小儿急性惊厥(英文).pptVIP

SeizuresProf.JiangLiDepartmentofNeurologyChildren’sHospitalofCHUMS

DefinitionsSeizure（发作）:asuddenattack,spasm,orconvulsion,asinepilepsyoranotherdisorderEpilepticseizure（癫痫样发作）:atransientepisodeofabnormalandexcessiveneuronalactivityinthebrainthatisapparenteithertothesubjectoranobserver.Epilepsy（癫痫）:achronicdisorderofthebraincharacterizedbyrecurrent,unprovokedepilepticseizures.

FeaturesofepilepticseizuresTheabnormalneuronalactivityduringanepilepticseizuremaybemanifestedasamotor,sensory,autonomic,cognitive,orpsychicdisturbance.Theneurophysiologicalbasisisinferredonclinicalgrounds.Aconvulsionisasubtypeofseizureinwhichmotoractivityoccurs.Canbeprovokedinindividualswhodonothaveepilepsy(examplesofprovokinginsultsincludingfever,trauma,hypoglycaemiaandhypoxia)Therearemanyparoxysmaldisturbances(‘funnyturns’)thatmimicepilepticseizures.

DifferentdiagnosisofepilepticseizuresBreath-holdingattacks:provokedbytemperorfrustration;thescreamingtoddleholdstheirbreathinexpiration,goesblue,thenlimp,andthenmakesarapidspontaneousrecovery.Reflexanoxicseizures:provokedbypainorfear;theinfantortoddlerbecomespaleandlosesconsciousness(reflectingsyncope,secondarytovagal-inducedbradycardia);Thesubsequenthypoxiamayinducedatonic-clonicseizure.Vasovagalsyncope(simplefaints):usuallyoccursinteenagers;provokedbyemotion,hotenvironment;precededbynauseaanddizziness;suddenlossofconsciousnessandposture;rapidrecovery.Rigors:transientexaggeratedshiveringinassociationwithhighfever.

ClassificationofepilepticseizuresGeneralizedseizures:thefirstclinicalchangeindicatesinitialinvolvementofbothcerebralhemispheresPartialseizures:thereisinitialactivationofpareofonecerebralhemisphere

GeneralizedseizuresAbsenceseizure:briefunawarenesslastingafewseconds;