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àÀÊѪÇÔ·ÂÒ
10 ¡ÒÃà¡Ô´»¯Ô¡ÃÂÒÃÐËÇ‹Ò§ÂÒ·ÕÁ¤ÇÒÁÊíҤѭ·Ò§¤ÅÔ¹¡
ÔÔ è Õ Ô 69
ÊÁÄ´Õ ©ÑµÃÊÔÃà¨ÃÔ­¡ØÅ
Ô
11 Availability of Antidote: A Current Status in Thailand 75
¸¹¡Ã ÈÔÃÊÁØ·Ã
Ô
12 Drug Administration Pitfalls: .rom Practitioner to Patient 81
»ÃÕªÒ Á¹·¡Ò¹µÔ¡Å
Ø
13 Drug Administration Pitfalls: Case Studies 87
ÍØäÃÇÃó ÈÔÅ»ÈØÀ¡Ãǧȏ
14 ¡ÒÃ㪌 Trigger Tool 㹡Ò䌹ËÒáÅÐÇÑ´ÍѵÃÒà˵ءÒóäÁ‹¾§»ÃÐʧ¤
Ö 95
¨Ò¡¡ÒÃ㪌ÂÒã¹âç¾ÂÒºÒÅ
ÇÕÃÇ´Õ ¨Ñ¹·Ã¹ÔÀÒ¾§È
ÃѧÊÕÇÔ·ÂÒ
15 PET/CT for Cancer in Head and Neck Region: Thyroid 103
and Nonthyroid Carcinoma
ອ¨ÒÀÒ à¢ÕÂÇËÇÒ¹
16 ¡ÒÃÃÑ¡ÉÒÁÐàÃç§ÈÕÃÉÐáÅÐÅíҤʹŒÇÂÃѧÊÕáÉÒ
Ñ 113
¨Ñ¹¨ÔÃÒ à¾ªÃÊØ¢ÈÔÃÔ
17 ÀÒ¾¹íÒÇÔ¶Õ ÃѧÊÕáÉÒ¡ŒÒÇä¡Å
Ñ 117
¹Ñ¹·¡Ò¹µ àÍÕÂÁǹҹ¹·ªÑÂ, ¤íÒÁØ¡ ¤ÃͧÂØ·¸, ÊѨ¨Ò ã¨à¤Ã‹§
è
ÇÔÊÑ­­ÕÇÔ·ÂÒ
18 Postoperative Pain Management in Pediatric Patients: What’s New? 125
What’s Recommendation?
ÊØÇÃÃ³Õ ÊØÃàÈóÕǧȏ
19 Outcome Improving in Neuroanesthesia: Neuro-interventional Perspective 131
ÍÑ­ªÅÕ ªÙâ蹏
àǪÈÒʵÏ»‡Í§¡Ñ¹áÅÐÊѧ¤Á
20 ¤ÇÒÁÊíҤѭ¢Í§ÂÒµŒÒ¹¾ÔÉ㹡ÒôÙáżٻÇÂÀÒÇоÔÉà©Õº¾Åѹ
Œ † 135
ÊÑÁÁ¹ â©Á©ÒÂ

22. xxi
àǪÈÒʵÏ¿„œ¹¿Ù
21 ¡ÒÃÍÍ¡¡íÒÅѧËÅѧ¡Ò÷íÒËѵ¶¡ÒÃËÃ×ͼ‹ÒµÑ´ËÑÇ㨠143
¡ÁŷԾ ËÒ­¼´Ø§¡Ô¨
22 ¡ÒÃÍÍ¡¡íÒÅѧ¡ÒÂã¹âä¤ÇÒÁ´Ñ¹âÅËÔµÊÙ§ 155
ÇÔÅÒÇѳ ¶ÔÃÀѷþ§È
23 ¡ÒÃÍÍ¡¡íÒÅѧ¡ÒÂã¹âäàºÒËÇÒ¹ 159
ÇÔÅÒÇѳ ¶ÔÃÀѷþ§È
24 Íغµà˵ؤÍÊкѴ
Ñ Ô 163
ÇÔÉ³Ø ¡ÑÁ·Ã·Ô¾Â
25 Whiplash Injury: Myogenic Cause and Conservative Treatment 171
¸ÕÃ´Ò ¾ÅÍÂྪÃ
ÈÑÅÂÈÒʵÏ
26 âä¢Í§·ÇÒÃ˹ѡáÅÐÅíÒäÊŒµÃ§·Õ¾ºº‹ÍÂ
è 177
ÇÃÁÔ¹·Ã àËÃÕ­ÊØÇÃó
27 Hepatocellular Carcinoma: Management in the New Era 183
ÊÁªÑ ÅÔÁÈÃÕ¨ÒàÃÔ­, §ÂØ·¸ ÈÔÃDz¹ÍÑ¡ÉÃ, ÊØ»ÃÕªÒ ÍÑÊÇ¡Ò­¨¹, ªØµÇªÂ âµÇÔ¡ÀÑÂ
é í ÔÑ ÔÔ Ñ
