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婴儿非癫痫性阵发性疾病

Authors
Thien T Nguyen, MD, PhD
Peter W Kaplan, MB, FRCP
Angus Wilfong, MD
Section Editor
Douglas R Nordli, Jr, MD
Deputy Editor
April F Eichler, MD, MPH
Translators
杨文, 主任医师

引言

癫痫是一种对反复发作有潜在易感性，并以此为特征的疾病。癫痫发作这一术语是指由大脑神经元异常过度活动引起短暂出现的体征和/或症状。

阵发性事件在婴儿中较为常见。一项基于人群的队列研究显示，1岁以内的婴儿有9%出现阵发性事件[1]。虽然通常认为癫痫发作和癫痫与阵发性事件是有差别的，但他们占这些事件的一小部分(<10%)。

新生儿及婴儿的非癫痫性阵发性发作与年龄较大的儿童及成人中的非癫痫性阵发性发作有差异(表 1)。由于临床症状有重叠，以及解读新生儿和婴儿的脑电图(electroencephalograms, EEG)较为困难，可能很难将这些非癫痫性阵发性事件与癫痫事件区别开来。对于临床医生来说，知道并识别类似于癫痫发作的短暂性非癫痫性事件很重要，以避免不必要的治疗，并在需要时开始正确的治疗。

本专题将总结新生儿及婴儿中的非癫痫性阵发性事件。在其他年龄组中癫痫的鉴别诊断见其他专题。 (参见“儿童非痫性阵发性疾病”和“青少年及成人中的非痫性发作性疾病”)

新生儿(从出生至出生后1个月)

正常新生儿通常会出现多种阵发性运动，包括非共轭眼球运动、不伴有眼部异常的吸允动作，以及睡眠相关肌阵挛。这些正常行为以及下文将讨论的病理性疾病可能很难与癫痫发作相鉴别，因为癫痫发作也可有稍轻微的表现(不显性发作)。EEG，尤其是视频EEG监测对于鉴别这些疾病具有重要价值。在一项新生儿的研究中，90%疑似癫痫发作的异常动作通过EEG记录结果被证实为非癫痫性[2]。 (参见“新生儿癫痫发作的临床特征、评估和诊断”)

                   

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Literature review current through: 2017-06 . | This topic last updated: 2016-09-09.
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