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创伤后癫痫发作和癫痫

Authors
Randolph W Evans, MD, FAAN
Steven C Schachter, MD
Section Editor
Timothy A Pedley, MD
Deputy Editor
April F Eichler, MD, MPH
Translators
陆钦池, 主任医师，教授

引言

癫痫发作是一种早就被公认的创伤性脑损伤(traumatic brain injury, TBI)的并发症。TBI后早期出现和晚期出现的癫痫发作对预后和治疗具有不同的影响。早期癫痫发作被认为是急性症状性事件且复发可能性低，而晚期癫痫发作即代表癫痫。

虽然所有癫痫病例中仅有4%的病例归因于创伤，但是已知病因的病例中有13%的病例为创伤后所致[1]。TBI也是15-24岁人群中症状性癫痫最重要的病因。对于TBI幸存者来说，创伤后癫痫显著地促成了功能障碍。

本专题将讨论针对创伤后癫痫发作的流行病学、临床、治疗及预后相关的问题。更多与癫痫发作和癫痫相关的一般问题将在别处讨论。 (参见“成人癫痫处理概述”)

早期癫痫发作

创伤后早期癫痫发作是指在头部创伤后1周内发生的癫痫发作。这类癫痫发作属于急性症状性事件，并不会被认为是癫痫。

对于即时癫痫发作(出现在撞击时或撞击后几秒内的发作)这一不同分类尚有争议。一些人认为这些是“惊厥性震荡”而非癫痫事件[2]；其他一些人由于它们相似的创伤后癫痫的相关风险而将其纳入早期癫痫发作的分类。[3,4](参见下文‘预后’)

             

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Literature review current through: 2017-06 . | This topic last updated: 2017-04-04.
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