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J Korean Neurol Assoc. 1999;17(5):637-644.
- Reappraisal and Practical Application of International League Against
Epilepsy(ILAE 1989) Classification of Localization-Related Epilepsies in Adult
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Jae Hong Han, M.D., Jang Sung Kim, M.D., Youn-Min Oh, M.D.
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Department of Neurology, Ajou University Hospital
- 성인에서 국소성 간질 분류(ILAE 1989 기준)의
임상 적용시의 문제점
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한재홍, 김장성 오윤민
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아주대학교 의과대학 신경과학교실
- Abstract
- Background
: Since 1985 when ILAE proposed its first classification system of epilepsy, many studies have reported
the practical applicability of the system. However, its limitations have been elucidated. In order to find out the
applicability and limitations of the ILAE classification system and the role that diagnostic parameters (semiology, EEG
and MRI) take in the anatomical localization of localization-related epilepsies (LREs), we investigated the clinical data
of adult patients with LRE in step-wise way. Methods : We recruited 173 patients with newly-referred/diagnosed LRE
from our departmental data registry. Idiopathic epilepsies were excluded. We evaluated the anatomical localization
rate(LR) according to each diagnostic parameter, the concordant localization rate(CLR) between two parameters and
between three parameters. LR in total patients by any one of three diagnostic parameters was also evaluated. MRI
abnormalities were evaluated in those patients showing concordant localization between semiology and EEG. Results :
The highest anatomical LR(67.1%) was reported in the semiological parameter. CLR between semiology and EEG was
28.9%. CLR between three parameters was 16.2%. MRI abnormalities were seen in 60% of patients with concordant
localization between semiology and EEG. Fifty six percent of electroclinically concordant patients showed concordant
localization with an MRI and 79% of them were concordantly localized in the temporal lobe. The LR in total patients
was 71.7%. In each of the evaluation steps, the temporal lobe LR was the highest. Conclusions : Total lobar LR by any
one diagnostic parameter in all the patients was high according to the ILAE diagnostic criteria. Semiology was the best
localizing parameter, however, combined evaluation with either EEG or MRI reduced the localizability. Even though
the MRI study showed a significant discordance rate in patients with electroclinical localizations, it could identify the
underlying etiology in a major proportion of the patients. This study showed the importance of an imaging study in the
lobar localization of LREs combined with an electroclinical localization by the ILAE classification system.
J Kor Neurol Ass 17(5):637~644, 1999
Key Words : ILAE classification, Localization-related epilepsy, Anatomical localization, Semiology, EEG, MRI
Keywords :
- 초록
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