andepilepsy癫痫课件

Partial seizures: start focally and have clinical and EEG changes that indicate onset from one brain region and in some cases one cerebral hemisphere. Generalized seizures: begin in both hemispheres at the same time. Appropriate treatment depends on correct classification. Cerebral hemisphere Cerebral hemisphere Prodrome Aura Tonic phase (lost consciousness) Clonic phase Postictal unconsciousness and hypotonia Postictal neurological deficit (Todds paralysis) Sleepiness Returning to normal functioning 20-60 years Brain tumors Trauma Vascular disease Infections Over 60 years Vascular disease Brain tumors Trauma Systemic metabolic Infections Scalp Cranial Bone Cerebral Spinal Fluid Cerebral Cortex Cavernous hemangioma Hippocampal Sclerosis Focal brain atrophy MRS (MR spectroscopy): The messurement of tissue metabolites with proton magnetic resonance spectroscopic imaging. MRS is able to lateralize temporal lobe epilepsy in most cases. MRS Interictal PET: hypometabolism and decrease in glucose uptake in the region of seizure onset Ictal PET: hypermetabolism and increased glucose uptake in the region of seizure onset Interictal SPECT: areas of decreased blood flow Ictal SPECT: areas of increased blood flow PETMRI Diagnosis Monotherapy 2nd Monotherapy 2 AEDsAdditional Monotherapy(s) Begin Evaluation for Epilepsy Surgery Focal resection of areas of epileptogenesis partial seizures, particularly those from one circumscribed area of the brain. Disconnecting procedures, usually corpus callosotomy severe generalized seizures, usually associated with atonic or