癫痫症状学详尽讲解课件.pptx

1、 and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesRevised by Zhang JG Yang AC Written by Shi Lin and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergen

2、ciesINTRODUCTIONINTRODUCTION and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesSEIZE-SEIZURES

3、EIZE-SEIZUREWhat is seizure?What is seizure? seizure epilepsyseizure epilepsy and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies1 1 SYMPTOMS SYMPTOMS and Hyperthermia Associated with Poisoning or and Neonatal Respiratory C

4、are Embryologic Development Births Obstetric Emergencies and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetr

5、ic Emergencies2 2 AURASAURAS and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies Aura: predictor, bode, indicator. Aura: predictor, bode, indicator. Unusual Feeling: physical, sensory, visceral, experientialUnusual Feeling:

6、 physical, sensory, visceral, experiential A Small Seizure: not spread into an observable seizure.A Small Seizure: not spread into an observable seizure. Indicating Seizure Focus. Indicating Seizure Focus. Usually in Temporal Lobe Seizure.Usually in Temporal Lobe Seizure.numbnessheadachedizzinesslig

7、ht-headedness and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies3 3 PROGRESSION PROGRESSION and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesMT

8、L FOCUSIPSL MFLCNTRL MFLCNTRL MTL1, Positive Effects VS Negative Effects 2, Non-Functional Areas. Inferred Focus Exact Focus3, Thumb Clonic Movement-Head/Eye Deviation-Gastric Rising -Abnormal Tastes and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development

9、Births Obstetric Emergencies4 4 FOUR STAGES FOUR STAGES and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesSEIZURE PHASESICTAL PHASE: ICTUS POST-ICTAL: RECOVERYPRE-ICTAL: PRODROMEICTAL ONSET:AURAPre-IctalProdromeFever/Sleep

10、less/MenstruationEnvironmentTo Exclude PseudoseizuresTime of Day/SleepMyoclonic/Rolandic /FrontalPrecipitantsPhotosensitive EPIctusProgressionInvolved Brain RegionsAphasiaDominant HemisphereConsciousnessABSENCE/CPS/GTCSDurationStatus EpilepticusIctal OnsetAuraLobe of OriginFocal OnsetLateralization

11、& LocalizationPost-IctusConfusionCPS/GTCSUnilateral HeadacheIPSL OriginTodds ParesisCNTRL Hemisphere OriginVisual Field DefectOccipital Involvement and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies5 5 CLASSIFICATIONCLASSI

12、FICATION and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesSingleMotor: Jerk, Head Turning, RigiditySensory: Unusual Taste, HearingAutonomic: Stomach SensationPsychological: Memory, EmotionalComplexAutomatism;Aura; Conscio

13、usnessGeneralizationPartial, Evolves into Grand-MalGTCSUnconscious, Rigidity + JerkingAbsenceBrief Unconscious and Staring, VentilationMyoclonicSudden Contraction (400ms)ClonicRepetitive, Jerking MovementsTonic20s, Continuous Contract Along Body AxisAtonicLoss of Muscle TensionCPSCPSABSENCEABSENCEGT

14、CSGTCSATONICATONIC and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies6 6 DIAGNOSISDIAGNOSIS and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies+

15、+PSEUDOSEIZURE?PSEUDOSEIZURE?Emotional Syncope (Prodrome, Tongue)Emotional Syncope (Prodrome, Tongue)Fever ConvulsionFever ConvulsionSEIZURE? SEIZURE? VSVSPROVOKED?PROVOKED?EPILEPTIC?EPILEPTIC?VSVSTYPE? TYPE? LOCATION?LOCATION? and Hyperthermia Associated with Poisoning or and Neonatal Respiratory C

16、are Embryologic Development Births Obstetric Emergencies7 7 ADVANCED SEMIOLOGYADVANCED SEMIOLOGY and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesSemiology: AUTOMATISMsignificanceOral AutomatismTL (Hippocampal)Unilateral

