Neonatal seizures: problems in diagnosis and classification.
Neonatal seizures: problems in diagnosis and classification.
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新生儿癫痫发作：诊断和分类中的问题。
DOI：
10.1111/j.1528-1157.1987.tb05757.x
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发表时间：
1987
期刊：
影响因子：
5.6
通讯作者：
Mizrahi,EM
中科院分区：
文献类型：
--
作者：
Mizrahi,EM
新生儿癫痫发作的临床识别对于识别脑功能障碍至关重要;然而，由于这些行为的组织性差和多样性，诊断往往很困难。目前的分类系统在准确传达癫痫发作的运动、自主神经和脑电图特征以及为统一有效的诊断、治疗和预后确定提供基础方面能力有限。最近的调查新生儿，利用床边脑电图/多导/视频监测技术，提供了基础，以改善诊断和分类的新生儿癫痫发作。这些研究表明，并非所有目前被认为是癫痫发作的临床现象都需要皮层电癫痫样活动来启动或阐述。此外，被认为是癫痫发作的现象的具体临床特征、婴儿的临床状态和EEG的特征表明了可能涉及的病理生理机制，并提示了可能的病因、预后和治疗。动物模型，表现出反射生理学和新生儿与运动自动症和强直性姿势的相似性表明，这些临床行为可能不是癫痫的起源，而是原始的运动进展和姿势介导的脑干机制。虽然并非所有目前被认为是新生儿癫痫发作的临床行为可能具有相似的病理生理机制，但它们具有临床意义，因为它们都表明脑功能障碍。
The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo‐graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.