Andrade Edgard, Shaikh Zakir, Chavez Wilson, Torres Alcy
Instituto de Neurociencias Pediátrico, Ocala, Florida, USA.
Instituto Municipal de Educación e Investigaciones Médicas Surat, Gujarat, India.
Medicina (B Aires). 2018;78 Suppl 2:30-35.
Neonatal seizures are among the most dramatic manifestations of acute central nervous system dysfunction. The incidence is much higher in very low weight neonates than in full term infants (˜ 58 and 3.5 per 100 live births, respectively). Neonatal seizures represent the clinical manifestation of a non-specific cortical cerebral dysfunction which can lead to permanent brain injury. The etiology is multifactorial and requires a judicious assessment for each clinical scenario. The diagnosis is further complicated by the fact that most neonatal seizures are subclinical, that is, may display very subtle or no clinical changes and the diagnosis may just be based on EEG findings. The treatment depends on the etiology, but an early and opportune intervention prevents further brain damage, thus improving prognosis. Although early identification and treatment are critical, the diagnosis of neonatal seizures is complicated by several factors such as different clinical presentations, possible etiologies and several treatment options. Nevertheless, research studies and clinical evidence have shown that early treatment with anti-seizure medications can change the outcome.
新生儿惊厥是急性中枢神经系统功能障碍最显著的表现之一。极低体重新生儿的发病率远高于足月儿(分别约为每100例活产中有58例和3.5例)。新生儿惊厥是非特异性皮质脑功能障碍的临床表现,可导致永久性脑损伤。病因是多因素的,需要针对每种临床情况进行审慎评估。由于大多数新生儿惊厥是亚临床的,即可能表现出非常细微或没有临床变化,诊断可能仅基于脑电图结果,这使得诊断更加复杂。治疗取决于病因,但早期及时干预可防止进一步脑损伤,从而改善预后。虽然早期识别和治疗至关重要,但新生儿惊厥的诊断因多种因素而复杂化,如不同的临床表现、可能的病因和多种治疗选择。然而,研究和临床证据表明,早期使用抗惊厥药物治疗可以改变结局。