Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands.
Semin Fetal Neonatal Med. 2013 Aug;18(4):209-15. doi: 10.1016/j.siny.2013.01.001. Epub 2013 Feb 9.
Seizures occur more often during the neonatal period than at any other period of life. Precise incidence is difficult to delineate and depends on study population and criteria used for diagnosis of seizures. Controversy exists as to whether neonatal seizures themselves cause damage to the developing brain, or if the damage is primarily due to the underlying cause of the seizures. As a result of this controversy there is an ongoing discussion as to whether all seizures (both clinical and subclinical) should be treated. When (sub)clinical seizures are treated, there is no consensus about the most appropriate treatment for neonatal seizures and how to assess the efficacy of treatment. Current therapeutic options to treat neonatal seizures (i.e. primarily first generation antiepileptics) are relatively ineffective. There is an urgent need for prospective, randomized, controlled trials for efficacy and safety of these second-generation antiepileptic drugs in neonates. The aim of this review is to survey current knowledge regarding treatment of neonatal seizures in both term and preterm infants.
新生儿期比生命中的任何其他时期更常发生癫痫发作。确切的发病率难以确定，取决于研究人群和用于癫痫发作诊断的标准。关于新生儿癫痫发作本身是否会对发育中的大脑造成损害，或者损害是否主要是由于癫痫发作的潜在原因，存在争议。由于存在这种争议，因此正在讨论是否应该治疗所有癫痫发作（临床和亚临床）。当（亚）临床癫痫发作时，对于新生儿癫痫发作的最佳治疗方法以及如何评估治疗效果尚无共识。目前治疗新生儿癫痫发作的治疗选择（即主要是第一代抗癫痫药）的效果相对较差。迫切需要针对这些第二代抗癫痫药在新生儿中的疗效和安全性进行前瞻性、随机、对照试验。本综述的目的是调查目前关于足月和早产儿新生儿癫痫发作治疗的知识。
