Janáčková Soňa, Boyd Steward, Yozawitz Elissa, Tsuchida Tammy, Lamblin Marie-Dominique, Gueden Sophie, Pressler Ronit
Department of Clinical Neurophysiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N JH, United Kingdom; Neurophysiology Department, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France.
Department of Clinical Neurophysiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N JH, United Kingdom; Clinical Neuroscience, Institute of Child Health, University College London, London, UK.
Clin Neurophysiol. 2016 Aug;127(8):2721-2727. doi: 10.1016/j.clinph.2016.05.006. Epub 2016 May 24.
Although seizures are more common in the neonatal period than in any other stage of childhood, those in preterm neonates are still poorly described. The aim of this study was to assess electro-clinical characteristics of seizures occurring before a corrected age of 40weeks in neonates born prematurely.
Retrospective analysis of EEG-documented seizures in neonates born prematurely. Seizures in a group of term neonates served as controls.
Fifty-six prematurely born and 46 term born neonates were included. Median duration of seizures was 52s in preterm and 96s in term neonates. Seizures were focal or multifocal. In least mature neonates, they involved smaller regions of onset and remained localised. With increasing corrected age, propagation became more frequent. The electrographic pattern - maximal frequency of oscillation and the onset pattern also evolved with age. Electro-clinical seizures were observed in 25% of preterm versus 50% of term neonates; almost all electro-clinical seizures involved the central (motor) regions.
Ictal EEG features undergo changes depending on corrected age. Most seizures are subclinical, thus EEG is essential for diagnosis.
Relating ictal EEG pattern to corrected age can improve diagnosis and ultimately management.
尽管癫痫发作在新生儿期比在儿童期的任何其他阶段都更常见，但早产儿的癫痫发作仍描述甚少。本研究的目的是评估早产新生儿在矫正年龄40周之前发生癫痫的电临床特征。
对有脑电图记录的早产新生儿癫痫发作进行回顾性分析。一组足月儿的癫痫发作作为对照。
纳入56例早产新生儿和46例足月儿。早产儿癫痫发作的中位持续时间为52秒，足月儿为96秒。癫痫发作是局灶性或多灶性的。在最不成熟的新生儿中，发作涉及较小的起始区域并局限于局部。随着矫正年龄的增加，扩散变得更频繁。脑电图模式——振荡的最大频率和起始模式也随年龄而演变。25%的早产儿与50%的足月儿观察到电临床癫痫发作；几乎所有电临床癫痫发作都涉及中央（运动）区域。
发作期脑电图特征随矫正年龄而变化。大多数癫痫发作是亚临床的，因此脑电图对诊断至关重要。
将发作期脑电图模式与矫正年龄相关联可改善诊断并最终改善治疗。
