小儿急性惊厥（英文）指南课件.ppt

Seizures Prof. Jiang Li Department of Neurology Children’s Hospital of CHUMS Definitions Seizure （发作）: a sudden attack, spasm, or convulsion, as in epilepsy or another disorder Epileptic seizure（癫痫样发作）: a transient episode of abnormal and excessive neuronal activity in the brain that is apparent either to the subject or an observer. Epilepsy（癫痫）: a chronic disorder of the brain characterized by recurrent, unprovoked epileptic seizures. Features of epileptic seizures The abnormal neuronal activity during an epileptic seizure may be manifested as a motor, sensory, autonomic, cognitive, or psychic disturbance. The neurophysiological basis is inferred on clinical grounds. A convulsion is a subtype of seizure in which motor activity occurs. Can be provoked in individuals who do not have epilepsy ( examples of provoking insults including fever,trauma, hypoglycaemia and hypoxia) There are many paroxysmal disturbances (‘funny turns’) that mimic epileptic seizures. Different diagnosis of epileptic seizures Breath-holding attacks: provoked by temper or frustration;the screaming toddle holds their breath in expiration,goes blue, then limp, and then makes a rapid spontaneous recovery. Reflex anoxic seizures: provoked by pain or fear; the infant or toddler becomes pale and loses consciousness( reflecting syncope, secondary to vagal-induced bradycardia); The subsequent hypoxia may induced a tonic-clonic seizure. Vasovagal syncope (simple faints): usually occurs in teenagers; provoked by emotion, hot environment; preceded by nausea and dizziness; sudden loss of consciousness and posture; rapid recovery. Rigors: transient exaggerated shivering in association with high fever. Classification of epileptic seizures Generalized seizures: the first clinical change indicates initial involvement of both cerebral hemispheres Partial seizures: there is initial activation of pare of one cerebral hemisphere Generalized seizures Absence seizure: brief unawareness