Carrasco Melisa, Stafstrom Carl E
Division of Pediatric Neurology, Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Division of Pediatric Neurology, Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,
Dev Neurosci. 2018;40(5-6):417-436. doi: 10.1159/000497471. Epub 2019 Apr 4.
Seizures in neonates represent a neurologic emergency requiring prompt recognition, determination of etiology, and treatment. Yet, the definition and identification of neonatal seizures remain challenging and controversial, in part due to the unique physiology of brain development at this life stage. These issues are compounded when considering seizures in premature infants, in whom the complexities of brain development may engender different clinical and electrographic seizure features at different points in neuronal maturation. In extremely premature infants (< 28 weeks gestational age), seizure pathophysiology has not been explored in detail. This review discusses the physiological and structural development of the brain in this developmental window, focusing on factors that may lead to seizures and their consequences at this early time point. We hypothesize that the clinical and electrographic phenomenology of seizures in extremely preterm infants reflects the specific pathophysiology of brain development in that age window.
新生儿癫痫发作是一种神经系统急症，需要迅速识别、确定病因并进行治疗。然而，新生儿癫痫发作的定义和识别仍然具有挑战性且存在争议，部分原因是这个生命阶段大脑发育的独特生理学特性。当考虑早产儿的癫痫发作时，这些问题会更加复杂，因为在早产儿中，大脑发育的复杂性可能在神经元成熟的不同阶段产生不同的临床和脑电图癫痫发作特征。在极早产儿（胎龄<28周）中，癫痫发作的病理生理学尚未得到详细研究。本综述讨论了这个发育阶段大脑的生理和结构发育，重点关注可能导致癫痫发作的因素及其在这个早期时间点的后果。我们假设极早产儿癫痫发作的临床和脑电图表现反映了该年龄阶段大脑发育的特定病理生理学。
