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部分性癫痫：病因和临床特征

Author
Selim R Benbadis, MD
Section Editors
Douglas R Nordli, Jr, MD
Timothy A Pedley, MD
Deputy Editor
April F Eichler, MD, MPH
Translators
宋毅军, 主任医师，教授

引言和术语

癫痫是一种异质性疾病，反复癫痫发作是一个必要的特征。癫痫综合征由一系列不同的症状组成，包括癫痫发作、癫痫的体征以及往往会同时发生并可界定某种表型的其他特征。1989年发布的《癫痫和癫痫综合征的国际分类》将其分为部分性和全面性癫痫，也可分为特发性和症状性癫痫[1]。部分性癫痫(partial epilepsy，又称localization-related epilepsy)也被称为局灶性癫痫。2010年发布了修订过的术语，但其尚未被广泛采用[2]。

多数部分性癫痫为症状性(即，病因已知)或隐源性的，后者指的是据推测存在之前无法识别的或目前影像学技术无法查明的局灶性结构性病因。如果该患者接受癫痫手术，有时随后可在病理学上界定其病因。特发性部分性癫痫指的是通常见于儿童期，一般为良性，据推测源于遗传的一组综合征。

部分性癫痫的病因、临床表现和脑电图特征将总结在此。儿童期特发性局灶性癫痫将会单独详细讨论。 (参见“儿童良性局灶性癫痫”)

部分性癫痫和其他癫痫综合征的处理将单独讨论。 (参见“成人癫痫处理概述”和“成人癫痫的初始治疗”和“耐药性癫痫的评估和治疗”和“儿童癫痫发作和癫痫：初始治疗和监测”)

病因学

根据定义，症状性部分性癫痫是由局灶性脑部异常导致的，尽管该异常并非总是可被鉴定出。这些病例表现为典型的“成人起病”癫痫，但在儿童期也常见。如果其病因已被发现或已知，则称其为症状性癫痫。如果其影像学检查正常，病因仍不明，则称其为隐源性癫痫。内侧颞叶硬化(mesial temporal sclerosis, MTS)是所发现的症状性部分性癫痫的最常见病因。

                

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