28 Exceeding 100 Liver Transplantations in Siriraj Hospital 189
§ÂØ·¸ ÈÔÃDz¹ÍÑ¡ÉÃ, ÊÁªÑ ÅÔÁÈÃÕ¨ÒàÃÔ­, »ÃÐÇѲ¹ â¦ÊÔµÐÁ§¤Å, »ÃÐàǪ ÁËÒÇÔ·µÇ§È,
ÔÑ é í Ô
ÊØ»ÃÕªÒ ÍÑÊÇ¡Ò­¨¹, ªØµÇªÂ âµÇÔ¡ÀÑÂ
ÔÔ Ñ
29 The .irst Live Donor Liver Transplantation in Thailand 193
§ÂØ·¸ ÈÔÃDz¹ÍÑ¡ÉÃ, ÊÁªÑ ÅÔÁÈÃÕ¨ÒàÃÔ­, »ÃÐÇѲ¹ â¦ÊÔµÐÁ§¤Å, »ÃÐàǪ ÁËÒÇÔ·µÇ§È,
ÔÑ é í Ô
ÊØ»ÃÕªÒ ÍÑÊÇ¡Ò­¨¹, ªØµÇªÂ âµÇÔ¡ÀÑÂ
ÔÔ Ñ
30 Robotic Surgery for General Surgeons: .uture or .antasy 197
ÇÔ·Ã ªÔ¹ÊÇ‹Ò§ÇѲ¹¡ØÅ, ¸ÇѪªÑ ÍѤÃÇÔ¾¸, ÍÑ°¾Ã µÃСÒÃʧ‹Ò, ÍÑÉ®Ò àÁ¸àÈÃÉ°
Ù Ø
¸Ñ­à´ª ¹ÔÁÁÒ¹Çز¾§É, ³Ã§¤ àÅÔÈÍÃæÂÁ³Õ
Ô
31 Siriraj Trauma Center 203
»ÃÕªÒ ÈÔ÷ͧ¶ÒÇÃ
Ô
32 Siriraj Trauma Center 205
ÇÔÀÒÀó ÈÃÕ¾¨¹¸ÃÃÁ
33 Journey to Excellent Burn Unit 211
¾Ã¾ÃËÁ àÁ×ͧáÁ¹

23. xxii
ÈÑÅÂÈÒʵÏÍÍÏ⸻´Ô¤Ê áÅСÒÂÀÒ¾ºíҺѴ
34 Treatment of Pathologic .racture 219
¨Ñ¹·¹ÃÑÈÁ ¨Ñ¹·¹Âԧ§, ¸ÕÃÇØ²Ô ¸ÃÃÁÇԺŏÈÃÕ, ÃоԹ·Ã ¾ÔÁÅÈÒ¹µÔ,ì ¡ŒÍ§à¢µ àËÃÕ­ÊØÇÃó
è Ù
ÊÙµÈÒʵÏ-¹ÃÕàǪÇÔ·ÂÒ
Ô
35 Practical Management of Dysfunctional Uterine Bleeding 229
¸Ñ¹ÂÒÃѵ¹ ǧȏǹҹØáɏ, ÊØªÒ´Ò ÍÔ¹·ÇÔDz¹, Á³Õ Ãѵ¹äªÂÒ¹¹·
Ñ Ñ
âʵ ¹ÒÊÔ¡ ÅÒÃÔ§«Ç·ÂÒ
Ô
36 䫹ÑÊÍÑ¡àʺ áÅÐÃÔ´Êմǧ¨ÁÙ¡ 241
»ÒÃÂÐ ÍÒȹÐàʹ, ¾§È¡Ã µÑ¹µÔÅ»¡Ã, ͹ѭ­ ྱdzԪ, ਵ¹ ÅíÒÂͧàʶÕÂÃ
Õ 
37 ¡ÒÃ䴌¹º¡¾Ã‹Í§ã¹à´ç¡â´ÂÀÒ¾ÃÇÁáÅСÒäѴ¡Ãͧ¡ÒÃ䴌¹ã¹à´ç¡ááà¡Ô´
Ô Ô 259
¡Ñ­­·Í§ ·Í§ãË­‹
38 ¡ÒÃÊÙ­àÊÕ¡ÒÃ䴌¹¨Ò¡¡ÒùíÒàÊÕ§àÊ×ÍÁã¹¼Ù»ÇÂà´ç¡
Ô è Œ † 265
ÍÒªÇÔ¹·Ã µÑ¹ä¾¨ÔµÃ
39 ¡ÒÃÊÙ­àÊÕ¡ÒÃ䴌¹㹼ٻÇÂà´ç¡¨Ò¡ÊÒà˵طҧ¾Ñ¹¸Ø¡ÃÃÁ
Ô Œ † 271
¹Ô¸ÇªÃ ÇѲ¹ÇÔ¨Òó
ÔÑ
40 ÊÒÂàÊÕ§໚¹ÍÑÁ¾Òµ 281
©Ñ¹·ÔªÒ ⪵ԡdzԪ
41 Hoarseness and Management 285
¨ÕÃÐÊØ¢ ¨§¡ÅÇѲ¹Ò
ÍÒÂØÃÈÒʵÏ
42 ¡Òû‡Í§¡Ñ¹âäËÅÍ´àÅ×Í´ÊÁͧ·Ñ§¡‹Í¹áÅÐËÅѧ¡Òü‹ÒµÑ´
é 289
ʧ¤ÃÒÁ ⪵ԡ͹تµ, §ªÑ ¹ÔÅй¹·, ¹ÒÃҾà »ÃÐÂÙÃÇÔDz¹, ¹Ô¾¹¸ ¾Ç§ÇÃÔ¹·Ã
Ô Ñ
