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新生儿癫痫发作的临床特征、评估和诊断

Author
Renee Shellhaas, MD, MS
Section Editors
Douglas R Nordli, Jr, MD
Joseph A Garcia-Prats, MD
Deputy Editor
April F Eichler, MD, MPH
Translators
朱雪萍, 主任医师，副教授

引言

新生儿癫痫发作可能是新生儿中枢神经系统(central nervous system, CNS)疾病的首发临床征象，而且可能是唯一的临床征象。因此，癫痫发作可能表明存在潜在可治疗的病因，应该提示立即评估以确定原因并开始病因特异性治疗。另外，癫痫发作本身可能需要紧急治疗，因为其可能对婴儿稳态产生不良影响或促成进一步的脑损伤。

本文将总结新生儿癫痫发作的临床特征、评估和诊断。新生儿癫痫发作的病因和治疗，以及相关癫痫综合征将单独讨论。 (参见“新生儿癫痫发作的病因和预后”和“新生儿癫痫综合征”和“新生儿惊厥的治疗”)

流行病学

相比于其他任何时期，新生儿期更常发生癫痫发作，在此期间，癫痫发作最常发生于出生后第1周内[1,2]。据报道，新生儿癫痫发作的发病率为1.5/1000-5.5/1000[2-4]，早产儿中发病率可能甚至更高[5]。癫痫发作的发病率因一些特定危险因素而变化。发病率随胎龄和出生体重的下降以及疾病急性程度的增加而增加[2,6,7]。

病因

几乎所有的新生儿癫痫发作都为“症状性”的，作为某一特定可识别病因的结果发生(表 1和表 2)[8-11]。大部分病因可以大致归类为：

●新生儿脑病和缺氧-缺血性脑病(hypoxic-ischemic encephalopathy, HIE)

                      

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Literature review current through: 2017-07 . | This topic last updated: 2016-08-22.
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