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Semiologie und Propagation epileptischer Anfälle

Semiology and propagation of epileptic seizures

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Zusammenfassung

Im allgemein-neurologischen Alltag stellt sich häufig die Frage der Einordnung passagerer anfallsartiger Symptome. Die klinisch zu erhebenden Zeichen (Semiologie) stellen den wichtigsten Baustein zur Abgrenzung epileptischer Anfälle von differenzialdiagnostischen Entitäten dar. Aufgrund der oft weitreichenden gesundheitlichen und sozialen Konsequenzen der Diagnose Epilepsie ist die gründliche Prüfung und frühe, möglichst exakte Einordnung anfallsartiger Störungen mittels Eigen- und Fremdanamnese auch für die weitere gezielte Diagnostik wichtig. Diese Einordnung beruht auf Kenntnissen zur Assoziation bestimmter Semiologien mit Epilepsiesyndromen und Hirnarealen, wobei gewisse Limitierungen und Fallstricke berücksichtigt werden müssen. Typische Propagationswege der Anfallsaktivität bestimmen den seriellen Verlauf der Semiologie und geben lokalisatorisch ergänzende Hinweise.

Summary

The evaluation of episodic seizure-like symptoms is a common challenge in the neurologist’s daily routine. The clinical signs (semiology) are the most important puzzle pieces to distinguish epileptic seizures from other episodic entities. Due to the often far-reaching health and social consequences of the diagnosis of epilepsy, the early and rigorous assessment of episodic symptoms by means of the patient history is important. This assessment is based on knowledge of the association of certain semiologies with epileptic syndromes and brain regions; however, certain limitations and pitfalls have to be considered. Typical propagation pathways of seizure activity determine the serial occurrence of semiological features and provide supplementary information.

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  1. Neurologische Universitätsklinik, Breisacher Str. 64, 79106, Freiburg, Deutschland

    A.-K. Gellner &  B. Fritsch

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  1. A.-K. Gellner
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  2. B. Fritsch
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Correspondence to B. Fritsch.

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Gellner, AK., Fritsch, B. Semiologie und Propagation epileptischer Anfälle. Nervenarzt 84, 747–761 (2013). https://doi.org/10.1007/s00115-013-3817-5

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