43 Scrub Typhus in Thailand 297
Âؾ¹ Èؾ·¸Á§¤Å
Ô Ø
44 Molecular Epidemiology of Scrub Typhus in Thailand 301
»¯ÔÁҾà ǧɏ¾ÃËÁ¾Ô·¡É
Ñ
45 Recent Advances in the Diagnosis of Scrub Typhus 305
Wei Mei Ching

24. xxiii
46 Iron Chelation: New Hope 313
ª®Ò ¾ÔÈÒž§È
47 Deferasirox ÂҢѺàËÅ硪¹Ô´ÃѺ»Ãзҹ 317
¹¾´Å ÈÔø¹ÒÃѵ¹¡ØÅ
Ô
ËÑÇ¢ŒÍàÃ×èͧÊËÊÒ¢ÒÇÔªÒªÕ¾
¡ÒÃÊ‹§àÊÃÔÁÊØ¢ÀÒ¾áÅСÒû‡Í§¡Ñ¹âä
48 ÂÒ¨Ò¡ÊÁعä¾Ã¡ÑºàǪÈÒʵÏàªÔ§»ÃШѡɏ 323
³Ñª¡Ã ÅéÒàÅÔÈ¡Ô¨, »ÃÐÇԷ ÍѤÃàÊÃÕ¹¹·, »ÃÐʾ¾Ã ¾Ñ¹¸à¾ç§, ·ÇÕ àÅÒ˾ѹ¸
í
49 ËÅÑ¡¡ÒÃÊíҤѭ¢Í§¡ÒÃᾷἹä·Â 333
·Ñ¾¾à·¾ ·Ô¾Âà¨ÃÔ­¸ÑÁ, Ãѵ´ÒÇÃó ·Ô¾Âà¨ÃÔ­¸ÑÁ, ·ÇÕ àÅÒ˾ѹ¸
50 ¡ÒÃÊ‹§àÊÃÔÁÊØ¢ÀÒ¾´ŒÇ¸ÃÃÁÒ¹ÒÁÑ 341
ÊÔáҹµ ÀÙâ»Ã‹§, »ÃÐÁÇÅ ¤íÒá¡ŒÇ, ·ÇÕ àÅÒ˾ѹ¸
Ô
51 ¹Çѵ¡ÃÃÁ¡ÒþÂÒºÒÅ: ÇѲ¹¸ÃÃÁÊÌҧàÊÃÔÁÊØ¢ÀÒ¾·Õ§Â×¹
è Ñè 349
Çѹà¾ç­ ÀÔ­â­ÀÒÊ¡ØÅ
52 Breast Cancer Prevention and Screening 351
Ê׺ǧȏ ¨Ø±ÒÀÔÊ·¸Ôì
Ô
53 Screening in Common Gynecologic Cancer: Ovarian Cancer Screening 355
»˜·ÁÒ àªÒǏ⾸Էͧ
ì
54 ¡Òû‡Í§¡Ñ¹ÀÒÇÐÊÁͧàÊ×ÍÁÃдѺ»°ÁÀÙÁÔ
è 361
ÇÕÃÈÑ¡´Ôì àÁ×ͧä¾ÈÒÅ
¡ÒôÙáżٌÊÙ§ÍÒÂØ
55 Harmonized Care for Older Patients: .ocus on Hospitalized Patients 367
Ãا¹Ôù´Ã »ÃдÔÉ°ÊØÇÃó
‹ Ñ
56 Harmonized Care for Older Patients: .ocus on Cognition 375
ÇÃÒÅѡɳ ÈÃÕ¹¹·»ÃÐàÊÃÔ°
57 Harmonized Care for Older Patients: .ocus on Mobility 387
ÇÔäÅ ¤Ø»µ¹ÃµÈ¡ØÅ
ÔÑ Ô Ñ

25. xxiv
ÊÔè§áÇ´ÅŒÍÁáÅÐÊØ¢ÀÒ¾
58 Health Impacts of Environmental Threats in Thailand: 397
Epidemiological Aspects
ÊÁà¡ÕÂÃµÔ ÈÔÃõ¹¾Ä¡É
ÔÑ
59 ¡ÒÃÈÖ¡ÉҼšÃзºµ‹ÍÊØ¢ÀÒ¾»ÃЪҪ¹·ÕèÍÒÈÑÂÍÂÙ‹Ãͺ¹Ô¤ÁÍصÊÒË¡ÃÃÁÁÒºµÒ¾Ø´ 401
¹ÔµÂÒ ÇѨ¹ÐÀÙÁ.Ô ¹Ñ¹·ÇÃó ÇÔ¨µÃÇÒ·¡ÒÃ, »ÃÒ³Õ ªÒ­³Ã§¤
Ô
60 Climate Change and Allergic Disease 405
ÇÃÇÔª­ àËÅ×ͧàǪ¡ÒÃ, »ÒÃÂÐ ÍÒȹÐàʹ, µ‹Í¾§É ·Í§§ÒÁ
Craniofacial Care
