Cerebral blood flow velocity during neonatal seizures
Cerebral blood flow velocity during neonatal seizures
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DOI：
10.1136/fn.80.2.f105
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发表时间：
1999-03-01
影响因子：
4.4
通讯作者：
Binnie, CD
中科院分区：
文献类型：
--
作者：
Boylan, GB;Panerai, RB;Binnie, CD
Aim-To确定是否脑血流速度增加，在所有类型的新生儿癫痫发作，以及是否影响是由于单纯的血压增加，传输到脑循环时autoregulation imported. Methods-癫痫发作被诊断为11个高危新生儿使用cotside 16通道视频脑电图多道描记术。进行脑电图、经颅多普勒超声脑血流速度（CBFV）和动脉血压（ABP）测量。对每名婴儿进行至少两次5-10分钟的同时测量。然后审查这些时期以消除伪影，并创建包含明确癫痫发作的1分钟数据周期。每个周期包含癫痫发作前20秒。数据期间没有从同一婴儿进行了分析，并与癫痫发作periods.Results-Four婴儿有纯粹的心电图症状，没有临床表现。6名婴儿有电临床癫痫发作。一名婴儿表现出两种癫痫发作类型。采用随机效应线性回归分析确定癫痫发作对CBFV和ABP的影响。在那些包含癫痫发作的时期，发现平均CBFV显著增加。所有婴儿的平均速度变化百分比为15.6%。三个婴儿表现出显着增加，平均ABP癫痫发作后，但在ABP的所有infants的整体增加是不显着的。结论-临床电和心电图新生儿癫痫发作产生CBFV的增加。在一些婴儿中，这种增加与血压升高无关。这些初步结果表明，电图癫痫发作与脑代谢紊乱有关。治疗新生儿癫痫发作，直到电图癫痫发作活动被取消，可能会改善这些婴儿的结果。
Aim-To determine if cerebral blood flow velocity increases during all types of neonatal seizure, and whether the effect is due solely to an increase in blood pressure, transmitted to the cerebral circulation when autoregulation is impaired.Methods-Seizures were diagnosed in 11 high risk neonates using cotside 16 channel video-EEG polygraphy. EEG, cerebral blood flow velocity (CBFV) using transcranial Doppler ultrasound, and arterial blood pressure (ABP) measurements were made. At least two 5-10 minute epochs of simultaneous measurements were performed on each infant. These epochs were then reviewed to eliminate artefacts, and one minute data periods containing a clear seizure onset were created. Each period contained 20 seconds before the seizure. Data periods without seizures from the same infants were also analysed and compared with seizure periods.Results-Four infants had purely electrographic seizures-without clinical manifestations. Six infants had electroclinical seizures. One infant displayed both seizure types. A random effects linear regression analysis was used to determine the effect of seizures on CBFV and ABP. A significant increase was found in mean CBFV in those periods containing seizures. The mean percentage change in velocity for all infants was 15.6%. Three infants showed a significant increase in mean ABP after seizures but the overall increase in ABP for all infants was not significant.Conclusion-Electroclinical and electrographic neonatal seizures produce an increase in CBFV. In some infants the increase is not associated with an increase in blood pressure. These preliminary results suggest that electrographic seizures are associated with disturbed cerebral metabolism. Treatment of neonatal seizures until electrographic seizure activity is abolished may improve outcome for these infants.