1970年国际抗癫痫联盟(ILAE)癫痫发作分类

1、部分性发作(发作由局部开始)(Partial seizuresor(seizures beginning locally))

  1. 部分性发作(Partial seizures)具有初级症状,通常无意识受损(With elementary symptomatology,generally without impairment of consciousne)
    1. 具有运动症状(With motor symptoms)
      1. 局限运动(不伴随扩散)(focal motor (without march))包括局限性癫痫性肌阵挛(including localized epileptic myoclonus)
      2. 杰克逊发作(jacksonian)
      3. 偏转性(常为对侧偏转性)(versive (generally contraversive))
      4. 姿势性(postural)
      5. 躯体抑制性(?)(somatic inhibitory)(?)
      6. 失语性(aphasic)
      7. 发音性(发音和语言中止)phonatory (vocalization and arrest of speech)
    2. 有特殊感觉或躯体感觉症状(With special sensory or somatosensory symptoms)
      1. 躯体感觉(somato-sensory)
      2. 视觉(visual)
      3. 听觉(auditory)
      4. 嗅觉(olfactory)
      5. 味觉(gustatory)
      6. 眩晕(vertiginous)
      7. 有自主神经症状(With autonomic symptoms)
      8. 复合型(Compound forms)
  2. 部分性发作(Partial seizures)具有复杂症状(通常有意识受损,有时可能以初级症状先起始)(With Complex Symptomatology (generally with impairment of consciousness, may sometimes begin with elementary symptomatology))
    1. 只有意识受损(With impaired consciousness only)
    2. 具有认知性症状(With cognitive symptomatology)
      1. 伴有记忆障碍(包括健忘、似曾相识感)(with dysmnesic disturbances (conscious amnesia, déjà vu, déjà vécu)
      2. 有观念上的干扰(包括“强迫思考”,梦境感)(with ideational disturbances (including “forced thinking”,dreamy state…))
    3. 具有情感性症状(With affective symptomatology)
    4. 具有“精神感觉”症状(With “psychosensory” symptomatology)
      1. 错觉(如视物变大,视物变形)illusions (e.g. : macropsia, metamorphopsia…)
      2. 幻觉(hallucinations)
    5. 有“精神运动”症状学(自动症)(With “psychomotor” symptomatology (automatisms))
    6. 复合型(Compound forms)
  3. 部分性发作继发全面性(所有形式的部分性癫痫发作,初级或复杂症状都可以演变为全面性发作,有时如此迅速以至于局灶特征可能观察不到,这些全身性发作可能是对称或不对称的,强直或阵挛,但最常见的是强直阵挛型)(Partial seizuressecondarily generalized (all forms of partial seizures, with elementary or elaborated symptomatology, can develop into generalized seizures, sometimes so rapidly that the focal features may be unobservable. These generalized seizures may be symmetrical or asymmetrical, tonic or clonic, but most often tonic-clonic in type))

2、全面性发作、双侧对称性发作或无局部起源的发作(generalized seizures, bilateral symmetrical seizures or seizures without local onset)

  1. 失神(absences)
    1. 简单失神,只有意识受损(Simple absences, with impairment of consciousness only)
    2. 复杂失神,意识受损同时伴有其它现象(Complex absences, with other phenomena associated with impairment of consciousness)
      1. 伴轻微阵挛成分(肌阵挛失神)(with mild clonic components (myoclonic absences))
      2. 伴姿势性张力增加(后冲性失神)(with increase of postural tone (retropulsive absences))
      3. 伴姿势性张力减退或消失((失张力失神))(with diminution or ablution of postural tone (atonic absences)
      4. 伴自动症(自动症性失神)(with automatisms)(automatic absences)
      5. 伴自主神经现象(如遗尿性失神)(with autonomic phenomena (e.g. enuretic absences)
      6. 混合形式(as mixed forms)
  2. 双侧严重的癫痫性肌阵挛(Bilateral massive epileptic myoclonus(Myoclonic jerks))
  3. 婴儿痉挛(infantile spasms)
  4. 阵挛性发作(Clonic seizures)
  5. 强直性发作(Tonic seizures)
  6. 强直阵挛性发作(大发作)(Tonic-clonic seizures)(‘‘grand mal” seizures)
  7. 失张力发作(有时伴有肌阵挛发作(肌阵挛失张力发作))Atonic seizures (sometimes associated with myoclonic jerks (myoclonic-atonic seizures))
    1. 持续很短时间(癫痫性跌倒发作)of very brief duration (epileptic drop attacks)
    2. 持续较长时间(包括失张力失神发作)of longer duration (including atonic absences)
  8. 运动不能发作(失去运动没有肌张力)(Akinetic seizures)(loss of movement without atonia)

3、一侧或主要以一侧为主(以阵挛、强直或强直阵挛性发作为特征,伴或不伴有意识障碍的,只表现或主要表现在一侧。这种发作有时从一边移到另一边,但通常不是对称的)(Unilateral or predominantly)(Characterised by clonic, tonic or tonic-clonic convulsions, with or without an impairment of consciousness, expressed only or predominantly in one side. Such seizures sometimes shift from one side to the other but usually do not become symmetrical)

4、未能分类的癫痫发作(包括无法分类的所有发作)(Unclassified epileptic seizures)(Includes all seizures which cannot be classified)

 

参考文献:

1、Gastaut, H., Clinical and electroencephalographical classification of epileptic seizures.Epilepsia, 1970. 11(1): p. 102-13.