61 ¡ÅàÁç´¡Ò÷íҧҹ໚¹·ÕÁ´ÙáżٻÇ¡ÐâËÅ¡ÈÕÃÉÐáÅÐãºË¹ŒÒ¼Ô´»¡µÔ
Œ † 415
ÈÃÕ»ÃÐÊÔ·¸Ôì ºØ­ÇÔÊ·¸Ô,ì ÈÃÕÇÁÅ Áâ¹àªÕÂǾԹ¨, ÇÃó´Õ ¾ÅÒ¹ØÀÒ¾
Ø Ô è Ô
Movement Disorders
62 Movement Disorder Surgery 433
ÈÃѳ ¹Ñ¹·ÍÒÃÕ, ºÃþµ ÊÔ·¸Ô¹ÒÁÊØÇÃó, ÍѤ¤¾§É ¹ÔµÊ§Ë, ¡¹¡ÇÃó ºØ­­¾ÔÊ®°‚,
ÔÔ Ô
ÍÀÔªÒµÔ ¾ÔÈÒž§È
Traumatic Brain Injury
63 Neurosurgical Perspective of Mild Traumatic Brain Injury 441
ºÃþµ ÊÔ·¸Ô¹ÒÁÊØÇÃó, »ÃШѡÉì ÈÃÕþվ²¹ì
Ñ
64 Neuropsychiatric Disorders after Mild Traumatic Brain Injury 453
¾Ã¨ÔÃÒ »ÃÔǪÃÒ¡ØÅ
Ñ
¡ÒúҴà¨çº¢Í§ËÅÍ´àÅ×Í´
65 ÀÒ¾ÃѧÊÕǹ¨©ÑÂÃкº»ÃÐÊÒ·ã¹¼Ù»ÇÂÍغµà˵Ø
Ô Ô Œ † Ñ Ô 459
ÊÔÃÍà µÃÔµÃСÒÃ
Ô
66 ÀÒ¾ÇÔ¹¨©ÑÂ㹼ٻǷÕ䴌úºÒ´à¨çººÃÔàdzËÅÍ´àÅ×Í´á´§¨Ò¡Íغµà˵Ø
Ô Œ † è Ñ Ñ Ô 469
¨ÔµÃÅÑ´´Ò ÇÐÈÔ¹Ãѵ¹
67 Imaging of Trauma: Abdominal Trauma 479
ÇÃóÇÃÒ§¤ ÊØ·¸Ô¤ÃÕ
Õ

26. xxv
68 Traumatic Cerebrovascular Injury: Neurosurgical Perspective 489
àÍ¡ÇØ²Ô ¨Ñ¹á¡ŒÇ, ·ÇÕÈ¡´Ôì àÍ×ͺح­ÒÇѲ¹, ÍÑ­ªÅÕ ªÙâ蹏
Ñ é
69 Interventional Radiology Management in Traumatic Patient 497
(Body and Peripheral Artery)
ÊÁÃÒª ¸ÃÃÁ¸ÃÇѲ¹
ÀÒÇмԴ»¡µÔ¢Í§¡Òù͹ËÅѺ
70 ¹Í¹¡Ã¹áÅÐÀÒÇÐËÒÂ㨼Դ»¡µÔ¢³ÐËÅѺª¹Ô´ÍØ´¡Ñ¹
é 505
ÇÔª­ ºÃóËÔí
Ñ
71 Narcolepsy 523
ÇѲ¹ªÑ ⪵ԹÂÇѵáØÅ
Ñ
72 Surgical Treatment for Sleep Disordered Breathing 529
ÇÔª­ ºÃóËÔí
Ñ
ÀÒÇмԴ»¡µÔ¢Í§¡ÒáÅ×¹
73 Management for Dysphagia Patients 535
⪤ªÑ àÁ¸ÕäµÃÃѵ¹, ๵ÃÒ ºÑÇ¡¹¡, ÀÒÇÔ¹ à¡É¡ØÅ, ÇÃصÁ ¾§ÈÒ¾Ôª­, Êع¹· ͧÍÒ¨
Ñ
ÀÒÇÐàÅ×Í´ÍÍ¡ã¹·Ò§à´Ô¹ÍÒËÒÃʋǹº¹
74 ÀÒÇÐàÅ×Í´ÍÍ¡ã¹·Ò§à´Ô¹ÍÒËÒÃʋǹº¹ 543
ÇÃÒÂØ »ÃѪ­¡ØÅ
75 Management of Esophageal Varices and Esophageal Variceal Hemorrhage 555
ÈÔÇоà äªÂ¹Øǵ,Ô ¹¹·ÅÕ à¼‹ÒÊÇÑÊ´Ô,ì Êؾ¨¹ ¹ÔÁ͹§¤
Ñ è
76 Embolization for Upper Gastrointestinal Hemorrhage 565
