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1、SemiologyofSeizuresRevisedbyZhangJGYangACWrittenbyShiLin●Symptoms●Auras●Progression●FourStages●Classification●Diagnosis●AdvancedSemiology●AbsencevsCPS●FLSvsTLS●HTSvsEHTSINTRODUCTIONSEIZE----SEIZUREWhatisseizure?seizure≠epilepsytoomanycellsexcitedsimuta
2、neouslyNormalINFOtransmission1SYMPTOMS2AURASAura:predictor,bode,indicator.UnusualFeeling:physical,sensory,visceral,experientialASmallSeizure:notspreadintoanobservableseizure.IndicatingSeizureFocus.UsuallyinTemporalLobeSeizure.numbnessheadachedizzinessl
3、ight-headedness3PROGRESSIONMTlfocusIpslmflCntrlmflCntrlmtl1,PositiveEffectsVSNegativeEffects2,Non-FunctionalAreas.InferredFocus≠ExactFocus3,ThumbClonicMovement------Head/EyeDeviation ------GastricRising------AbnormalTastes4FOURSTAGESSEIZUREPHASESICTALP
4、HASE:ICTUSPOST-ICTAL:RECOVERYPRE-ICTAL:PRODROMEICTALONSET:AURAPre-IctalProdromeFever/Sleepless/MenstruationEnvironmentToExcludePseudoseizuresTimeofDay/SleepMyoclonic/Rolandic/FrontalPrecipitantsPhotosensitiveEPIctusProgressionInvolvedBrainRegionsAphasi
5、aDominantHemisphereConsciousnessABSENCE/CPS/GTCSDurationStatusEpilepticusIctalOnsetAuraLobeofOriginFocalOnsetLateralization&LocalizationPost-IctusConfusionCPS/GTCSUnilateralHeadacheIPSLOriginTodd’sParesisCNTRLHemisphereOriginVisualFieldDefectOccipitalI
6、nvolvement5CLASSIFICATIONSingleMotor:Jerk,HeadTurning,RigiditySensory:UnusualTaste,HearingAutonomic:StomachSensationPsychological:Memory,EmotionalComplexAutomatism;Aura;ConsciousnessGeneralizationPartial,EvolvesintoGrand-MalGTCSUnconscious,Rigidity+Jer
7、kingAbsenceBriefUnconsciousandStaring,VentilationMyoclonicSuddenContraction(400ms)ClonicRepetitive,JerkingMovementsTonic20s,ContinuousContractAlongBodyAxisAtonicLossofMuscleTensionCPSABSENCEGTCSATONIC6DIAGNOSIS+PSEUDOSEIZURE?EmotionalSyncope(Prodrome,T
8、ongue)FeverConvulsionSEIZURE?VSPROVOKED?EPILEPTIC?VSTYPE?LOCATION?7ADVANCEDSEMIOLOGYSemiology:AUTOMATISMsignificanceOralAutomatismTL(Hippocampal)UnilateralLimbAutomatismIPSL(FL,TL,Limbic)100%UnilateralEyeBlinkingIPSL(FL)BipedAutomatismF
