儿童期全身性癫痫发作
小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 凝视发作或注意力不集中
- 强直阵挛发作
- 短暂、无节律的肌肉抽搐运动
- 眼球向头后部翻转
- 伴发的疾病
- 不明原因的跌倒
其他诊断因素
- 失禁
- 咬舌
- 发作后表现
- 可被疲乏或缺乏睡眠诱发
- 可被光或噪音诱发
- 发育迟缓
- 神经皮肤红斑
危险因素
- 遗传倾向或家族史
- 围产期窒息
- 代谢性/神经退行性疾病
- 头部外伤
- 中枢神经系统 (CNS) 的结构异常
- 自闭症谱系障碍
- 中枢神经系统 (CNS) 感染
- 神经皮肤综合征
- 热性惊厥史
诊断性检查
首要检查
- 脑电图 (EEG)
- 血糖水平
- 基本代谢指标
- 全血细胞计数 (FBC)
- 心电图 (ECG)
需考虑的检查
- 颅脑磁共振成像 (MRI)
- 颅脑计算机体层成像 (CT)
治疗流程
进展期间的全身性癫痫发作
<1 岁儿童（不包括新生儿）的癫痫综合征
幼童期癫痫综合征
中童期癫痫综合征
儿童晚期或青少年癫痫综合征
不明确的癫痫综合征
撰稿人
作者
Leena Mewasingh, MBChB, MSc, FRCPCH
Consultant Paediatric Neurologist
St. Mary's Hospital
Imperial College Healthcare NHS Trust
London
UK
利益声明
LM has attended educational events hosted by Eisai (Perampanel/fycompa) and by Novartis (Everolimus for Tuberous Sclerosis patients).
Alla Nechay, MD
Pediatric Neurologist
Pediatric Hospital No 1
Kiev
Ukraine
利益声明
AN declares that she has no competing interests.
鸣谢
Dr Leena Mewasingh and Dr Alla Nechay would like to gratefully acknowledge Dr Ewa Posner, a previous contributor to this topic. EP declares that she has 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 monograph.
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.
鉴别诊断
- 非痫性发作或“解离性发作 (dissociative seizure)
- 屏气发作（长期紫绀型呼气暂停）
- 长 QT 综合征
更多 鉴别诊断指南
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