Neonatal seizures
Neonatal seizures
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DOI：
10.1136/fn.78.1.f70
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发表时间：
1998-01-01
影响因子：
4.4
通讯作者：
Levene, M
中科院分区：
文献类型：
--
作者：
Evans, D;Levene, M
新生儿癫痫是常见的，可能是神经功能障碍的第一个表现后，各种侮辱。新生儿癫痫具有临床意义，因为很少有特发性癫痫。进一步调查以及时诊断潜在疾病非常重要，因为许多病因都有特定的治疗方法，如果早期使用，可能会改善预后。新生儿癫痫发作导致进一步的神经元损害，但尚不清楚这是否会导致所有甚至许多癫痫发作中的进一步临床显著神经元损伤。许多检查与癫痫发作活动相关的结局的临床研究受到与潜在病因相关的预后的混淆。目前还不清楚癫痫发作引起的不良神经发育结局是否可以通过目前的治疗预防。因此，许多临床医生不确定何时治疗癫痫发作以及如何评估治疗的充分性。[1]未成熟的大脑似乎更容易发生癫痫发作;这些在新生儿时期比一生中的任何其他时期都更常见。这可能反映了兴奋性突触的早期发育，在成熟的早期阶段，抑制性影响占主导地位。足月出生婴儿临床癫痫发作的发生率为每1000例活产0.7-2.7例。2-6早产儿的发病率较高，范围为每1000例活产57.5至132例3 7（出生体重< 1500 g）。心电图、临床无症状癫痫发作的发生率尚不清楚。婴儿在一次临床发作后的连续EEG监测显示，79%的后续EEG发作在临床上是无症状的。8这种现象似乎在早产儿中更为常见。6
Neonatal seizures are common and may be the first manifestations of neurological dysfunction after a variety of insults. Neonatal seizures are clinically significant because very few are idiopathic. Further investigation leading to prompt diagnosis of the underlying condition is important because many of the aetiologies have specific treatments which, when used early, may improve the prognosis. Neonatal seizures cause further neuronal compromise, but it is not clear whether this leads to further clinically significant neuronal injury in all, or even many seizures. Many of the clinical studies examining outcome associated with seizure activity have been confounded by the prognosis associated with the underlying aetiology. It is also unclear if adverse neurodevelopmental outcome, occurring as a consequence of seizures, can be prevented by current treatment. Many clinicians are therefore uncertain when to treat seizures and how to assess the adequacy of treatment. 1 The immature brain seems more prone to seizures; these are more common in the neonatal period than during any other time throughout life. This may reflect the earlier development of excitatory synapses, predominating over inhibitory influences at early stages of maturation. The incidence of clinical seizures in infants born at term is 0.7–2.7 per 1000 live births. 2–6 The incidence is higher in preterm infants, ranging from 57.5 to 132 per 1000 live births3 7 (< 1500 g birthweight). The incidence of electrographic, clinically silent seizures is unknown. Continuous EEG monitoring of infants after one clinical seizure showed that 79% of subsequent EEG seizures were clinically silent. 8 Such phenomena seem to be more common in preterm infants. 6