Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- episódios de olhar perdido ou desatenção
- Crises convulsivas tônico-clônicas
- espasmos musculares breves e arrítmicos
- revirar os olhos
- doença intercorrente
- quedas inexplicadas
Outros fatores diagnósticos
- incontinência
- morder a língua
- fenômenos pós-ictais
- precipitadas por fadiga ou ausência de sono
- precipitadas pela luz ou por ruídos
- atraso do desenvolvimento
- estigmas neurocutâneos
Fatores de risco
- predisposição genética ou história familiar
- insultos pré-natais ou perinatais
- distúrbios metabólicos/neurodegenerativos
- lesão cerebral traumática
- anormalidades estruturais do sistema nervoso central (SNC)
- síndromes neurocutâneas
- história de convulsões febris
- transtorno do espectro autista
- infecção do SNC
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- eletroencefalograma (EEG)
- nível glicêmico
- perfil metabólico básico
- Hemograma completo
- eletrocardiograma (ECG)
Investigações a serem consideradas
- ressonância nuclear magnética (RNM) cranioencefálica
- TC cranioencefálica
- teste genético
Algoritmo de tratamento
convulsões agudas repetitivas (crianças >1 mês de idade)
síndromes epilépticas com início na infância (1 mês a 2 anos)
síndromes epilépticas com início na infância (2-12 anos)
síndromes epilépticas com início em idade variável
síndrome epiléptica não identificada
Colaboradores
Autores
Katherine C. Nickels, MD
Associate Professor, Neurology
EEG Lab Director
Child and Adolescent Neurology Residency Recruitment Chair
Mayo Clinic
Rochester
MN
გაფრთხილება:
KCN has received travel compensation for attending advisory board meetings for Biocodex, Zogenix/UCB, and Takeda pharmaceuticals and will be receiving compensation for participating in advisory board meeting for Longboard. She receives compensation for participating in the J. Kiffin Penry Epilepsy Education Programs. She received hotel compensation for participating in CME education symposium through Miller Medical Communications, LLC, sponsored by UCB. She has received and will receive hotel compensation for participating in the Jack Pellock Resident on Pediatric Epilepsy Seminar through the Child Neurology Society. She is on the professional advisory board for the Epilepsy Foundation of Minnesota and receives no compensation. She serves as an assistant editor for Epilepsy Currents, for which she has not received compensation. She has participated in research and innovation for SEER medical and receives no compensation or royalties. She is an author of references cited in this topic.
მადლიერება
Dr Katherine C. Nickels would like to gratefully acknowledge Dr Leena Mewasingh, Dr Alla Nechay, and Dr Ewa Posner, previous contributors to this topic.
გაფრთხილება:
LM attended educational events hosted by Eisai and Novartis. AN and EP declare that they have no competing interests.
რეცენზენტები
Adam L. Hartman, MD
Assistant Professor of Neurology and Pediatrics
Johns Hopkins Hospital
Baltimore
MD
გაფრთხილება:
AH has received research support from the National Institutes of Health that is greater than 6 figures. ALH's research is funded in part by the National Institutes of Health. He is the co-author of one review that is referenced in this topic.
Roger Weis, MD
Pediatric Neurologist
Kinderneurologisches Zentrum Mainz
Mainz
Germany
გაფრთხილება:
RW declares that he has no competing interests.
John Stephenson, MA, BM, DM, FRCP, HonFRCPCH
Consultant
Paediatric Neurology Emeritus
Fraser of Allander Neurosciences Unit
Royal Hospital for Sick Children
Honorary Professor in Paediatric Neurology and Senior Research Fellow
Department of Child Health
Division of Developmental Medicine
University of Glasgow
Glasgow
UK
გაფრთხილება:
JS declares that he has no competing interests.
Anna Basu, BM, BCh, PhD, MA, MRCPCH
Honorary Clinical Lecturer
Paediatric Neurology
Newcastle General Hospital
Newcastle-upon-Tyne
UK
გაფრთხილება:
AB has previously worked as part of a clinical team with Dr Ewa Posner, a previous contributor to this topic. AB declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
წყაროები
ძირითადი სტატიები
Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017 Apr;58(4):512-21.სრული ტექსტი აბსტრაქტი
Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017 Apr;58(4):522-30.სრული ტექსტი აბსტრაქტი
Wirrell EC, Nabbout R, Scheffer IE, et al. Methodology for classification and definition of epilepsy syndromes with list of syndromes: report of the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022 Jun;63(6):1333-48.სრული ტექსტი აბსტრაქტი
Hirsch E, French J, Scheffer IE, et al. ILAE definition of the idiopathic generalized epilepsy syndromes: position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022 Jun;63(6):1475-99.სრული ტექსტი აბსტრაქტი
Gaillard WD, Chiron C, Cross JH, et al; ILAE Committee for Neuroimaging, Subcommittee for Pediatric Neuroimaging. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia. 2009 Sep;50(9):2147-53.სრული ტექსტი აბსტრაქტი
American College of Radiology. ACR appropriateness criteria: seizures and epilepsy. 2019 [internet publication].სრული ტექსტი
Zuberi SM, Wirrell E, Yozawitz E, et al. ILAE classification and definition of epilepsy syndromes with onset in neonates and infants: position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022 Jun;63(6):1349-97.სრული ტექსტი აბსტრაქტი
Specchio N, Wirrell EC, Scheffer IE, et al. International League Against Epilepsy classification and definition of epilepsy syndromes with onset in childhood: position paper by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022 Jun;63(6):1398-442.სრული ტექსტი აბსტრაქტი
Kossoff EH, Zupec-Kania BA, Auvin S, et al; Charlie Foundation; Matthew's Friends; Practice Committee of the Child Neurology Society. Optimal clinical management of children receiving dietary therapies for epilepsy: updated recommendations of the International Ketogenic Diet Study Group. Epilepsia Open. 2018 Jun;3(2):175-92.სრული ტექსტი აბსტრაქტი
გამოყენებული სტატიები
ამ თემაში მოხსენიებული წყაროების სრული სია ხელმისაწვდომია მომხმარებლებისთვის, რომლებსაც აქვთ წვდომა BMJ Best Practice-ის ყველა ნაწილზე.
დიფერენციული დიაგნოზები
- Convulsões funcionais (crises não epilépticas)
- Episódios de apneia voluntária (apneia expiratória cianótica prolongada)
- Síndrome do QT longo
მეტი დიფერენციული დიაგნოზებიგაიდლაინები
- Epilepsies in children, young people and adults
- Teratogenesis, perinatal, and neurodevelopmental outcomes after in utero exposure to antiseizure medication
მეტი გაიდლაინებიპაციენტის ბროშურები
Epilepsia: perguntas a fazer ao seu médico
Convulsões febris
მეტი პაციენტის ბროშურები
შედით სისტემაში ან გამოიწერეთ BMJ Best Practice
ამ მასალის გამოყენება ექვემდებარება ჩვენს განცხადებას