When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Convulsões generalizadas em crianças

查看 PDF
  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 18 Jan 2026
最后更新： 02 May 2025

小结

定义

病史和体格检查

关键诊断因素

  • 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
完整详情

其他诊断因素

  • 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
完整详情

危险因素

  • 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
完整详情

诊断性检查

首要检查

  • eletroencefalograma (EEG)
  • nível glicêmico
  • perfil metabólico básico
  • Hemograma completo
  • eletrocardiograma (ECG)
完整详情

需考虑的检查

  • ressonância nuclear magnética (RNM) cranioencefálica
  • TC cranioencefálica
  • teste genético
完整详情

治疗流程

急症处理

convulsões agudas repetitivas (crianças >1 mês de idade)

持续性治疗

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

撰稿人

作者

Katherine C. Nickels, MD

Associate Professor, Neurology

EEG Lab Director

Child and Adolescent Neurology Residency Recruitment Chair

Mayo Clinic

Rochester

MN

利益声明

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.

鸣谢

Dr Katherine C. Nickels would like to gratefully acknowledge Dr Leena Mewasingh, Dr Alla Nechay, and Dr Ewa Posner, previous contributors to this topic.

利益声明

LM attended educational events hosted by Eisai and Novartis. AN and EP declare that they have no competing interests.

同行评议者

Adam L. Hartman, MD

Assistant Professor of Neurology and Pediatrics

Johns Hopkins Hospital

Baltimore

MD

利益声明

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

利益声明

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

利益声明

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

利益声明

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.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

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.全文  摘要

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.全文  摘要

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.全文  摘要

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.全文  摘要

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.全文  摘要

American College of Radiology. ACR appropriateness criteria: seizures and epilepsy. 2019 [internet publication].全文

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.全文  摘要

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.全文  摘要

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.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Convulsões generalizadas em crianças images

  • 鉴别诊断

    • Convulsões funcionais (crises não epilépticas)
    • Episódios de apneia voluntária (apneia expiratória cianótica prolongada)
    • Síndrome do QT longo
    更多 鉴别诊断

  • 指南

    • Epilepsies in children, young people and adults
    • Teratogenesis, perinatal, and neurodevelopmental outcomes after in utero exposure to antiseizure medication
    更多 指南

  • 患者教育信息

    Epilepsia: perguntas a fazer ao seu médico

    Convulsões febris

    更多 患者教育信息
  • padlock-locked登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容

内容使用需遵循免责声明