Clinical Neuroscience, UCL- Great Ormond Street Institute of Child Health, London, UK.
Department of Clinical Neurophysiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.
Epilepsia. 2021 Mar;62(3):615-628. doi: 10.1111/epi.16815. Epub 2021 Feb 1.
Seizures are the most common neurological emergency in the neonatal period and in contrast to those in infancy and childhood, are often provoked seizures with an acute cause and may be electrographic-only. Hence, neonatal seizures may not fit easily into classification schemes for seizures and epilepsies primarily developed for older children and adults. A Neonatal Seizures Task Force was established by the International League Against Epilepsy (ILAE) to develop a modification of the 2017 ILAE Classification of Seizures and Epilepsies, relevant to neonates. The neonatal classification framework emphasizes the role of electroencephalography (EEG) in the diagnosis of seizures in the neonate and includes a classification of seizure types relevant to this age group. The seizure type is determined by the predominant clinical feature. Many neonatal seizures are electrographic-only with no evident clinical features; therefore, these are included in the proposed classification. Clinical events without an EEG correlate are not included. Because seizures in the neonatal period have been shown to have a focal onset, a division into focal and generalized is unnecessary. Seizures can have a motor (automatisms, clonic, epileptic spasms, myoclonic, tonic), non-motor (autonomic, behavior arrest), or sequential presentation. The classification allows the user to choose the level of detail when classifying seizures in this age group.
癫痫发作是新生儿期最常见的神经系统急症,与婴儿期和儿童期的癫痫发作不同,新生儿期的癫痫发作通常是由急性原因引起的,可能仅为脑电图异常。因此,新生儿癫痫发作可能不易符合主要为年龄较大的儿童和成人制定的癫痫发作和癫痫分类方案。国际抗癫痫联盟 (ILAE) 成立了新生儿癫痫发作工作组,以对 2017 年 ILAE 癫痫发作和癫痫分类进行修改,使其适用于新生儿。新生儿分类框架强调脑电图 (EEG) 在新生儿癫痫发作诊断中的作用,并包括与该年龄组相关的癫痫发作类型分类。发作类型由主要临床特征决定。许多新生儿癫痫发作仅为脑电图异常,无明显临床特征;因此,这些被包括在拟议的分类中。没有脑电图相关的临床事件不包括在内。因为新生儿期的癫痫发作已被证明有局灶性发作,所以不需要分为局灶性和全面性。癫痫发作可以有运动(自动症、阵挛、癫痫性痉挛、肌阵挛、强直)、非运动(自主神经、行为抑制)或顺序发作。该分类允许用户在对该年龄段的癫痫发作进行分类时选择详细程度。