Assistant Professor, Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center.
Assistant Professor, Departments of Emergency Medicine and Pediatrics, Alpert Medical School of Brown University.
R I Med J (2013). 2022 Mar 1;105(2):17-21.
Pediatric seizures are a common reason for emergency department visits. The highest risk of seizures in children is during the neonatal period. A low index of suspicion is important to facilitate the early assessment, workup, and treatment of inborn errors of metabolism to optimize developmental outcomes. We present the rare case of a 9-day-old with seizures refractory to multiple anticonvulsant medications who was diagnosed with pyridoxine-dependent epilepsy. We review differences in the management of neonatal seizures from older patients, the utility of a trial of pyridoxine in refractory neonatal seizures, and the importance of preparing for emergent airway management given pyridoxine's ability to cause apnea and central nervous system depression.
儿科癫痫发作是急诊就诊的常见原因。儿童癫痫发作的风险最高时期是新生儿期。怀疑程度低对于促进代谢性遗传病的早期评估、检查和治疗以优化发育结果很重要。我们报告了一例 9 天大的癫痫持续状态婴儿病例，该婴儿对多种抗癫痫药物治疗无效，被诊断为吡哆醇依赖性癫痫。我们回顾了新生儿癫痫与老年患者管理的差异，吡哆醇治疗难治性新生儿癫痫的作用，以及鉴于吡哆醇可引起呼吸暂停和中枢神经系统抑制，做好紧急气道管理准备的重要性。
