Abstract: Objective To investigate the relationship between grand mal epilepsy and radiological and electroencephalogram(EEG) findings;and to discuss the points for attention in forensic medical expertise of grand mal epilepsy.Methods 43 forensic medicine cases involving grand mal epilepsy caused by traffic accident from January 2006 to December 2007 were collected;the relationship between the disability degree and the age of the injured person as well as the injury parts was analyzed.Then the necessary conditions and exclusion conditions were proposed.Results Positive signs of grand mal epilepsy caused by injury could be found in radiological imaging including CT and MRI,but there might be no positive signs in EEG for partial grand mal epilepsy.Conclusion Positive signs in the radiological imaging is the necessary conditions for the expertise of grand mal epilepsy,while the EEG is the reference conditions.

Key words: traffic accident, craniocerebral injury, grand mal epilepsy, disability degree, forensic expertise

摘要： 目的研究交通事故脑外伤致癫痫大发作者伤残等级评定的影响因素,探讨癫痫大发作伤残等级评定中的注意事项。对象与方法应用SPSS软件,统计2006年1月至2007年12月本中心受理的交通事故致癫痫大发作鉴定案例共43例,对受伤时年龄、初次癫痫发作时间、损伤部位与伤残等级的相关性进行分析,并对外伤性癫痫的认定方法进行探讨。结果左、右两侧大脑半球脑损伤致癫痫大发作后伤残等级比较有统计学意义(P<0.01),20岁以下者与60岁以上者脑损伤后癫痫的伤残等级比较有统计学意义(P<0.01),20岁以下者与20岁以上(未达60岁)脑损伤后癫痫的伤残等级比较无统计学意义(P<0.05);癫痫初次发作时间不同的各组间伤残等级比较无统计学意义(P<0.05)。影像学(CT片、MRI片)资料是确定外伤性癫痫的必备条件,而脑电图检查则是参考条件。结论根据损伤部位、影像学表现等认定外伤性癫痫,并对癫痫大发作做出准确的伤残等级鉴定。

关键词: 交通事故, 颅脑损伤, 癫痫大发作, 伤残等级, 法医学鉴定