Couto-Sales S, Rey E, Radvanyi M F, Dreyfus-Brisac C, Rapon L, Castex M
Rev Electroencephalogr Neurophysiol Clin. 1979 Jan-Mar;9(1):26-34. doi: 10.1016/s0370-4475(79)80049-0.
The poor prognostic significance of inactive or paroxystic E.E.G. recordings in new-born babies appears to be well established (Monod et al., ibid., 1972, 32, 529-544). However, some cases have been described as having a favourable evolution even though such tracings had been proesent during the neonatal period. The authors studied, therefore, the effects of anticonvulsants (diazepam, phenobarbital) to see if they produced inactive or paroxystic tracings. A total of 19 new-born babies with convulsions of various etiologies were treated with phenobarbital and diazepam and recordings were made less than 24 hours after the beginning of treatment. Plasma levels were measured at the time of recording and varied from 3 to 26 micrograms/ml for phenobarbital and 0 to 2.75 micrograms/ml for diazepam. No paroxystic tracings were noted, but 2 inactive tracings were seen in infants who had been severely asphyxiated at birth, and in whom the plasma levels of the anticonvulants was found to be low. The injection of diazepam during the E.E.G. recording caused suppression of electrical discharges without notably altering the inter-seizure E.E.G. activity. The authors conclude that in the 19 cases studied the changes noted in the E.E.G. were related to the severity of the condition and were not secondary to therapy.
新生儿脑电图记录呈静止或阵发性表现时预后不良,这一点似乎已得到充分证实(莫诺德等人,出处同上,1972年,第32卷,第529 - 544页)。然而,有一些病例尽管在新生儿期出现过此类脑电图描记,但后来病情却向好的方向发展。因此,作者研究了抗惊厥药物(地西泮、苯巴比妥)的作用,以观察它们是否会导致脑电图出现静止或阵发性表现。共有19名病因各异的惊厥新生儿接受了苯巴比妥和地西泮治疗,并在治疗开始后不到24小时进行了脑电图记录。记录时测定了血浆浓度,苯巴比妥的血浆浓度在3至26微克/毫升之间,地西泮的血浆浓度在0至2.75微克/毫升之间。未观察到阵发性脑电图描记,但在出生时严重窒息且抗惊厥药物血浆浓度较低的婴儿中发现了2次静止性脑电图描记。在脑电图记录过程中注射地西泮可抑制放电,且未显著改变发作间期的脑电图活动。作者得出结论,在所研究的19例病例中,脑电图的变化与病情严重程度有关,而非治疗的继发结果。