Department of Neurology, Children's National Hospital, 111 Michigan Avenue Northwest, Washington, DC 20010, USA.
Department of Neurology, Washington University in St Louis, 1 Brookings Drive, Saint Louis, MO 63130, USA.
Clin Perinatol. 2024 Sep;51(3):573-586. doi: 10.1016/j.clp.2024.04.013. Epub 2024 May 22.
Hypoxic-ischemic encephalopathy is the most common cause of neonatal seizures. Continuous electroencephalographic monitoring is recommended given high rates of subclinical seizures. Prompt diagnosis and treatment of seizures may improve neurodevelopmental outcomes. International League Against Epilepsy guidelines indicate that (1) phenobarbital remains the first-line treatment of neonatal seizures and (2) early discontinuation of antiseizure medications following resolution of acute provoked seizures, and prior to discharge home, is recommended. Long-term follow-up of these infants is necessary to screen for postneonatal epilepsy and support neurodevelopment.
缺氧缺血性脑病是新生儿癫痫发作最常见的原因。鉴于亚临床癫痫发作率较高,建议进行连续脑电图监测。及时诊断和治疗癫痫发作可能改善神经发育结局。国际抗癫痫联盟指南指出:(1)苯巴比妥仍然是新生儿癫痫发作的一线治疗药物,(2)建议在急性诱发性癫痫发作缓解后、出院前,尽早停用抗癫痫药物。对这些婴儿进行长期随访,以筛查新生儿后期癫痫并为神经发育提供支持是必要的。