Helmers S L, Wypij D, Constantinou J E, Newburger J W, Hickey P R, Carrazana E J, Barlow J K, Kuban K C, Holmes G L
Department of Neurology, Children's Hospital, Harvard Medical School, Boston, MA, USA.
Electroencephalogr Clin Neurophysiol. 1997 Jan;102(1):27-36. doi: 10.1016/s0013-4694(96)95079-8.
Many infants with cardiac anomalies undergo repair early in life. Both commonly used support techniques, deep hypothermic circulatory arrest (DHCA) and low-flow cardiopulmonary bypass (LFB), may be associated with adverse neurological outcomes, including seizures. In a single center study, 171 infants undergoing correction for D-transposition of the great arteries were randomized to one of these support techniques. Incidence and onset times of EEG seizures during continuous EEG-video monitoring in the first 48 h postoperatively and clinical seizures in the first postoperative week were compared. EEG seizures were characterized by time, duration, and localization of onset. Incidence of EEG seizures (20%) was more than 3 times that of clinical seizures (6%). Most infants with EEG seizures had multiple seizures beginning between 13 and 36 h postoperatively. Durations ranged from 6 s to 980 min. Onset of EEG seizures occurred most commonly in frontal and central regions. Factors associated with EEG seizures included randomization to DHCA, longer duration of circulatory arrest, and diagnosis of VSD. In this study EEG seizures were common following this type of cardiac surgery, illustrating the importance of EEG monitoring in detecting seizures. This data adds insight into mechanisms of seizures in infants undergoing cardiac surgery.
许多患有心脏畸形的婴儿在生命早期接受修复手术。两种常用的支持技术，即深低温循环停搏（DHCA）和低流量体外循环（LFB），都可能与不良神经学后果相关，包括癫痫发作。在一项单中心研究中，171例接受大动脉转位矫正术的婴儿被随机分配至其中一种支持技术组。比较术后48小时内持续脑电图-视频监测期间脑电图癫痫发作的发生率和发作时间，以及术后第一周内的临床癫痫发作情况。脑电图癫痫发作通过发作时间、持续时间和发作部位进行特征描述。脑电图癫痫发作的发生率（20%）是临床癫痫发作发生率（6%）的3倍多。大多数脑电图癫痫发作的婴儿在术后13至36小时之间出现多次发作。持续时间从6秒到980分钟不等。脑电图癫痫发作最常发生在额叶和中央区域。与脑电图癫痫发作相关的因素包括随机分配至DHCA组、循环停搏时间较长以及室间隔缺损的诊断。在这项研究中，此类心脏手术后脑电图癫痫发作很常见，这说明了脑电图监测在检测癫痫发作方面的重要性。该数据为接受心脏手术的婴儿癫痫发作机制提供了深入见解。
