Department of Pediatrics, Section of Neurology and Developmental Neuroscience, Houston, Texas, USA.
Curr Opin Pediatr. 2009 Dec;21(6):731-6. doi: 10.1097/MOP.0b013e328332c77d.
Seizures during an acute illness demand immediate evaluation, as they indicate an acute central nervous system insult. There are three goals: identify and treat the precipitating cause; determine the need for antiepileptic drug therapy; and recognize nonconvulsive seizures. Management depends upon whether there is a primary or secondary central nervous system insult. Seizures may persist despite antiepileptic drugs if the precipitating cause is untreated.
Seizures and epilepsy and children with neurodevelopmental disabilities comprise a significant percentage of acute care in children. A continuum exists from a single seizure and escalating seizures to status epilepticus. Seizure treatment is more successful when given earlier, and prognosis depends on the cause. Guidelines for the diagnostic evaluation and treatment of status epilepticus have been produced. Continuous electroencephalographic monitoring reveals frequent nonconvulsive seizures and nonconvulsive status epilepticus in the sick child.
The recognition and rapid treatment of clinical and electrographic seizures is important during acute illness.
急性疾病期间的发作需要立即评估，因为它们表明存在急性中枢神经系统损伤。有三个目标：确定并治疗诱发原因；确定是否需要抗癫痫药物治疗；并识别非惊厥性发作。管理取决于是否存在原发性或继发性中枢神经系统损伤。如果未治疗诱发原因，即使给予抗癫痫药物，发作也可能持续存在。
癫痫和癫痫发作以及伴有神经发育障碍的儿童在儿童急性护理中占很大比例。从单次发作和发作加剧到癫痫持续状态存在连续体。尽早给予治疗时，癫痫治疗的成功率更高，预后取决于病因。已经制定了癫痫持续状态的诊断评估和治疗指南。连续脑电图监测揭示了患病儿童中频繁的非惊厥性发作和非惊厥性癫痫持续状态。
在急性疾病期间，识别和快速治疗临床和脑电图发作非常重要。
