Division of Pediatric Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
Division of Pediatric Epilepsy, Stanford University School of Medicine, Palo Alto, CA, USA.
J Child Neurol. 2024 Oct;39(11-12):425-432. doi: 10.1177/08830738241273347. Epub 2024 Aug 23.
Childhood absence epilepsy is one of the most prevalent pediatric epilepsy syndromes, but diagnostic delay is common and consequential. Childhood absence epilepsy is diagnosed by history and physical examination including hyperventilation with electroencephalography (EEG) used to confirm the diagnosis. Hyperventilation produces generalized spike-wave discharges on EEG in >90% of patients with childhood absence epilepsy and provokes clinical absence seizures consisting of brief loss of consciousness typically within 90 seconds. Child neurologists report a high volume of referrals for children with "staring spells" that strain already limited health care resources. Resources are further strained by the use of EEG for monitoring antiseizure medication effectiveness with unclear benefit. In this review, we examine the safety and efficacy of hyperventilation activation as a tool for the diagnosis and management of childhood absence seizures.
儿童失神癫痫是最常见的儿童癫痫综合征之一，但诊断延误很常见，且后果严重。儿童失神癫痫的诊断依据为病史和体格检查，包括脑电图（EEG）下的过度通气，以确认诊断。过度通气可使 >90%的儿童失神癫痫患者的 EEG 出现全面性棘慢波放电，并引发临床失神发作，通常在 90 秒内导致短暂的意识丧失。儿童神经科医生报告称，大量患儿因“凝视发作”而被转诊，这给本已有限的医疗资源带来了压力。由于 EEG 用于监测抗癫痫药物的有效性，但益处并不明确，这进一步加重了资源紧张的情况。在这篇综述中，我们研究了过度通气激活作为诊断和管理儿童失神发作的工具的安全性和有效性。
