Moshé S L
Epilepsia. 1987;28 Suppl 1:S3-15. doi: 10.1111/j.1528-1157.1987.tb05753.x.
Epidemiological studies indicate that the incidence of seizures is highest early in life. This report discusses the experimental data derived from studies of focal epileptogenesis of the immature brain in tandem with ongoing maturational changes. During development, neurons have characteristic neurophysiological properties. Local interictal discharges are long in duration, lack a stereotypic morphology, and have limited fields. Yet the immature brain is very susceptible to the development of bilateral, although asynchronous, seizures and status epilepticus induced by amygdala kindling or by convulsant drugs. This increased seizure susceptibility may be due to a functional immaturity of a substantia nigra, GABA-sensitive output system. The morbidity of convulsions occurring early in life may not be as grave as previously thought in terms of subsequent acquisition of "normal" developmental milestones. The propensity to develop recurrent convulsions in adulthood is not related to the severity of a single seizure in infancy. Although multiple severe seizures may predispose animals to the development of seizures later in life, this is not a unique feature of the immature brain, since it also occurs in the adult brain. Finally, there is evidence that the immature brain may respond to anticonvulsant drugs differently from its mature counterpart; these findings emphasize the need to develop new antiepileptic therapies that take into account the maturational state of the brain.
流行病学研究表明，癫痫发作的发生率在生命早期最高。本报告讨论了源自未成熟脑局灶性癫痫发生研究的数据，并结合了持续的成熟变化。在发育过程中，神经元具有独特的神经生理特性。局部发作间期放电持续时间长，缺乏刻板形态，且范围有限。然而，未成熟脑非常容易发展为双侧性癫痫发作（尽管不同步）以及由杏仁核点燃或惊厥药物诱发的癫痫持续状态。癫痫易感性增加可能是由于黑质GABA敏感输出系统功能不成熟所致。就随后获得“正常”发育里程碑而言，生命早期发生惊厥的发病率可能不像以前认为的那么严重。成年期发生反复惊厥的倾向与婴儿期单次癫痫发作的严重程度无关。虽然多次严重癫痫发作可能使动物在生命后期易患癫痫，但这并非未成熟脑的独特特征，因为在成年脑中也会发生。最后，有证据表明未成熟脑对抗惊厥药物的反应可能与其成熟对应物不同；这些发现强调需要开发新的抗癫痫疗法，同时考虑到脑的成熟状态。
