Andre M, Matisse N, Vert P, Debruille C
Service de Médecine Néonatale, Maternité Régionale, Nancy, France.
Neuropediatrics. 1988 Nov;19(4):201-7. doi: 10.1055/s-2008-1052446.
This study reports the neonatal aspects and prognosis of seizures observed in 71 neonates from 1.3. 1980 to 30.6 1981. Forty-five were full-term, 26 preterm babies. Twenty-one children had status epilepticus (SE), 50 isolated crises (IC). An etiology was found in 68 cases. Acute fetal distress (AFD) was observed in half of the cases. AFD and intracranial hemorrhages represented 62% of the etiologies in term babies, 42% in preterm. Fifteen children died in the neonatal period. The outcome of the 56 survivors was followed until at least two years of age. Forty-one children were neurologically normal; 15 were not: 9 had a cerebral palsy, 12 a mental retardation, 1 was deaf, 4 were epileptic. Sequelae occurred in 24.3% of term, 31.6% of preterm survivors (p less than or equal to 0.01). The outcome was normal in 8 out of 15 living children with SE (53%), in 32 out of 41 (78%) with IC (p less than or equal to 0.01). The prognosis of hypoxic-ischemic seizures was good if crises lasted less than two days. Treatment was discontinued as soon as possible, during the days following the end of the crises and the recovery from the initial disease, without adverse effects. Convulsions following obstetrical abnormalities were less frequent, and the prognosis was better in premature babies than in previous studies.
本研究报告了1980年1月3日至1981年6月30日期间71例新生儿惊厥的新生儿期情况及预后。其中45例为足月儿,26例为早产儿。21例患儿发生癫痫持续状态(SE),50例为孤立性惊厥(IC)。68例患儿找到病因。半数病例观察到急性胎儿窘迫(AFD)。AFD和颅内出血占足月儿病因的62%,早产儿为42%。15例患儿在新生儿期死亡。对56例存活者的预后进行随访直至至少2岁。41例患儿神经功能正常;15例不正常:9例患有脑瘫,12例智力发育迟缓,1例失聪,4例癫痫。足月儿存活者后遗症发生率为24.3%,早产儿为31.6%(p≤0.01)。15例患有SE的存活患儿中有8例(53%)预后正常,41例患有IC的患儿中有32例(78%)预后正常(p≤0.01)。如果惊厥持续时间少于两天,缺氧缺血性惊厥的预后良好。在惊厥结束及最初疾病恢复后的数天内尽快停止治疗,无不良反应。产科异常后发生的惊厥较少见,早产儿的预后比以往研究更好。