Pisani Francesco, Spagnoli Carlotta
Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, Parma, Italy.
Neuropediatrics. 2016 Jan;47(1):12-9. doi: 10.1055/s-0035-1567873. Epub 2015 Nov 20.
The majority of neonatal seizures are of acute symptomatic origin, and their occurrence is associated with higher mortality and morbidity compared with the general population, even if there is conflicting evidence of a detrimental effect per se. Etiology is considered the main determinant of outcome, but other factors, including gestational age, brain damage severity, neonatal neurological examination, and electroencephalographically (EEG) interictal and ictal characteristics are also related to neurodevelopmental outcome or death. Therefore, accuracy in early prognostication since the neonatal period can be improved by conveniently integrating different clinical and instrumental findings.The aim of this review is first to review the outcome of newborns with seizures (mortality, epilepsy, cerebral palsy, and intellectual disability), second to review the risk factors for adverse outcome after seizures in the newborn period, considering clinical, EEG/amplitude-integrated EEG, and neuroimaging findings associated with adverse outcome and lack of response to treatment, and finally to review published scoring systems for predicting neurologic outcome after neonatal seizures.
大多数新生儿惊厥起源于急性症状性病因，与普通人群相比，其发生与更高的死亡率和发病率相关，即使关于惊厥本身有害影响的证据存在矛盾。病因被认为是预后的主要决定因素，但其他因素，包括胎龄、脑损伤严重程度、新生儿神经学检查以及脑电图（EEG）发作间期和发作期特征，也与神经发育结局或死亡有关。因此，通过方便地整合不同的临床和检查结果，可以提高新生儿期早期预后评估的准确性。本综述的目的，一是回顾惊厥新生儿的结局（死亡率、癫痫、脑瘫和智力残疾），二是回顾新生儿期惊厥后不良结局的危险因素，考虑与不良结局及治疗无反应相关的临床、EEG/振幅整合脑电图和神经影像学检查结果，最后回顾已发表的用于预测新生儿惊厥后神经学结局的评分系统。