17、Limb AutomatismIPSL (FL, TL, Limbic) 100%Unilateral Eye BlinkingIPSL (FL)Biped AutomatismFLIctal Spitting or DrinkingRight TLIctal Laughter (Gelastic)Hypothalamus, MTLPostictal Nose WipingIPSL (FL/TL)Postictal CoughTL and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryo

18、logic Development Births Obstetric EmergenciesSemiology: MOTORsignificanceForced Sustained Head/Eye/Mouth Turn+ GnrlznCNTRL, FL/TL 94-100%Reproductive Nonforced Head/Eye Turn-GnrlznIPSL FL/TL (BSL GN) 80%Focal Clonic JerkingCNTRL, Rolandic (4) 95%Unilateral Ictal ParesisCNTRLFrequent Brief Hyperkine

19、tic MovementsMesial Part of TL/FLAsymmetric Clonic EndingIPSL, TL/FL 80%Unilateral DystoniaCNTRL, TL/FL (BSL GN) 93%Fencing PostureCNTRL, FLPostictal Todds ParesisCNTRL, FLIctal Eye ClosureNonepilepticFigure 4 SignCNTRL to Extended Limb, TL and Hyperthermia Associated with Poisoning or and Neonatal

20、Respiratory Care Embryologic Development Births Obstetric EmergenciesSemiology: SPEECHsignificanceIctal Speech ArrestDominant Temporal InfluencedIctal Speech PreservationDominant Temporal Spaired Postictal DysphasiaDominant HemisphereIctus VomitingRight TLIctus Urinary UrgeRight TLHair ErectionLeft

21、TLSemiology: FEELsignificanceWell-defined Somatosensory SymptomsCNTRL Rolandic (1,2,3) 90%Unilateral Elementary Visual PhenomenaCNTRL Occipital 80%Ascending Visceral FeelingsMesial Temporal, Premotor (6), InsulaForced ThinkingDominant Frontal/MesiotemporalIctal FearAmygdala, Hippocampus and Hyperthe

22、rmia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies8 8 ABSENCEABSENCE vsvs CPSCPS and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesAbsenceCPSSleep Activatio

23、nNoneCommonHyperventilationActivaingNoneFrequencyMany/DayLessOnsetAbruptSlowAuraNoneCommonAutomatismNoneCommonProgressionNoneCommonCyanosisNoneCommonMotor SignsRareCommonDurationBriefMinutesPost-Ictal ConfussionNoneCommonPost-Ictal DysphasiaNoneCommon(Dominant) and Hyperthermia Associated with Poiso

24、ning or and Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies9 9 FLS FLS vsvs TLS TLS and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesTLSFLSFrequencySleep ActivitionOnsetSlowAbruptProgression

25、SlowQuickMotionless StaringAutomatismBipedal Automatism-Complex PosturesLate/LessEarly/FrequentHyperkinetic MotorSpeechVerbalization (Non Dominant)VocalizationDurationLongBriefGeneralizationPost-Ictal ConfutionPost-Ictal DysphasiaPost-Ictal Weakness and Hyperthermia Associated with Poisoning or and

26、Neonatal Respiratory Care Embryologic Development Births Obstetric Emergencies10 10 HTS HTS vsvs EHTS EHTS and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesHTSEHTSConvulsion HistoryYes (13/16)No(19/19)AurasEpigastric, Gus

27、tatory, Fear, SmellDj Vu, Somatic, Seeing Himself, Voice in Tunel, Dreamlike StateEarly AutomatismsOral (11/16)Upper Limb (11/19)Oral (2/19)MRINormal (13/16)Hippocampal Atrophy(3/16)Tumor (19/19)PathologyNormal (9/16)MTS (7/16)Glioma (16/19)Hamartoma (1/19)CA (2/19) and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesSEMIOLOGYMRI and Hyperthermia Associated with Poisoning or and Neonatal Respiratory Care Embryologic Development Births Obstetric EmergenciesTHANK YOU !THANK YOU !