癫痫ILAE分类与ICD分类的探讨

Study on the Classification of ILAE Epilepsy and ICD

癫痫的临床表现非常复杂,疾病诊断名称与ICD诊断有差异,使得癫痫ICD编码成为工作中的难点。2017年ILAE推出了新的癫痫发作及癫痫分类,本文通过系统分析ILAE2017版癫痫发作及癫痫分类和ICD-10中癫痫的编码分类,对比发现两者均将起源部位、意识状态、初始临床表现以及脑电图检查等作为分类标准,但前者调整了相关术语、增加了新的癫痫发作类型,使得癫痫发作的命名有较大的灵活性和透明度。世界卫生组织将于2018年发布ICD-11最终版,ICD-11中将有癫痫的专属模块,并可能会应用到扩展码这种形式来进行编码分类,这也将有利于提高癫痫编码的准确性。

The clinical manifestation of epilepsy is very complicated, and the diagnosis name is different from the disease in ICD-10, which makes the coding of epileptic ICD become a difficulty in the work. In 2017,ILAE introduced a new classification of epilepsy. Based on the systematic analysis of the ILAE2017 version classification of epilepsy and the coding classification of epilepsy in ICD-10, it is found that the origin location,state of consciousness, initial clinical manifestations and EEG examination are used as classification criteria.However, the former adjusts the terms and adds new seizure types, which makes the naming of epileptic seizures more flexible and transparent. The World Health Organization（WHO） will release the final version of ICD-11 in2018, which will have a special module for epilepsy, and may be used in the form of extended codes for coding classification, which will also help to improve the accuracy of epileptic coding.