【正文】 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 should know : ? where epileptic seizure is, ? how long the seizure continue, ? what signs there are during seizure, ? and we should also know the patients’s consciousness during seizure.Part 5: Diagnosis and Differential Diagnosis Physical Examination: for the symptomatic ep.Part 5: Diagnosis and Differential Diagnosis Laboratory Test:Which one is important for epilepsy in lab test ?Diagnosis of EpilepsyEEGCT or MRI+MRSSPECT or PETDSAMEGPart 5: Diagnosis and Differential Diagnosis Differential Diagnosis GTCS and Hysteria Absence Seizure and Syncope Idiopathic and Symptomatic Epilepsy Table 1. General Differentiation of GTCS from Hysteria Characteristic GTCS Hysteria Seizure Triggers Unmon Emotional disturbance Diurnal pattern Day or night Usually day, never during sleep Convulsion Stereotypic synchro Atypical, irregular movements nous Movements Forced eye closure , Crying Consciousness Unconsciousness(a) Confusion, Twilight state Pupillary and Dilatation Dilatation or normal Reactivity to light Loss Normal Physiological reflex Disappear Normal Babinski reflex (+) () Enuresis (+) () Part 5: Diagnosis and Differential DiagnosisPart 5: Diagnosis and Differential Diagnosis Table 2. General Differentiation of Absence Seizure from SyncopeCharacteristic Absence Seizure SyncopeCauses Unclear(Inheritance) Vasodepressor syncope Orthostatic hypotension Cardiac origin Hypoglycemia Aura No Dizziness, Visual blurring or loss Palpitation(心悸 ), Short of breath Onset Sudden Gradual Facial color Normal Pallor Drop attack No More monPart 5: Diagnosis and Differential DiagnosisDiagnosis of EpilepsyAnswer Question1. Whether the seizure is epilepsy or n