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[新生儿痉挛——症状、病因、治疗及预后综述]

[Neonatal spasms--a review of symptoms, etiology, therapy and prognosis].

作者信息

Mielke R, Schmid G, Kowalewski S

出版信息

Klin Padiatr. 1986 Nov-Dec;198(6):449-56. doi: 10.1055/s-2008-1033906.

Abstract

Seizures in the newborn are a distinctive sign of underlying disease. Different convulsive patterns are described. The most common neurologic syndrome consists of subtle seizures. The most important cause is ischemic encephalopathy. Hypocalcemia is the main metabolic disease. Hypoglycemia seems not to be of special relevance for pathogenesis of newborn seizures. Other episodic symptoms of non-epileptic origin should be considered in the differential diagnosis. It is critical to diagnose the cause and to treat it, since the prognosis depends on the underlying disturbance. Phenobarbital is the anticonvulsive drug of first choice. Duration of treatment is determinated of an preexisting brain damage. Newborns with normal neurological evaluation don't need any longer anticonvulsive treatment after cessation of seizures. The EEG is an important prognostic tool.

摘要

新生儿惊厥是潜在疾病的一个显著体征。已描述了不同的惊厥模式。最常见的神经综合征由细微惊厥组成。最重要的病因是缺血性脑病。低钙血症是主要的代谢性疾病。低血糖似乎与新生儿惊厥的发病机制没有特别关联。在鉴别诊断中应考虑其他非癫痫性起源的发作性症状。诊断病因并进行治疗至关重要,因为预后取决于潜在的紊乱情况。苯巴比妥是首选的抗惊厥药物。治疗持续时间取决于先前存在的脑损伤。神经评估正常的新生儿在惊厥停止后无需再进行抗惊厥治疗。脑电图是一项重要的预后工具。

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