编辑“︁癫痫”︁（章节）

==症状和体征==
[[File:Epilpesia.ogv|thumb|癲癇抽搐发作影片]]
[[File:Bittentongue.JPG|thumb|在抽搐发作时咬到自己舌尖的一位病人]]

癲癇的特点是长期反复发作[[抽搐]]<ref name=Adult2006>{{cite journal|last=Duncan|first=JS|coauthors=Sander, JW, Sisodiya, SM, Walker, MC|title=Adult epilepsy.|journal=Lancet|date=1 April 2006|volume=367|issue=9516|pages=1087–100|pmid=16581409|url=http://www.acutemed.co.uk/docs/Epilepsy,%20Lancet%204-06.pdf|doi=10.1016/S0140-6736(06)68477-8|author=|access-date=2014-09-14|archive-url=https://web.archive.org/web/20130324031646/http://www.acutemed.co.uk/docs/Epilepsy%2C%20Lancet%204-06.pdf|archive-date=2013-03-24|dead-url=yes}}</ref>。这些发作可能因涉及的脑部区域和病人年龄有好几种不同形式<ref name=Adult2006/><ref name=NChp1>{{cite book |title=The Epilepsies: The diagnosis and management of the epilepsies in adults and children in primary and secondary care |author=National Clinical Guideline Centre |publisher=National Institute for Health and Clinical Excellence |url=http://www.nice.org.uk/nicemedia/live/13635/57784/57784.pdf |date=January 2012 |pages=21–28 |deadurl=no |archiveurl=https://web.archive.org/web/20131216151008/http://www.nice.org.uk/nicemedia/live/13635/57784/57784.pdf |archivedate=16 December 2013}}</ref>。

===抽搐发作===
* [[抽搐]]类型（約佔60%）
** {{link-en|局部性癲癇發作|Partial_seizure}}（約佔三分之二），但可能惡化为{{link-en|全身性癲癇發作|Generalised_epilepsy}}。通常會先有某些感觉或经历，称为[[先兆]]<ref name=EB06>{{cite web|last=Shearer|first=Peter|title=Seizures and Status Epilepticus: Diagnosis and Management in the Emergency Department|url=http://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=77|work=Emergency Medicine Practice|deadurl=yes|archiveurl=https://web.archive.org/web/20101230141114/https://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=77|archivedate=2010-12-30|accessdate=2018-05-02}}</ref>，包括：感官先兆（视觉、听觉或嗅觉）、通感或情绪、自主神经、或肢体感觉性<ref name="Ham2010"/>。
*** 阵发抽搐可能开始于一个特定的肌肉群，并扩散到邻近肌肉群，又称为{{link-en|傑克遜尼式行軍|Jacksonian march}}<ref name=Brad2012>{{cite book|last=Bradley|first=Walter G.|title=Bradley's neurology in clinical practice.|url=https://archive.org/details/bradleysneurolog00unse|year=2012|publisher=Elsevier/Saunders|location=Philadelphia, PA|isbn=978-1-4377-0434-1|edition=6th ed.|chapter=67}}</ref>。
*** {{link-en|自动症|Automatism_(medicine)}}是非自觉地产生的活动，多为简单重复动作如上下砸嘴唇，或更为复杂的活动如试图拾起物品等<ref name=Brad2012/>。
** 全身性抽搐<ref name=NChp1/>（約佔三分之一），有六种主要类型：[[强直－阵挛性发作|强直－阵挛性]]、強直性（tonic）、[[陣攣性狀態]]（clonic）、{{link-en|肌痙挛性|Myoclonus}}、失神性（Absence seizure）、以及{{link-en|失张性发作|Atonic_seizure}}<!--<ref name=NChp9/>-->。这六种都会失去意识，通常事先没有预警<!-- <ref name=Neuro2012/> -->。
*** 强直 - 阵挛性：发作以四肢收缩开始，接着是四肢挺直、背部拱起，因胸部肌肉收缩，病人可能会发出哭叫声，歷時约10–30秒，稱為强直期（tonic phase）；<!