【正文】 CryptogenicunclearCannot make sure focal generalized eplepsy or epileptic Syn Neonatal Epilepsy, Dravet39。 CryptogenicunclearCannot make sure focal generalized eplepsy or epileptic Syn Neonatal Epilepsy, Dravet39。s syndrome et al Specific Syndromes FC、 Oligo Epileptic Status, et alClassification of Epilepsy and Epileptic Syndrome from ILAECryptogenic Epilepsy: Type, Sign, Aetiology, and Anatomy Seizures: Generalized TonicClonic Seizures/ Absence Seizures) Generalized TonicClonic Seizures They occur at some time in the course of epilepsy in most patients with seizures regardless of the patients’s usual clinical pattern. They are divided into two types: ?Primary Generalized TonicClonic Seizure and ?Secondarily Generalized TonicClonic Seizure.Second: Clinical Manifestations of Epileptic Seizures Primary Generalized TonicClonic Seizure(PGE): This is characterized by plete loss of consciousness and falling, and no aura. Secondarily Generalized TonicClonic Seizure(SGS): This is characterized by a partial seizure evolving to a secondarily generalized tonic clonic seizure.Second: Clinical Manifestations of Epileptic Seizures Seizures:? PreConvulsion Phase PGTCS SGTCS? Convulsion Phase (TonicClonic Phase) Tonic Phase Clonic Phase? Recovery PhaseSecond: Clinical Manifestations of Epileptic Seizures Seizures: PreConvulsion PhasePGTCE is frequently preceded by several myoclonic jerks or a brief clonic seizure in bilateral limbs, and then falling as well as loss of consciousness.SGTCS usually evolve from partial seizures, in which signs beginning with sensory symptoms are called “aura” . Clinical Manifestations of Generalized TonicClonic Seizures(Three Phases) Convulsion Phase (TonicClonic Phase)Tonic Phase: As the patient falls, the body stiffens because of genera lized tonic contraction of the axial and limb muscles.Eyes: upward eye deviation and pupillary dilation.Mouth: to be forced closure of the mouth, which sometimes produces oral trauma.“Epileptic cry”: to be caused by forcible expiration against opposed vocal cords, which results from sudden involuntary contraction of the respiratory and laryngeal muscles.Limbs: to be tonic flexion or extension of the axial musculature。s syndrome et al Specific Syndromes FC、 Oligo Epileptic Status, et alClassification of Epilepsy and Epileptic Syndrome from ILAECryptogenic Epilepsy: Type, Sign, Aetiology, and Anatomy ? The infantile spasms (West syndrome) denotes a unique, agespecific form of generalized epilepsy that may be either idiopathic (15%) or symptomatic (85%). Symptomatic cases result from diverse conditions, including cerebral dysgenesis(發(fā)育不全） , tuberous sclerosis, phenylketonuria苯丙酮尿 , intrauterine infections, 宮內(nèi)感染 or hypoxicischemic injury.3. Infantile spasms (West syndrome refractory epilepsy)? Seizures are characterized by sudden flexor or extensor spasms that involve the head, trunk, and limbs simultaneously. ? The attacks usually begin before 6 months of age. The EEG is generalized abnormal, showing chaotich雜亂 , highvoltage slow activity with multifocal spikes, a pattern termed hypsarrhythmia. 3. Infantile spasms (West syndrome refractory epilepsy)The EEG Feature in Patients with WS is Hypesarrhythmia? This term is applied to a heterogeneous group of childhood epileptic encephalopathies that are characterized by mental retardation, uncontrolled seizures, which consist of GTCS, TS, CS and Atonic seizure, and a distinctive EEG pattern. 4. LennoxGastaut Syndrome refractory epilepsy? The syndrome is not only a pathologic entity, because clinical and EEG manifestations result from brain malformations, perinatal asphyxia, severe head injury, CNS infection, or, rarely, a progressive degenerative or metabolic syndrome. A presumptive cause can be identified in 65 to 70% of affected children. ? Seizures usually begin before age 4 years, and about 25% of children have a history of infantile spasms. No treatment is consistently effective, and 80% of children continue to have seizures as adults. 4. LennoxGastaut Syndromerefractory epilepsyThe EEG Sign in Patients With LGS is SpikeWave Complex ?It is important for symptomatic epilepsy to be pletely examine in nerve system.?EEG test is necessary for patients with epilepsy, but only 8095% of the patients may be diagnosed by EEG test at onset phase. ? EEG may show spike waves, spikewave plex, sharp waves and sharpwave plex.?CT scan, MRI +MRS, SPECT, PET, DSA, MEG and Cerebrospinal Fluids test are helpful for us to find epileptic cause and locus.Part 4: Physical Examination and Laboratory Test 尖波 棘波Spike waves, spikewave plex, sharp waves and sharpwave plex.Part 5: Diagnosis and Differential DiagnosisDiagnosis of EpilepsyAnswer some questions1. Whether the seizure is epilepsy or not types or syndrome of epilepsy3. Idiopathic or Symptomatic or Cryptogenic Epilepsy What is the basis of diagnosing epilepsy ?Part 5: Diagnosis and Differential DiagnosisDiagnosis of EpilepsyDetailed Medical HistoryEEGCT or MRI+MRSSPECT or PETDSAMEG What is the basis of diagnosing epilepsy ?. It is important for us to explore the detailed and accurate history, which is provided by the patients with partial seizure or their relatives with generalized seizure.Part 5: Diagnosis and Differential Diagnosis? We shoul