ÇÅÑÂÅѡɳ ªÑÂÊÙµÃ
¡ÒÃÇÔ¨ÑÂáÅÐÇÔ·ÂÒÈÒʵϾ×é¹°Ò¹·Ò§¡ÒÃᾷ
77 General Aspects of Tumor Microenvironment 569
»‚µÔ ¸ØǨԵµ
78 Cancer-associated .ibroblasts in Tumor Progression 573
ª¹ÔµÃÒ ¸ØǨԵµ

27. xxvi
79 Digital Image Processing and Data Management for Clinical 579
Registry and Clinical Research
»ÃоѲ¹ ÊØüÅ
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80 Research and Road to Innovation and Business 587
ÇÃóРÁËÒ¡ÔµµÔ¤³, ¾ÔÁ¾»ÃÐä¾ ¸ÕÃЪվ, ¸ÒÃÔ¹ àÍÕÂÁྪÃÒ¾§È, ¸¹¾Å ÇÕÃÒÊÒ
Ø è
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81 Transplantation: Medico-legal Investigation 595
»ÃÕªÒ ÈÔ÷ͧ¶ÒÇÃ
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82 ¤ÇÒÁ¼Ô´»¡µÔ¢Í§ÊÒÂàÊÕ§ 597
侺Ùŏ ÊØþ§É
Õ 
83 Hearing Loss in Children: 120 year Evolution in Management 601
ÊØǨ¹Ò ͸ÔÀÒÊ
Ñ
´Ñª¹Õ
´Ñª¹Õ 605

28. àǪÈÒʵÏ·¹Âؤ 2553
Ñ º··Õè 1
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áÅÐàÁ×Í»˜¨¨ÑÂËÃ×ÍâäàËÅ‹Ò¹ÕËÒ ÍÒ¡Òêѡ¡ç¨ÐËÒÂä»àª‹¹¡Ñ¹ ÊÒà˵آͧÍÒ¡Òêѡ㹡ÅØÁ¹ÕÁÁÒ¡ÁÒÂ
è é ‹ é Õ
´Ñ§áÊ´§änj㹵ÒÃÒ§·Õè 1
2. Unprovoked seizure ËÁÒ¶֧ ÍÒ¡Òêѡ·Õà¡Ô´¢Ö¹â´Â·ÕäÁ‹Á»¨¨ÑÂÍ×¹ÁÒ¡Ãеع
è é è Õ ˜ è Œ

29. 2 Childhood Seizure and Epilepsy
µÒÃÒ§·Õè 1 ÊÒà˵آͧ symptomatic seizure ·Õ辺º‹ÍÂ
! Cerebrovascular disease: Thrombosis, embolism, hemorrhage, vasculitis
! Central nervous system infection: Meningitis, encephalitis, brain abscess
! Hypoxic-ischemic encephalopathy
! Brain tumor
! Hypotensive/Hypertensive encephalopathy
! Metabolic: hypoglycemia, hypo/hypernatremia, hypocalcemia, hypomagnesemia
! Head injury
! Congenital brain malformation
! Drug / drug withdrawal
! Inborn errors of metabolism
