【正文】 ot types of epilepsy3. Idiopathic or Symptomatic or Cryptogenic EpilepsyPart 5: Diagnosis and Differential DiagnosisDiagnosis of EpilepsyAnswer some question2. Which types of epilepsy? An attempt should be made at the same time to categorise the seizure according to classification,because it is greatly important for correct therapy. The Type of Epileptic Seizure Have to Be Diagnosis for Treatment.Part 5: Diagnosis and Differential DiagnosisPartial seizures(seizures beginning locally) A. Simple partial seizures B. Complex partial seizures C . Partial seizures secondarily generalizedGeneralized Seizures A. Absence seizures B. Tonicclonic seizuresPart 5: Diagnosis and Differential DiagnosisDiagnosis of EpilepsyAnswer Question1. Whether the seizure is epilepsy or not types of epilepsy3. Idiopathic or Symptomatic or Cryptogenic Epilepsy Differentiation of Primary Epilepsy from Sympt or Crypt Epilepsy Characteristic Primary Epilepsy Secondary Epilepsy Causes Unknown Often found Age of onset Usually,520yrs, Any age 30yrs Family history Often found Less mon Types of seizure PGTCS and AS PS, SGTCS Duration of onset 10 –30 seconds in AS 10 minutes 5–10 minutes in PGTCS PE (–) Positive signs related primary disease ( infective disease) EEG Bilaterally synchronous Focally abnormal EEG epileptic discharges Other Laboratory Usual normal Usual abnormal Test Part 5: Diagnosis and Differential DiagnosisPart 6: Prevention and Treatment of Epilepsy Prevention of Risk Factors Identification and Elimination of Factors Principles of Anticonvulsant Therapy Treatment on The OnsetPart 6: Prevention and Treatment of Epilepsy Prevention of Risk Factors It is the most important preventive measure to prevent brain trauma, infective disease, high fever and so on. Identification and Elimination of Factors The elimination of factors that cause seizures requires the identification and treatment of structural or physiologic abnormalities discovered in the examination. Examples include removal of an operable brain tumor or vascular malformation, treatment of infectionsPart 6: Prevention and Treatment of Epilepsy The need for medication to be taken regularly should be stressed, and the patient advised of the risk of withdrawal seizures if medication is abruptly withdrawal. According to the specific type of seizure disorder and toxic side effects of the drugs, the choice of antiepileptic drugs should be done. Principles of Anticonvulsant Therapy★Part 6: Prevention and Treatment of Epilepsy Principles of Anticonvulsant TherapyEthosuximide(乙琥胺 ) Valproate(丙戊酸 ) * Phenytoin(苯妥因 ) Barbiturate(巴比妥 )Carbamazepine(卡馬西平卡馬西平 )* Primidone (撲癇酮 ) Lamotrigine(拉莫三嗪 ) Topomax(妥泰 ) Garbapentin(加巴噴丁 ) Levetiracetam（ 左乙拉西坦）Oxcarbazepine(奧卡西平） Zonisamide（唑尼沙胺）Vigabatrin(/喜保寧 ) Felbamate(非氨酯）Part 6: Prevention and Treatment of EpilepsyTable 4 The Choice of Antiepileptic Drugs Seizure Type First Second AS Ethosuximide/Valproate, Lamotrigine PGTCS Valproate Carbamazepine Phenytoin PGTCS+AS Valproate Lamotrigine, Clonizepine TS Carbamazepine Phenytoin Barbiturate CS Valproate Lamotrigine SPS Carbamazepine Phenytoin Barbiturate SPSSGTCS Carbamazepine Phenytoin Barbiturate CPS Carbamazepine Primidone ValproatePart 6: Prevention and Treatment of Epilepsy The drug is usually started at a low dose, which is gradually increased until either the seizures are controlled, or toxic effects are experienced by the patient. The antiepileptic drug levels should be monitored. Treatment is begun with monotherapy. The advantages of monotherapy are fewer side effects, no drug interactions, reduced cost of medication, reduced teratogenic effects, and improved quality of life.Part 6: Prevention and Treatment of Epilepsy During change of AEDs, after the new drugs are taken (gradually increased or directly to target dosage)， the old drug should be decreased. Regularly taking AEDs is more important for patients to achieve seizure control and avoid status epilepticus.Part 6: Prevention and Treatment of Epilepsy Drugs should be withdrawn slowly over a period of several months (6 months). The duration of treatment is about 4—5 years for GTCS, 8—12 months for AS. The adverse effects of medication should be stressed and treatedThis is allergic reaction with red rash resulted from LTG (1) The patient should be protected from injury during the convulsive episode and placed on a flat, soft surface with side rails up and padded to avoid injury. (2) It is important to ensure adequate respiratory exchange and oxygenation. (3) After convulsion controlled, the