García Peñas Juan José
Unidad de Epilepsia, Sección de Neuropediatría, Hospital Infantil Universitario Niño Jesús, Madrid, España. E-mail:
Medicina (B Aires). 2018;78 Suppl 2:6-11.
Paroxysmal episodes are one of the most common neurological disorders in children. It is important to distinguish between paroxysmal non-epileptic events, symptomatic seizures, febrile seizures, and unprovoked seizures. Patient's history is the key to proper diagnosis in most of the cases. A single unprovoked seizure is a frequent phenomenon in the pediatric population. Studies of recurrence after a first unprovoked seizure show percentages between 23% and 96% over a median follow-up of two years. The aim of this study is to define how to evaluate the first unprovoked epileptic seizure in a child and to review the weight of the different recurrence risk factors. Several factors enable us to predict the recurrence risk after a first unprovoked seizure including family history of epilepsy, prior history of febrile seizures, age at onset, type of seizure, prolonged seizures at onset, multiple seizures in a single day, sleep state, neurological abnormalities, etiology, and abnormalities in the electroencephalogram. The most important of these risk factors are the etiology of the seizures and the evidence of epileptiform abnormalities in the electroencephalogram.
发作性疾病是儿童最常见的神经系统疾病之一。区分发作性非癫痫性事件、症状性癫痫发作、热性惊厥和特发性癫痫发作很重要。在大多数情况下，患者病史是正确诊断的关键。单次特发性癫痫发作在儿科人群中很常见。对首次特发性癫痫发作后复发情况的研究表明，在两年的中位随访期内，复发率在23%至96%之间。本研究的目的是确定如何评估儿童首次特发性癫痫发作，并回顾不同复发风险因素的权重。有几个因素使我们能够预测首次特发性癫痫发作后的复发风险，包括癫痫家族史、既往热性惊厥史、发病年龄、癫痫发作类型、发作起始时持续时间延长、一天内多次发作、睡眠状态、神经功能异常、病因以及脑电图异常。这些风险因素中最重要的是癫痫发作的病因和脑电图中癫痫样异常的证据。
