Campistol J
Servicio de Neurología, Unitat Integrada Hospital Sant Joan de Déu-Clínic, Universitat de Barcelona, España.
Rev Neurol. 2000;31(7):601-4.
Notable changes have occurred in the field of neonatology in recent years. Logically, neonatal neurology has made a major contribution to this progress.
Knowledge in the field of neonatal neurology has multiplied: fetal neurology has developed, fetal and neonatal welfare is better understood, and spectacularly modified by techniques of assisted ventilation. High resolution ultrasonography permits visualization of fetal cerebral anomalies, the treatment of hypoxic encephalopathy is advancing as is non-invasive cerebral hemodynamic monitoring. Neuroimaging techniques let us see not only the structure of the brain but also how it functions, to some extent. New antiepileptic drugs have appeared. Various treatable causes of neonatal convulsions have been identified. Infections and the incidence of hemorrhage in premature babies have fallen at the same time as new metabolic disease of neonatal onset (protein glycosilation, folinic-sensitive convulsions and adenylsuccinate deficiency) have been identified. Ethics committees for consensual decisions in neonatal intensive care units have become established. We emphasize the need for units for the follow-up of newborn babies with a risk of developing neurological complications, with programmes adapted to the needs of each individual centre.
近年来新生儿学领域发生了显著变化。从逻辑上讲，新生儿神经学为这一进展做出了重大贡献。
新生儿神经学领域的知识成倍增长：胎儿神经学得到发展，对胎儿和新生儿的健康状况有了更好的理解，并且辅助通气技术对其产生了显著改变。高分辨率超声检查能够可视化胎儿脑部异常情况，缺氧性脑病的治疗正在取得进展，无创性脑血流动力学监测也是如此。神经成像技术不仅能让我们看到大脑的结构，在一定程度上还能看到其功能。新型抗癫痫药物已经出现。已经确定了新生儿惊厥的各种可治疗病因。早产儿感染和出血的发生率下降，同时也发现了新的新生儿期发病的代谢性疾病（蛋白质糖基化、对亚叶酸敏感的惊厥和腺苷琥珀酸缺乏症）。新生儿重症监护病房用于达成共识性决策的伦理委员会已经成立。我们强调需要设立针对有发生神经并发症风险的新生儿的随访单位，并制定适合每个中心需求的方案。
