PATHOPHYSIOLOGICAL STUDIES OF NEONATAL SEIZURES

新生儿癫痫发作的病理生理学研究

• 批准号: 3078184
• 负责人: ELI M MIZRAHI
• 金额: $ 5.58万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 1984
• 资助国家: 美国
• 起止时间: 1984-04-01 至 1989-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3078184
• 关键词: autonomic nervous system; brain disorder diagnosis; brain stem; convulsions; developmental neurobiology; electroencephalography; electromyography; electrooculography; epilepsy; human subject; intensive care; longitudinal human study; metabolism; neurophysiology; newborn human (0-6 weeks); patient monitoring device; polygraphy; premature infant human; respiratory function; videotape /videodisc

The purpose of this prospective study is to examine the pathophysiology of neonatal seizures and their consequences in order to establish a comprehensive basis for the continued investigation and clinical management of seizures in the newborn. The relationship between maturational, metabolic, autonomic and etiologic factors in the determination of the clinical and electroencephalographic expression of neonatal seizures will be explored initially by testing three specific hypotheses: 1) Activation of the autonomic nervous system is a frequent, but not widely appreciated feature of neonatal seizures which may extend neurological injury; 2) Depression of cortical inhibitory influences on normal tonic brainstem facilitory mechanisms may initiate nonepileptic tonic activity which may appear epileptic by current criteria; 3) Acute disturbances of the metabolic state of the newborn may alter patterns of epileptic activity or may produce depression of forebrain activity and thereby initiate nonepileptic tonic activity. Preliminary to the testing of the hypotheses will be the precise characterization of the full range of behavioral, motor, autonomic and neurophysiological manifestations of neonatal seizures which will, in turn, serve as the substrate for their classification. The study will be accomplished through the application of a newly designed and fabricated cribside monitoring system that permits prolonged recording in the neonatal intensive care unit without interfering with the patient's medical care. The following physiological parameters will be recorded continuously with this time-synchronized monitoring system: electroencephalogram, electromyogram, electrooculogram, electrocardiogram, triaxial accelerometry, respiratory movements, expired pCO2, transcutaneous pO2, oropharyngeal airway flow, and systemic blood pressure. The proposal also identifies specific training objectives for the teacher-investigator to acquire new investigatory skills. These include the development of technical and interpretative skills, and the establishment of a more complete conceptual basis of the developmental neurobiology of the premature and full-term newborn.

这项前瞻性研究的目的是检查 新生儿癫痫及其后果，以便建立一个 继续研究和临床管理的全面基础 新生儿癫痫发作 成熟， 代谢，自主神经和病因因素在确定 新生儿癫痫发作的临床和脑电图表现 首先通过测试三个具体的假设来探索：1）激活 自主神经系统是一种常见的，但不被广泛认识 新生儿癫痫发作的特征可能会扩大神经损伤; 2） 抑制性皮层抑制对正常紧张性脑干的影响 易化机制可以启动非癫痫性紧张性活动， 根据目前的标准出现癫痫; 3） 新生儿的代谢状态可能会改变癫痫活动的模式， 可能会导致前脑活动的抑制， 非癫痫性紧张活动 假设检验的初步步骤将是 表征的全方位的行为，运动，自主和 新生儿癫痫发作的神经生理学表现，反过来， 作为其分类的基础。 这项研究将通过应用新设计的 和预制的床边监控系统， 在新生儿重症监护室， 医疗等 将记录以下生理参数 通过这个时间同步的监控系统， 脑电图，肌电图，眼电图，心电图， 三轴加速度计，呼吸运动，呼气二氧化碳分压，经皮 pO 2、口咽气道流量和全身血压。 该建议还确定了培训的具体目标， 教师调查员获得新的解释技能。 这些包括 发展技术和口译技能， 建立一个更完整的发展 早产儿和足月新生儿的神经生物学。