-- <ref name=Neuro2012/> --><!-- <ref name=Neuro2012/> -->之后是四肢同时抖动，稱為阵挛期（clonic phase）<!-- <ref name=Neuro2012/> -->。咬到舌头两侧更为常见<ref name=Engel2008pg2797>{{cite book|last=Engel|first=Jerome|title=Epilepsy : a comprehensive textbook|year=2008|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-5777-5|page=2797|url=http://books.google.ca/books?id=6Kq4Zt2KOpcC&pg=PA2797|edition=2nd ed.|access-date=2014-09-15|archive-date=2014-11-29|archive-url=https://web.archive.org/web/20141129054042/http://books.google.ca/books?id=6Kq4Zt2KOpcC&pg=PA2797|dead-url=no}}</ref>。
*** 阵挛性抽搐：发作时四肢同时抖动，令肌肉不断收缩<!-- <ref name=Neuro2012/> -->，当呼吸停止，病人会呈青黑色<!-- <ref name=Neuro2012/> -->。<!-- <ref name=Neuro2012/> -->在抖动结束10–30分钟后才可能恢复正常，此阶段称为「发作后期（postictal phase）」<!-- <ref name=Neuro2012/> -->。发作期间可能會大小便失控<ref name=WHO2012>{{cite web | url = https://www.who.int/mediacentre/factsheets/fs999/en/ | title = Epilepsy | series = Fact Sheets | date = October 2012 | access-date = 24 January 2013 | publisher = [[World Health Organization]] | archive-date = 2016-03-11 | archive-url = https://web.archive.org/web/20160311001129/http://www.who.int/mediacentre/factsheets/fs999/en/ | dead-url = no }}</ref>及咬到舌尖或舌头两侧<ref name=Engel2008pg2797/>。
*** 肌强直性：发作會引起数个局部或全身性的肌肉痉挛，失神性非常轻微，可能只是轻轻转头或眨眼<ref name=Ham2010/>。病人并不会跌倒，发作结束后马上会恢复正常<ref name="Ham2010"/>。失张性发作的肌肉失去活动的过程則會超过一秒钟<ref name=Brad2012/>，这樣的發作通常會在身体两侧发生<ref name=Brad2012/>。
* 非抽搐类型（約佔40%）
** {{link-en|失神|Absence_seizure}}，症狀为失去意识，通常持续10秒左右<ref name=Ham2010>{{cite book|last=Hammer|first=edited by Stephen J. McPhee, Gary D.|title=Pathophysiology of disease : an introduction to clinical medicine|year=2010|publisher=McGraw-Hill Medical|location=New York|isbn=978-0-07-162167-0|edition=6th ed.|chapter=7}}</ref><ref>{{cite journal|last=Hughes|first=JR|title=Absence seizures: a review of recent reports with new concepts.|journal=Epilepsy & behavior : E&B|date=August 2009|volume=15|issue=4|pages=404–12|pmid=19632158|doi=10.1016/j.yebeh.2009.06.007}}</ref>。咬舌也较为常见<ref name=Engel2008pg2797/>。
* 诱因
** {{link-en|反射性发作|Reflex seizure}}<ref name=Reflex2008>{{cite book|title=Behavioral aspects of epilepsy : principles and practice|year=2008|publisher=Demos|location=New York|isbn=978-1-933864-04-4|page=125|url=http://books.google.ca/books?id=a6Ygv5_RKKsC&pg=PA125|edition=[Online-Ausg.].|editor=Steven C. Schachter|access-date=2014-09-21|archive-date=2014-11-02|archive-url=https://web.archive.org/web/20141102064721/http://books.google.ca/books?id=a6Ygv5_RKKsC&pg=PA125|dead-url=no}}</ref>經常由特定事件触发，约佔6%患者。
** {{link-en|反射性癲癇发作|Reflex epilepsy}}只能由特定的刺激引发<ref>{{cite journal|last=Xue|first=LY|coauthors=Ritaccio, AL|title=Reflex seizures and reflex epilepsy.