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治愈的前提是 “明确诊断”,需通过 “脑电图(长程视频脑电图)+ 脑影像(3.0T MRI)+ 病因检查(基因检测、代谢筛查)” 的综合评估,明确:①发作类型(局灶性 / 全面性);②致痫灶位置与数量;③病因(遗传 / 结构 / 代谢 / 感染)。例如,儿童频繁失神发作需通过长程脑电图明确是否为 “儿童失神癫痫”,同时排查是否存在葡萄糖转运体 1 缺陷综合征(GLUT1-DS)等代谢病因;成人局灶性发作需通过功能 MRI 明确是否存在海马硬化或脑肿瘤,避免漏诊可切除病灶。
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