小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 发热性疾病
- 癫痫发作
其他诊断因素
- 发作后体检正常
危险因素
- 体温升高
- 低龄
- 男性
- 热性惊厥家族史
- 中枢神经系统以外的病毒或细菌感染
- 疫苗接种
- 产前接触尼古丁
- 铁缺乏症
- 孕期、生产和分娩并发症
诊断性检查
首要检查
- 为临床诊断
需考虑的检查
- 腰椎穿刺：
- 病毒检测
- 血液培养
- 脑电图 (EEG)
- 脑部 MRI
- 血清钠
- 全血细胞计数 (FBC）
- 血清葡萄糖
- 铁分析检测
治疗流程
热性惊厥持续状态
首次单纯性热性惊厥发作
首次复杂性惊厥
发热性疾病伴既往单纯性惊厥或 1 次复杂性惊厥病史
有2 次或 2 次以上的地西泮治疗无效的复杂性热性惊厥病史
撰稿人
作者
Leena Mewasingh, MBChB, MSc
Consultant Paediatric Neurologist
St Mary’s Hospital
Imperial College Healthcare NHS Trust
London
UK
利益声明
LM has received funding from drug companies (e.g., Eisai) to attend medical conferences and been invited to an educational symposium (Novartis, LivaNova).
Frances Morrison, MBChB, DCH, MRCPCH
Paediatric Specialist Trainee
St Mary’s Hospital
Imperial College Healthcare NHS Trust
London
UK
利益声明
FM declares that she has no competing interests.
鸣谢
Dr Leena Mewasingh and Dr Frances Morrison wish to gratefully acknowledge Dr John J. Millichap and Dr J. Gordon Millichap, previous contributors to this topic. JJM serves as an Associate Editor of Neurology and serves on the editorial board of Pediatric Neurology Briefs; volunteers on the medical advisory board of The Jack Pribaz Foundation (KCNQ2.org); received speaker honoraria from Invitae; received royalties for online monographs from Up-To-Date; served on the scientific advisory board for Mallinckrodt; is principal investigator for a clinical trial funded by UCB Pharma; and is the principal investigator for research grants from Citizens United for Research in Epilepsy and the Thrasher Research Fund. JJM is an author of a number of references cited in this topic. JGM is an author of a number of references cited in this topic.
同行评议者
Robert S. Rust, Jr., MA, MD
Professor
Department of Neurology
University of Virginia Health System
Charlottesville
VA
利益声明
RSR declares that he has no competing interests.
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