Mohammadi Mahmoud, Rezaei Zahra
Head Department of Pediatric Neurology, Clinical Neurophysiology and Epilepsy, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
Child Neurologist, Neurology Clinic, Shahid Fahmideh Children Hospital, Iran University of Medical Sciences, Tehran, Iran.
Iran J Child Neurol. 2020 Fall;14(4):9-16.
Seizure is the most common neurologic event in the neonatal period when the immature, growing brain is vulnerable to various injuries. Seizure might be present as an atypical feature in neonates, which makes diagnosis a challenge. A vast majority of seizures are symptomatic due to an underlying cause, searching for etiology to remove them leads to more effective therapy. However, there is doubt about the diagnosis of seizures and the best treatment for them. Here, we reviewed articles related to diagnosis and treatment of neonatal seizures to evaluate the available evidence. The results showed that despite numerous studies on the topic, neither an implicit diagnosing method nor a therapeutic regime was proposed. It was also observed that phenobarbital prescription was reduced while newer anti-seizure medication such as levetiracetam was further prescribed. Seizure, the most common neurologic disorder in neonates, is a challenging topic for both neonatologists and neurologists. Since patients are critically ill, designing a randomized clinical trial appears not to be easy for neonates admitted to a neonatal intensive care unit. Moreover, both the diagnosis and treatment of seizures should be re-evaluated based on neonatal characteristics. In the recent decade, new less harmful anti-seizure medications are being replaced with old ones.
癫痫发作是新生儿期最常见的神经系统事件,此时发育不成熟的大脑容易受到各种损伤。癫痫发作在新生儿中可能表现为非典型特征,这使得诊断成为一项挑战。绝大多数癫痫发作是由潜在病因引起的症状性发作,寻找病因以消除发作可导致更有效的治疗。然而,对于癫痫发作的诊断及其最佳治疗方法仍存在疑问。在此,我们回顾了与新生儿癫痫发作诊断和治疗相关的文章,以评估现有证据。结果表明,尽管对此主题进行了大量研究,但既未提出明确的诊断方法,也未提出治疗方案。还观察到苯巴比妥的处方量减少,而左乙拉西坦等新型抗癫痫药物的处方量进一步增加。癫痫发作是新生儿中最常见的神经系统疾病,对新生儿科医生和神经科医生来说都是一个具有挑战性的话题。由于患者病情危重,为入住新生儿重症监护病房的新生儿设计一项随机临床试验似乎并不容易。此外,癫痫发作的诊断和治疗都应根据新生儿的特点重新评估。在最近十年中,新的危害较小的抗癫痫药物正在取代旧的药物。