PATHOPHYSIOLOGICAL STUDIES OF NEONATAL SEIZURES

这项前瞻性研究的目的是检查慢性阻塞性肺疾病的病理生理学。 新生儿癫痫及其后果，以建立一个 为继续调查和临床管理提供全面的依据 新生儿癫痫发作的可能性。成熟期、成熟期和成熟期 代谢、自主神经和病因学因素在测定高血压病中的作用 新生儿惊厥的临床和脑电表现 通过检验三个具体的假设来初步探索：1)激活 自主神经系统是一种常见的疾病，但并未得到广泛的认识 可能扩大神经损伤的新生儿癫痫的特征；2) 皮层抑制对正常紧张性脑干的影响 促进机制可能启动非癫痫的紧张性活动，这可能 根据目前的标准显示为癫痫；3)急性脑功能障碍 新生儿的代谢状态可能会改变癫痫活动的模式或 可能导致前脑活动抑制，从而引发 非癫痫的紧张性活动。 对假设进行初步的检验将是准确的 全系列的行为、运动、自主和 新生儿癫痫的神经生理表现，这将反过来， 作为它们分类的底物。 这项研究将通过应用新设计的 和捏造的婴儿床边监控系统，允许长时间录音 在新生儿重症监护室，而不干扰病人的 医疗护理。将记录以下生理参数 持续使用这一时间同步的监控系统： 脑电、肌电、眼电、心电、 三轴加速度计，呼吸运动，呼气二氧化碳分压，经皮 动脉血氧分压、口咽呼吸道流量和全身血压。 该提案还确定了以下方面的具体培训目标： 教师兼调查员将获得新的调查技能。这些措施包括 技术和口译技能的发展，以及 建立更完整的发展性概念基础 早产儿和足月儿的神经生物学。

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.