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1、Howtoidentifyclinicalepilepsyandsyncope（临床上如何鉴别癫痫与晕厥）Thedifferentialdiagnosisofsyncopeandepilepsyisquitedifficult.Accordingtostatistics,aboutl/3ofpatientswithsyncopemisdiagnosedasepilepsy.SyncopeandepilepsymisdiagnosedduetoboththeDepartmentofcommonclini
2、cal,andaccompaniedbymanyofthesameepisodicmanifestations:lossofconsciousness,pupildilation,clonicbeatingtonicconvulsions,incontinence,increasedsalivasecretionaccompaniedbyvomitingfatigueaftertheonsetofsyncopeandepilepsyarelikelytooccur.晕厥与癫痫的鉴别诊断是相当困难的。据
3、统计大约l／3的晕厥患者被误诊为癫痫。晕厥和癫痫极易误诊的原因是两者都系临床上常见，且伴有许多相同的发作性表现：意识丧失、瞳孔扩大、阵挛性跳动、强直性惊厥、大小便失禁、唾液分泌增多，伴有呕吐的发作后疲劳在晕厥和癫痫中都可能出现。 Howtoidentifyclinicalepilepsyandsyncope 临床上如何鉴别癫痫与晕厥 1,themainclinicalsymptomsofsyncopeislossofconsciousness,andthereforesubjecttoepile
4、pticgeneralizedtonic-clonicortonic-clonicseizures,complexpartialseizuresidentifyabsenceseizuresandonlyadisturbanceofconsciousness.Ingeneral,thefollowingpointstosupportthediagnosisofsyncope. 1、晕厥的主要临床症状是意识丧失，因而须与癫痫的全身性强直阵挛或强直阵挛发作、失神发作和仅有意识障碍的复杂部分发作鉴别。一般
5、说来，以下几点支持晕厥的诊断。 Seizuresofteninducedbyanxietyorpain. 发作常由焦虑或疼痛诱导。 Arestandingorsitting. 都在站立或坐位时发生。 Accompaniedbypale,sweating. 伴有面色苍白、大汗。 Tonic-clonicactivityandthetonguebittenoraftertheonsetofconfusion,drowsinessandheadache.Bradycardiasupportsy
6、ncopeattack,althoughsomeepisodesmayalsohaveheartrate,butrarelycausebradycardia. 无强直一阵挛活动和舌咬伤或发作后意识模糊、昏睡及头痛。发作时心率减慢支持晕厥，虽然部分发作也可有心率减慢，但很少引起心动过缓。 2,EEGsyncopeandepilepsytoidentifygreatvalue,tonic-clonicseizuresinpatientsinthetonicphaseshowedamplitudegra
7、duallyenhanceddiffuse10Hzwavetheclonicphasefordiffuseslowgraduallyslows,miscellaneousflocksofspikes,absenceseizurescanbeseenintheregularityandsymmetry3Hzspikeandslowwave,irregularthel~2.5Hzsharp-slowwaveandspike-slowwavetheintermittentperiod80%ofpatient
8、swithabnormalEEG.Syncopeslow-waveEEGintermittentmajorityofnormal,suchasitisstillnotconfirmed,especiallydifficulttodistinguishconvulsivesyncopeandepilepsy,and24-hourambulatoryEEGmonitoringorvideoEEGinidentifyingspecialhelpful. 2、