! Degenerative brain disease
! .ebrile seizure
ã¹¼Ù»ÇÂà´ç¡¹Ñ¹ ÍÒ¨ÁÕÍÒ¡ÒÃÍ×¹æ·Õà¡Ô´¢Ö¹ªÑÇ¢³Ð (paroxysmal events) ·ÕÁšɳкҧÍ‹ҧ
Œ † é è è é è è ÕÑ
¤ÅŒÒ¡ѺÍÒ¡Òêѡ ·íÒãËŒÍÒ¨ÊѺʹ¡ÑºÍÒ¡Òêѡ䴌 â´Âᵡµ‹Ò§¡Ñ¹ä»µÒÁᵋÅЪ‹Ç§ÍÒÂØ (1) ´Ñ§áÊ´§
änj㹵ÒÃÒ§·Õè 2
µÒÃÒ§·Õè 2 Paroxysmal non-epileptic events ã¹à´ç¡·Õ¾ºº‹ÍÂᡵÒÁª‹Ç§ÍÒÂØ
è
Neonates Infants Children and adolescents
Sleep myoclonus Apnea Breath-holding spell, Syncope,
Hyperexplexia Jitteriness Sandifer, Day dreaming
Sleep myoclonus Abnormal movement eg. Chorea, Tics
Benign paroxysmal torticolis Benign paroxysmal vertigo
Spasmus nutans Hyperventilation syndrome
Opsoclonus Psychologic disorder
Night mare / night terror
Narcolepsy
ËÁÒÂà赯 ´´á»Å§¨Ò¡àÍ¡ÊÒÃËÁÒÂàÅ¢ 1
Ñ
âäÅÁªÑ¡ (epilepsy) ¤×Íâä·Õ¼»ÇÂÁÕÍÒ¡Òêѡâ´ÂäÁ‹Á»¨¨Ñ¡Ãеع (unprovoked seizure)
è ÙŒ † Õ ˜ Œ
ÁÒ¡¡Ç‹Ò 2 ¤Ãѧ¢Ö¹ä»
é é

30. àǪÈÒʵÏ·¹Âؤ 2553
Ñ 3
âäÅÁªÑ¡ÁÕÊÒà˵ØáÅоÂÒ¸Ô¡Òà¹Ô´ä´ŒËÅÒÂÍ‹ҧ ã¹·Õ¹¢Íẋ§µÒÁÊÒà˵Øä´Œ´§¹Õé (2)
í è Õé Ñ
1. Idiopathic: âäÅÁªÑ¡¹ÕäÁ‹ä´Œà¡Ô´¨Ò¡¾ÂÒ¸ÔÊÀÒ¾ã¹ÊÁͧᵋÁÊÒà˵Øà¹×ͧ¨Ò¡¾Ñ¹¸Ø¡ÃÃÁ
é Õ è
2. Symptomatic epilepsy: âäÅÁªÑ¡·ÕÁÊÒà˵ØÁÒ¨Ò¡¡Ò÷ÕÁ¾ÂÒ¸ÔÊÀÒ¾¢Í§ÊÁͧ«Ö§ÍÒ¨
è Õ è Õ è
໚¹¾ÂÒ¸ÔÊÀÒ¾·Õà¡Ô´¢Ö¹ÁÒ¹Ò¹ áÅÐäÁ‹Á¡ÒÃà»ÅÕ¹á»Å§ ઋ¹ cortical dysplasia, congenital brain
è é Õ è
anomaly, á¼Å໚¹¨Ò¡¡Ò÷Õà¤Â໚¹âäÊÁͧÍÑ¡àʺ (encephalitis), à¤ÂÁÕàÅ×Í´ÍÍ¡ã¹ÊÁͧáÅÐä´Œ
è
ÃѺ¡Òü‹ÒµÑ´, à¤ÂÁÕ»ÃÐÇѵ¢Í§ÊÁͧ¢Ò´ÍÍ¡«Ôਹ (birth asphyxia) ËÃ×ÍÍÒ¨¨ÐÁÕÊÒà˵بҡ¡Ò÷Õà¹×Í
Ô è é
ÊÁͧ¶Ù¡·íÒÅÒ¨ҡâä metabolic ËÃ×Í degenerative brain disorder
3. Cryptogenic âäÅÁªÑ¡·Õ¤Ò´Ç‹Ò¹‹Ò¨ÐÁÕÊÒà˵بҡҡ÷ÕÁ¾ÂÒ¸ÔÊÀÒ¾¢Í§ÊÁͧ ᵋ¡ÒÃ
è è Õ
Ê‹§µÃǨ·Ò§ËŒÍ§»¯Ôºµ¡ÒÃã¹»˜¨¨Øº¹ÂѧäÁ‹ÊÒÁÒöµÃǨ¾ºä´Œ
Ñ Ô Ñ
â´ÂÊÃØ» ÍÒ¡ÒêѡáÅÐâäÅÁªÑ¡¹Ñ¹áµ¡µ‹Ò§¡Ñ¹ â´ÂÁÕá¹Ç·Ò§¡ÒÃÇÔ¹¨©Ñ´ѧἹÀÙÁ·Õè 1
