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儿童癫痫的管理

Management of childhood epilepsy.

作者信息

Glauser Tracy A, Loddenkemper Tobias

机构信息

Hospital Medical Center, 3333 Burnet Avenue, ML2015, Cincinnati, OH 45229, USA.

出版信息

Continuum (Minneap Minn). 2013 Jun;19(3 Epilepsy):656-81. doi: 10.1212/01.CON.0000431381.29308.85.

Abstract

PURPOSE OF REVIEW

This article outlines a diagnostic and management approach to pediatric seizures and epilepsy syndromes, and delineates pharmacologic and nonpharmacologic treatment options.

RECENT FINDINGS

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.

SUMMARY

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.

摘要

综述目的

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。

最新发现

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。

总结

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。

相似文献

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Management of childhood epilepsy.儿童癫痫的管理
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本文引用的文献

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Autoimmune encephalitis in children.儿童自身免疫性脑炎
J Child Neurol. 2012 Nov;27(11):1460-9. doi: 10.1177/0883073812448838. Epub 2012 Aug 29.
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Development and validation of the Pediatric Epilepsy Side Effects Questionnaire.儿童癫痫不良反应问卷的编制与验证。
Neurology. 2012 Sep 18;79(12):1252-8. doi: 10.1212/WNL.0b013e3182635b87. Epub 2012 Aug 8.
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Long-term outcome in pyridoxine-dependent epilepsy.吡哆醇依赖性癫痫的长期预后。
Dev Med Child Neurol. 2012 Sep;54(9):849-54. doi: 10.1111/j.1469-8749.2012.04347.x. Epub 2012 Jul 13.

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