|journal=American journal of electroneurodiagnostic technology|date=March 2006|volume=46|issue=1|pages=39–48|pmid=16605171}}</ref>，常见诱因包括闪烁的灯光和突發的聲響<ref name=Reflex2008/>。
** 某些类型，抽搐是频繁地在[[睡眠]]中发生<ref>{{cite journal|last=Malow|first=BA|title=Sleep and epilepsy.|url=https://archive.org/details/sim_neurologic-clinics_2005-11_23_4/page/1127|journal=Neurologic Clinics|date=November 2005|volume=23|issue=4|pages=1127–47|pmid=16243619|doi=10.1016/j.ncl.2005.07.002}}</ref>。
** 某些类型，抽搐只在睡眠时发生<ref>{{cite journal|last=Tinuper|first=P|coauthors=Provini, F; Bisulli, F; Vignatelli, L; Plazzi, G; Vetrugno, R; Montagna, P; Lugaresi, E|title=Movement disorders in sleep: guidelines for differentiating epileptic from non-epileptic motor phenomena arising from sleep.|journal=Sleep medicine reviews|date=August 2007|volume=11|issue=4|pages=255–67|pmid=17379548|doi=10.1016/j.smrv.2007.01.001}}</ref>。

===发作后期===
在抽搐高峰发生后、正常{{link-en|意识水平|level of consciousness}}恢复正常前，通常会有一段意识混乱的时期，被称为是{{link-en|发作后期|Postictal_state}}。此阶段通常長3到15分钟<ref>{{cite book|last=Holmes|first=Thomas R.|title=Handbook of epilepsy|year=2008|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-7397-3|page=34|url=http://books.google.ca/books?id=gLOv8XZ5u48C&pg=PA34|edition=4th ed.|access-date=2014-09-21|archive-date=2014-11-02|archive-url=https://web.archive.org/web/20141102054519/http://books.google.ca/books?id=gLOv8XZ5u48C&pg=PA34|dead-url=no}}</ref>，但也可能持续数小时<ref name=Post2010/>。其他常见的症状包括：感觉疲惫、[[头痛]]、言语困难、以及行为异常<ref name=Post2010>{{cite book|last=Panayiotopoulos|first=CP|title=A clinical guide to epileptic syndromes and their treatment based on the ILAE classifications and practice parameter guidelines|year=2010|publisher=Springer|location=[London]|isbn=978-1-84628-644-5|page=445|url=http://books.google.ca/books?id=yJQQzPTcbYIC&pg=PA445|edition=Rev. 2nd ed.|access-date=2014-09-21|archive-date=2014-11-02|archive-url=https://web.archive.org/web/20141102053621/http://books.google.ca/books?id=yJQQzPTcbYIC&pg=PA445|dead-url=no}}</ref>。[[思覺失調]]在抽搐发作后并不罕见，比率大约为6-10%<ref>{{cite book|title=Advanced therapy in epilepsy|year=2009|publisher=People's Medical Pub. House|location=Shelton, Conn.|isbn=978-1-60795-004-2|page=443|url=http://books.google.ca/books?id=4W7UI-FPZmoC&pg=PA443|editor=James W. Wheless|access-date=2014-09-21|archive-date=2014-11-02|archive-url=https://web.archive.org/web/20141102054516/http://books.google.ca/books?id=4W7UI-FPZmoC&pg=PA443|dead-url=no}}</ref>。病人往往不记得发作期间发生的事情<ref name=Post2010/>。局灶性抽搐后也可能会发生局部性麻痹，即{{link-en|托德麻痹|Todd's paralysis}}<!