é Ô Ô
á¼¹ÀÙÁÔ·Õè 1 á¹Ç·Ò§¡ÒÃÇÔ¹Ô¨©ÑÂÍÒ¡ÒêѡáÅÐâäÅÁªÑ¡
¡ÒÃẋ§»ÃÐàÀ·¢Í§ÍÒ¡Òêѡ (Seizure classification)
¡ÒÃẋ§»ÃÐàÀ·¢Í§ÍÒ¡Òêѡ·ÕÂÍÁÃѺáÅÐ㪌¡¹á¾Ã‹ËÅÒ·ÕÊ´¤×Í¡ÒÃẋ§µÒÁ International
è Ñ èØ
League Against Epilepsy (ILAE) ã¹»‚ ¤.È. 1981 â´ÂÍÒÈÑÂÅѡɳÐÍÒ¡Òêѡ (clinical seizure
(3)
description) áÅСÒÃà»ÅÕ¹á»Å§¢Í§¤Å׹俿‡ÒÊÁͧ (electroencephalography, EEG) ໚¹ËÅÑ¡ã¹
è è
¡ÒÃẋ§ «Ö§áº‹§»ÃÐàÀ·¢Í§ÍÒ¡Òêѡ䴌 3 »ÃÐàÀ· ¤×Í partial seizure, generalized seizure áÅÐ
è
unclassified seizure

31. 4 Childhood Seizure and Epilepsy
Partial seizure (.ocal seizure) (4)
Partial ËÃ×Í focal seizure ໚¹ÍÒ¡Òêѡ«Ö§à¡Ô´¨Ò¡¡Ò÷ÕÁ¡ÃÐáÊä¿¿‡Ò·ÕÁÒ¡¼Ô´»¡µÔà¡Ô´¢Ö¹
è è Õ è é
¨Ò¡ÊÁͧʋǹã´Ê‹Ç¹Ë¹Ö§ â´Â¡ÃÐáÊä¿¿‡Ò´Ñ§¡Å‹ÒÇÍÒ¨¤§ÍÂÙ·à´ÔÁËÃ×Í ÍÒ¨à¤Å×͹价ÕÊÁͧʋǹÍ׹䴌
è ‹ Õè è è è
«Ö§¨ÐÁռŵ‹ÍÅѡɳСÒêѡ¢Í§¼Ù»Ç ÍÒ¡ÒêѡẺ¹Õẋ§ä´ŒÍ¡à»š¹ 2 ª¹Ô´Â‹Í¤×Í
è Œ † é Õ
1. Simple partial seizure (SPS) ã¹¢³ÐªÑ¡¼Ù»Ç¨ÐÂѧÃÙÊ¡µÑÇ (consciousness) ·Õ´ÍÂÙ‹
Œ † ŒÖ è Õ
ÅѡɳСÒêѡ¢Í§¼ÙŒ»†Ç¹Ñ鹨ТÖé¹ÍÂÙ‹¡ÑºÇ‹ÒÊÁͧʋǹ㴶١¡Ãе،¹â´Â¡ÃÐáÊä¿¿‡Ò·Õè¼Ô´»¡µÔ
¼Ù»ÇÂÍÒ¨¨ÐÁÕÍÒ¡ÒÃà¤Å×͹äËǢͧËҧ¡Ò·ռ´»¡µÔ (motor seizure) ઋ¹ à¡Ãç§ ¡Ãеء ʋǹ˹֧
Œ † è è Ô è
ʋǹ㴢ͧËҧ¡Ò ઋ¹ãºË¹ŒÒ äËÅ‹ ᢹ Á×Í ¢ÒËÃ×Íà·ŒÒ ¢ŒÒ§ã´¢ŒÒ§Ë¹Ö§ ºÒ§ÃÒÂÍÒ¨¨ÐÁÕÍÒ¡Ò÷ҧ è
¤ÇÒÁÃÙÊ¡ËÃ×Í »ÃÐÊÒ·ÊÑÁ¼ÑʾÔàÈÉÍ×¹æ (somatosensory or special-sensory seizure) ઋ¹ ªÒᢹ
ŒÖ è
¢Ò¢ŒÒ§ã´¢ŒÒ§Ë¹Ö§ àËç¹áʧ 䴌¹àÊÕ§ ËÃ×Íä´Œ¡ÅÔ¹µ‹Ò§æ ·Õ¼´»¡µÔ
è Ô è è Ô
2. Complex partial seizure (CPS) ¼ÙŒ»†Ç¨ÐÁÕ impairment of consciousness «Öè§
consciousness ·Õ㪌¡¹ã¹âäÅÁªÑ¡¹Ñ¹»ÃСͺ´ŒÇ 2 ʋǹ¤×Í responsiveness (¡Òõͺʹͧµ‹Í
è Ñ é
ÊÔ§àÃŒÒ ËÃ×Í·íÒµÒÁ¤íÒÊѧÍ‹ҧÁÕ¤ÇÒÁËÁÒÂ) áÅÐ awareness (¡ÒÃÃѺÃÙáÅÐÊÒÁÒö¨´¨íÒà˵ءÒó
è è Œ
µ‹Ò§æ ·Õèà¡Ô´¢Öé¹ã¹¢³Ð·ÕèÁÕÍÒ¡Òêѡ) ¼ÙŒ·Õ辺àË繡Òêѡ¢Í§¼ÙŒ»†ÇÂÍÒ¨¨Ð͸ԺÒÂÇ‹Ò¼ÙŒ»†ÇÂÁÕÍÒ¡ÒÃ
