University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Comprehensive Epilepsy Center, New York University Grossman School of Medicine, New York, New York, USA.
Epilepsia. 2021 Mar;62(3):570-582. doi: 10.1111/epi.16833. Epub 2021 Feb 14.
Although seizures are common in children, they are often overlooked as a potential cause of death. Febrile and nonfebrile seizures can be fatal in children with or without an epilepsy diagnosis and may go unrecognized by parents or physicians. Sudden unexpected infant deaths, sudden unexplained death in childhood, and sudden unexpected death in epilepsy share clinical, neuropathological, and genetic features, including male predominance, unwitnessed deaths, death during sleep, discovery in the prone position, hippocampal abnormalities, and variants in genes regulating cardiac and neuronal excitability. Additionally, epidemiological studies reveal that miscarriages are more common among individuals with a personal or family history of epilepsy, suggesting that some fetal losses may result from epileptic factors. The spectrum of seizure-related deaths in pediatrics is wide and underappreciated; accurately estimating this mortality and understanding its mechanism in children is critical to developing effective education and interventions to prevent these tragedies.
虽然癫痫发作在儿童中很常见，但它们常常被忽视，成为潜在的致死原因。无论是癫痫患儿还是非癫痫患儿，热性惊厥和非热性惊厥都可能致命，且可能未被家长或医生察觉。婴儿猝死综合征、儿童不明原因猝死和癫痫相关猝死具有临床、神经病理学和遗传学特征，包括男性占优势、无目击者、睡眠中死亡、发现时处于俯卧位、海马异常和调节心脏和神经元兴奋性的基因变异。此外，流行病学研究表明，有个人或家族癫痫史的个体流产更为常见，这表明一些胎儿丢失可能是由癫痫因素引起的。儿科与癫痫相关的死亡谱很广，但未被充分认识；准确估计这种死亡率并了解其在儿童中的机制对于制定有效的教育和干预措施以预防这些悲剧至关重要。
