Nickels Katherine, Joshi Charuta
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Department of Pediatrics and Neurology, UT Southwestern Medical Center, Dallas, Texas.
Semin Neurol. 2025 Apr;45(2):189-197. doi: 10.1055/a-2531-3610. Epub 2025 Feb 4.
While pediatric epilepsy shares some features with adult epilepsy, the growing and developing brain during childhood is associated with differences in epilepsy etiologies, syndromes, comorbidities, management, and outcomes. We must also consider the long-term effects of epilepsy and treatments. This section highlights unique considerations for pediatric epilepsy. These include pediatric onset electroclinical syndromes that commonly resolve prior to adulthood, treatment duration of self-limited pediatric epilepsy syndromes, pediatric-onset epilepsy with etiology-specific treatment, and therapies used more commonly in the pediatric population. In addition, pediatric-onset epilepsy is associated with a higher risk for developmental, psychiatric, and behavioral comorbidities in a bidirectional fashion. Family dynamics are affected by a child with epilepsy, and transitioning to the adult clinic is a particular challenge for this population. Finally, there are special issues that occur in pediatric epilepsy, including the lack of pediatric FDA approvals for newly available therapies and the need for sedation for investigations.
虽然小儿癫痫与成人癫痫有一些共同特征，但儿童期正在生长发育的大脑与癫痫的病因、综合征、合并症、治疗及预后等方面的差异相关。我们还必须考虑癫痫及其治疗的长期影响。本节重点介绍小儿癫痫的特殊注意事项。这些包括通常在成年前缓解的小儿起病的电临床综合征、自限性小儿癫痫综合征的治疗时长、具有病因特异性治疗的小儿起病癫痫，以及在儿科人群中更常用的治疗方法。此外，小儿起病癫痫与发育、精神和行为合并症的双向高风险相关。癫痫患儿会影响家庭动态，而向成人诊所过渡对这一人群来说是一项特殊挑战。最后，小儿癫痫还存在一些特殊问题，包括新可用疗法缺乏儿科FDA批准以及检查需要镇静。
