Glauser Tracy A, Loddenkemper Tobias
Hospital Medical Center, 3333 Burnet Avenue, ML2015, Cincinnati, OH 45229, USA.
Continuum (Minneap Minn). 2013 Jun;19(3 Epilepsy):656-81. doi: 10.1212/01.CON.0000431381.29308.85.
This article outlines a diagnostic and management approach to pediatric seizures and epilepsy syndromes, and delineates pharmacologic and nonpharmacologic treatment options.
Progress in tracking of seizures, identifying and addressing medication nonadherence, treatment with novel devices, and clinical decision support algorithms will provide additional management options in the future.
The management of pediatric seizures and epilepsies presents multiple challenges to the clinician because of nonepileptic imitators, evolving classification approaches, clinical presentations, limited clinical trial data for medications, and the toxicities of therapies. While certain pediatric seizures and epilepsy syndromes respond best to certain medications, early identification of pharmacologically resistant patients who may be candidates for epilepsy surgery is important. Alternative treatment options may include ketogenic diet or vagus nerve stimulation.
本文概述了小儿癫痫发作及癫痫综合征的诊断与管理方法，并阐述了药物及非药物治疗选择。
在癫痫发作追踪、识别及解决药物治疗依从性问题、新型设备治疗以及临床决策支持算法方面取得的进展，将在未来提供更多管理选择。
由于存在非癫痫性模仿发作、不断演变的分类方法、临床表现、药物临床试验数据有限以及治疗的毒性，小儿癫痫发作及癫痫的管理给临床医生带来了多重挑战。虽然某些小儿癫痫发作及癫痫综合征对特定药物反应最佳，但尽早识别可能适合癫痫手术的药物抵抗性患者很重要。替代治疗选择可能包括生酮饮食或迷走神经刺激。
