失神发作

最后审阅: 1 九月 2022
最后更新: 24 六月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 儿童痫样发作家族史
  • 凝视发作,持续 5 至 10 秒;每天数次,无先兆/发作后状态
  • 儿童期发病
  • 体格检查结果正常
  • 过度通气诱导的癫痫发作
更多 关键诊断因素

其他诊断因素

  • 简单自动症
  • 近期学习成绩下降
  • 复杂自动症
  • 早发型(4 岁之前)
其他诊断因素

危险因素

  • 儿童失神癫痫或青少年肌阵挛癫痫家族史/遗传史
  • 获得性脑损伤:例如缺氧-缺血、外伤、感染
  • 其他先天性代谢障碍、结构性缺陷、染色体异常
  • 发育延迟或智力障碍
  • 女性
更多 危险因素

诊断性检查

首要检查

  • 脑电图 (EEG)
更多 首要检查

需考虑的检查

  • 颅脑 MRI 扫描
  • 代谢性疾病检测(例如血清氨基酸、尿有机酸、乳酸/丙酮酸或特定酶试验)
  • 脑脊液和血清中的葡萄糖
更多 需考虑的检查

新兴检查

  • 基因检测

治疗流程

急症处理

无全身性强直阵挛发作病史(儿童失神癫痫)的典型失神发作

有全身性强直阵挛发作病史(CAE、JAE、JME)的典型失神发作

非典型失神发作

持续性治疗

顽固性疾病的治疗

撰稿人

作者

Judith L. Z. Weisenberg, MD

Assistant Professor of Neurology

Washington University Medical School

St. Louis

MO

利益声明

JLZW states that she has no competing interests.

鸣谢

Dr Judith L. Z. Weisenberg would like to gratefully acknowledge Dr Michael Wong, a previous contributor to this topic.

利益声明

MW declares that he has no competing interests.

同行评议者

Anita Devlin, MBBS, MD

Consultant Paediatric Neurologist

Royal Victoria Infirmary

NHS Foundation Trust

Newcastle-upon-Tyne

UK

利益声明

AD and two epilepsy nurses from her department have been reimbursed by UCB Pharma, the manufacturer of levetiracetum, for attending several conferences. One of the epilepsy nurses received a one-off sponsorship payment from UCB Pharma to cover the initial set-up costs of the adolescent epilepsy support group. One epilepsy nurse has been reimbursed by Cyberonics, the manufacturer of vagal nerve stimulators, for attending one or more conferences.

Cigdem Akman, MD

Division of Pediatric Neurology

Columbia University College of Physicians and Surgeons

New York

NY

利益声明

CA declares that he has no competing interests.

Angus A. Wilfong, MD

Associate Professor

Pediatrics and Neurology

Baylor College of Medicine

Medical Director

Comprehensive Epilepsy Program

Texas Children's Hospital

Houston

TX

利益声明

AAW declares that he has no competing interests.

Helen Cross, MB, ChB, PhD, FRCP, FRCPCH

Head of Neurosciences Unit

The Prince of Wales’s Chair of Childhood Epilepsy

National Centre for Young People with Epilepsy

London

UK

利益声明

HC has received research funds from HAS, Epilepsy Research UK, SHS, and the Milk Development Council. She has received funding for an epilepsy training fellowship from UCB and Eisai. She has also received travel funding from Eisai, UCB, and GlaxoSmithKline.

  • 鉴别诊断

    • 白日梦
    • 注意缺陷多动障碍 (ADHD)
    • 起源于额叶或颞叶的复杂部分性癫痫
    更多 鉴别诊断
  • 指南

    • 儿童、青年和成人癫痫
    • 无癫痫发作患者停用抗癫痫药物:实践咨询更新总结
    更多 指南
  • 患者教育信息

    儿童失神发作

    更多 患者教育信息
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