Epileptic SeizuresSimple partial seizures With motor symptomsComplex partial seizuresAbsence seizures(Typical absence seizure)Generalized Tonicclonic seizuresWe’ll focus our discussion onStatus Epilepticus with GTCSFocal EpIdiopathicSynptomaticBRE, benign childhood occipital epilepsy, P Reading EpFrontal L, parietal L, Occipital L, Temporal L Ep GeneralizedIdiopathicSynptomaticbenign neonatal familial convulsions et alWest S、 LGS et alEarly myo