-- <ref name=Larner2010/> -->，通常持续几秒钟到几分钟，但在少见的情况下可能会持续一到两天<ref name=Larner2010>{{cite book|last=Larner|first=Andrew J.|title=A dictionary of neurological signs|publisher=Springer|location=New York|isbn=978-1-4419-7095-4|page=348|url=http://books.google.ca/books?id=mY-6eweiQm8C&pg=PA348|edition=3rd ed.|year=2010|access-date=2014-09-21|archive-date=2014-11-02|archive-url=https://web.archive.org/web/20141102054832/http://books.google.ca/books?id=mY-6eweiQm8C&pg=PA348|dead-url=no}}</ref>。约 2% 的癫痫患者会经历发作后精神病，尤其是在出现多次[[强直－阵挛性发作|全身强直阵挛发作]]之后。<ref>{{Cite journal |last1=Clancy |first1=Maurice J. |last2=Clarke |first2=Mary C. |last3=Connor |first3=Dearbhla J. |last4=Cannon |first4=Mary |last5=Cotter |first5=David R. |date=2014-03-13 |title=The prevalence of psychosis in epilepsy; a systematic review and meta-analysis |journal=BMC Psychiatry |language=en |volume=14 |issue=1 |page=75 |doi=10.1186/1471-244X-14-75 |doi-access=free |issn=1471-244X |pmc=3995617 |pmid=24625201}}</ref><ref name=Post2010/>

=== 心理社會面 ===
癲癇可能會在社会支持和心理福祉上造成负面影响，包括被他人孤立、羞辱，或肢體殘障。也可能导致较低的教育水平和就业不易。患者常有学习困难的問題，尤其在{{link-en|患有脑痫的儿童|Epilepsy_in_children}}身上。在公開場合發作，可能對患者與家庭帶來異樣眼光<ref name=WHO2012/>。

併發症包括：[[重性憂鬱障礙]]、[[焦虑症]]、[[偏头痛]]、及[[精神病]]等。
* 癲癇併發精神病的可能性高於一般人，類似精神分裂，以幻覺、妄想為主。若癲癇病灶在顳葉者，則發作機率更高。有些研究發現左腦病灶者較易併發精神病，但未獲得一致性的結論。另有些癲癇是因腦病變造成，這些腦病本身也會造成精神不穩定的症狀<ref>{{cite book|last=Stefan|first=Hermann|title=Epilepsy Part I: Basic Principles and Diagnosis E-Book: Handbook of Clinical Neurology|year=2012|publisher=Newnes|isbn=978-0-444-53505-4|page=471|url=http://books.google.ca/books?id=K-1UqhH2BtoC&pg=PA471|edition=Volume 107 of Handbook of Clinical Neurology|access-date=2014-09-21|archive-date=2015-04-02|archive-url=https://web.archive.org/web/20150402182943/http://books.google.ca/books?id=K-1UqhH2BtoC&pg=PA471|dead-url=no}}</ref>。
* [[注意力不足過動症]]在癲癇儿童中发生率是正常儿童的3到5倍<ref>{{cite journal |journal=J Am Acad Child Adolesc Psychiatry |year=2007 |volume=46 |issue=11|pages=1389–402 |title= 10-year research update review: psychiatric problems in children with epilepsy |author= Plioplys S, Dunn DW, Caplan R|doi=10.1097/chi.0b013e31815597fc |pmid=18049289}}</ref>。多动症和癫痫对儿童的行为、学习和社会互动发展有显著影响<ref>{{cite journal|author=Reilly CJ|title=Attention Deficit Hyperactivity Disorder (ADHD) in Childhood Epilepsy|journal=Research in Developmental Disabilities: A Multidisciplinary Journal|date=May–June 2011 |volume=32 |issue=3 |pages=883–93|doi=10.1016/j.ridd.2011.01.019 |pmid= 21310586}}</ref>。癲癇在[[自闭症]]患者中也更为常见<ref>{{cite journal|journal=Epilepsia |year=2007|volume=48 |issue= Suppl 9 |pages=33–5 |title= The autism-epilepsy connection |author= Levisohn PM|pmid=18047599 |doi=10.1111/j.1528-1167.2007.01399.x}}</ref>。