Mayo Clinic Rochester Department of Neurology, 200 First St SW Floor 8, Rochester, MN 55905.
FP Essent. 2022 Dec;523:8-14.
Seizure is one of the most common neurologic conditions in children, occurring most often in the first year of life. Identification of provoking factors, such as fever, illness, head trauma, electrolyte disturbance, or central nervous system infection, is important for determining prognosis and likelihood of recurrence. In patients presenting with a suspected first seizure, a history should be taken and a neurologic examination performed to determine whether the event was a seizure. If seizure is confirmed, it should be determined whether it was a first seizure and was provoked or unprovoked. The final step is to determine the cause. For children who present with simple febrile seizures, no additional evaluation typically is needed. An electroencephalogram performed during wakefulness and sleep is recommended for children with a first unprovoked seizure. For children with new-onset seizures, particularly focal seizures or status epilepticus, neuroimaging with magnetic resonance imaging study is recommended. Most children will have only a single seizure, whereas a small number will develop epilepsy. Risk factors for epilepsy development include a history of febrile seizures, status epilepticus, a family history of epilepsy, developmental delay, and abnormal neurologic examination results.
癫痫发作是儿童中最常见的神经系统疾病之一，最常发生在生命的第一年。确定诱发因素，如发热、疾病、头部外伤、电解质紊乱或中枢神经系统感染，对于确定预后和复发的可能性很重要。对于疑似首次癫痫发作的患者，应进行病史采集和神经系统检查，以确定该事件是否为癫痫发作。如果确定为癫痫发作，则应确定是否为首次发作，是否为有诱因或无诱因发作。最后一步是确定病因。对于表现为单纯性热性惊厥的儿童，通常不需要进一步评估。建议对首次无诱因发作的儿童进行清醒和睡眠期间的脑电图检查。对于新发癫痫发作的儿童，特别是局灶性发作或癫痫持续状态，建议进行磁共振成像检查。大多数儿童只会出现单次发作，而少数儿童会发展为癫痫。癫痫发作发展的危险因素包括热性惊厥史、癫痫持续状态、癫痫家族史、发育迟缓以及异常的神经系统检查结果。