àËÁèÍ à»ç¹ÅÁ ËÁ´ÊµÔ ËÃ×ͺҧ¤ÃѧÍÒ¨¨Ð´ÙàËÁ×͹ÃÙÊ¡µÑÇ´ÕáµèäÁè·ÓµÒÁ¤ÓÊѧ ã¹¢³Ð·Õª¡¹Ñ¹ ¼Ù»ÇÂ-
é éÖ è è Ñ é é è
ºÒ§ÃÒÂÍÒ¨¨ÐÁÕ¡ÒÃà¤Å×è͹äËǢͧËҧ¡Ò«éíÒæ àÃÕÂ¡Ç‹Ò automatism «Ö觼ٌ»†ÇÂÍÒ¨¨Ð¢ÂѺ»Ò¡
àËÁ×͹à¤ÕÂÇ ËÃ×Í¡Å×¹ (lips smacking, swallowing) ¨ÑºÁ×ÍËÃ×ÍËÂÔº¨ÑºÊÔ§¢Í§µ‹Ò§æ ËÃ×Íà´Ô¹ä»ÁÒ
é è
«Ö§à»š¹¾ÄµÔ¡ÃÃÁ·ÕäÁ‹Á¤ÇÒÁËÁÒ â´Â·ÑÇä»ÃÐÂÐàÇÅÒ·Õª¡»ÃÐÁÒ³ 2-3 ¹Ò·Õ (30 ÇÔ¹Ò·Õ – 10 ¹Ò·Õ)
è è Õ è è Ñ
¹Í¡¨Ò¡¹ÕÍÒ¨¾ºÍÒ¡ÒùíÒ pre-ictal symptom (aura) «Ö§à»š¹¤ÇÒÁÃÙÊ¡·Õ¼»Çºҧ¤¹ÍÒ¨¨Ð͸ԺÒÂ
é è Œ Ö è ÙŒ †
ä´Œ¡Í¹ÁÕÍÒ¡Òêѡ ´Ñ§·Õ¾ºã¹ SPS ËÅѧ¨Ò¡ªÑ¡ (post-ictal state) ¼Ù»ÇÂÁÑ¡¨ÐÁÕÍÒ¡ÒÃÊѺʹ䴌µÍ
‹ è Œ † ‹
໚¹¹Ò·Õ
¼ÙŒ»†Ç·ÕèàÃÔèÁµŒ¹¡Òêѡ´ŒÇ SPS ËÃ×Í CPS ¹Ñé¹ÍÒ¨¨ÐÁÕ¡ÒÃà¡Ãç§ËÃ×Í¡Ãеء¢Í§Ã‹Ò§¡ÒÂ
·Ñ§µÑǵÒÁÁÒ ¨ÐàÃÕÂ¡Ç‹Ò partial seizure evolving to secondarily generalized seizure ´Ñ§¹Ñ¹¼Ù»Ç·Õè
é é Œ †
ÁÕ¼¾ºÇ‹ÒÁÕÍÒ¡ÒÃà¡Ã秡Ãеء·Ñ§µÑǹѹÍÒ¨¨Ð໚¹¡ÒêѡẺ focal ¹íÒÁÒ¡‹Í¹¡çä´Œ
ÙŒ é é
Generalized seizure (4)
Generalized seizure ໚¹ÍÒ¡Òêѡ·Õà¡Ô´¢Ö¹¨Ò¡¡ÒÃà»ÅÕ¹á»Å§¢Í§¡ÃÐáÊä¿¿‡Ò·Õè¡Ãеع
è é è Œ
ÊÁͧ·ÑèÇæ仾ÌÍÁ¡Ñ¹·Ñé§Êͧ¢ŒÒ§ ·íÒãËŒÁռŵ‹Í¤ÇÒÁÃÙŒÊÖ¡µÑÇáÅÐ ¡ÒÃà¤Å×è͹äËǢͧ¡ÅŒÒÁà¹×éÍ
·ÕäÁ‹¨Òà¾Òзբҧ㴢ŒÒ§Ë¹Ö§¢Í§Ã‹Ò§¡Ò generalized seizure ẋ§Í͡໚¹ 4 ¡ÅØÁãË­‹æ 䴌ᡋ
è í è Œ è ‹
1. Tonic-clonic seizure (grand mal) ¼Ù»Ç¨ÐÁÕ¤ÇÒÁÃÙÊ¡µÑÇ·ÕŴŧ ËÇÁ¡ÑºÍÒ¡ÒÃà¡Ãç§ áÅÐ/
Œ † ŒÖ è
ËÃ×Í¡Ãеء¢Í§ÅíÒµÑÇ, ᢹ¢Ò â´Â·ÑèÇä»ÍÒ¡Òêѡ¨ÐàÃÔèÁµŒ¹´ŒÇÂÍÒ¡ÒÃà¡Ãç§ (tonic phase) áÅŒÇ
µÒÁÁÒ´ŒÇÂÍÒ¡ÒáÃеء (clonic phase) ª‹Ç§·ÕèÁÕÍÒ¡Òêѡ¼ÙŒ»†ÇÂÍÒ¨ÁÕÍÒ¡Ò÷ҧÃкº»ÃÐÊÒ·
Íѵâ¹ÁѵÃÇÁ´ŒÇ¤×Í ÁÕÁÒ¹µÒ¢ÂÒÂ, ¹éÒÅÒ¿ÙÁ»Ò¡, à˧×ÍÍÍ¡, »˜ÊÊÒÇÐ Íب¨ÒÃÐÃÒ´ ËÅѧ¨Ò¡ªÑ¡
Ô‹ ‹ í è
¼Ù»ÇÂÁÑ¡¨ÐÁÕÍÒ¡ÒÃà¾ÅÕ ÊѺʹ ËÅÑºä» ÍÒ¡Òêѡª¹Ô´¹Õé ¼Ù¤¹·ÑÇä»ÁÑ¡ÃÙ¨¡ã¹ª×Í ÅÁºŒÒËÁÙ ¼Ù»ÇÂ
Œ † Œ è ŒÑ è Œ †