两种癫痫发作分类体系临床价值和可信度的比较研究  

A comparison on the clinical value and reliability between two classification systems of epileptic seizures

作　　者：秦兵[1] 陈勇军[2] 段现来[2] 廖卫平[2] 臼井直敬 井上有史 

机构地区：[1]广东省人民医院神经科,广东省医学科学院,广东省神经科学研究所,广州市510080 [2]广州医学院第二附属医院神经科,广州医学院神经科学研究所,510060 [3]日本国家癫痫中心,静冈癫痫与神经疾病研究所,420-8688

出　　处：《实用医学杂志》2012年第13期2126-2129,共4页The Journal of Practical Medicine

基　　金：广东省科技计划项目(编号:2011B061300094);日本癫痫研究基金

摘　　要：目的:评估和比较两种癫痫发作分类体系即发作症状学分类法(SSC)和国际癫痫发作分类法(ICES)的临床价值和可信度。方法:2名医生独立地观看106例患者发作的录像资料,采用双盲法对患者的每一次发作录像仔细进行回顾分析并分别使用上述两种分类法进行分类,数据进行百分比计算及Kappa一致性检验。结果:106例患者共计有256次发作,对2名医生诊断的一致性进行比较,结果显示SSC明显高于ICES。SSC体系中一些症状如过度运动发作、自动运动发作、愣神发作等具有更高的一致性。结论:SSC提供了一个比ICES更为容易理解的癫痫发作分类体系,提示SSC是一种非常有用的、可靠的分类方法。Objective To assess and compare two kinds of systems：Semiological Seizure Classification （SSC） and International Classification of Epileptic Seizures （ICES）. Methods Two doctors independently reviewed 106 patients＇ video-EEG. They were double-blinded to the EEG findings and final diagnosis, they classified all seizures according to both classifications. Datas were analysised by percentage and Kappa test. Results Two hundred and fifty-six seizures from 106 patients were reviewed. The average consistency of the two doctors was higher for SSC （Kappa = 0.762） than for ICES （Kappa = 0.513）. Some categories of SSC, such as hypermotor, automotor or dialeptie had excellent consistency. Conclusion SSC provides a more comprehensive picture of epileptic seizure than does ICES and appears to be very useful and reliable.

关 键 词：癫痫 痫性发作国际分类 发作症状学分类 

分 类 号：R742.1[医药卫生—神经病学与精神病学]