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Evaluation of etiologic and prognostic factors in neonatal convulsions

机译:新生儿惊厥的病因和预后评估

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This study evaluated etiologic and risk factors affecting long-term prognoses of neurologic outcomes in newborns with neonatal seizures. We enrolled patients at chronologic ages of 23-44 months, referred to the Department of Pediatric Neurology, Istanbul Medical Faculty, from January 1, 2007-December 31, 2009, after manifesting seizures in their first postnatal 28 days. Of 112 newborns, 41 were female, 71 were male, 33 were preterm, and 79 were full-term. Perinatal asphyxia (28.6%) and intracranial hemorrhage (17%) were the most common causes of neonatal seizures. Cerebral palsy developed in 27.6% of patients during follow-up. The incidence of epilepsy was 35.7%. Almost 50% of patients manifested developmental delay in one or more areas. Global developmental delay was the most common (50.8%) neurologic disorder. The correlation between gestational age or birth weight and adverse outcomes was nonsignificant. Etiology, Apgar score, need for resuscitation at birth, background electroencephalogram, neonatal status epilepticus, cranial imaging findings, type/duration of antiepileptic treatment, and response to acute treatment were all strong prognostic factors in neurologic outcomes. Neonatal seizures pose a threat of neurologic sequelae for preterm and full-term infants. Although the number of recognized etiologic factors in neonatal seizures has increased because of improvements in neonatology and diagnostic methods, perinatal asphyxia remains the most common factor.
机译:这项研究评估了影响新生儿癫痫发作的新生儿神经系统预后的长期预后的病因和危险因素。我们在2007年1月1日至2009年12月31日对出生后28天内出现癫痫发作的年龄在23-44个月的患者进行了研究,这些患者转诊至伊斯坦布尔医学院的儿科神经病学系。在112例新生儿中,女性41例,男性71例,早产33例,足月79例。围产期窒息(28.6%)和颅内出血(17%)是新生儿惊厥的最常见原因。随访期间发生脑瘫的患者占27.6%。癫痫的发生率为35.7%。几乎50%的患者在一个或多个区域表现出发育迟缓。全球发育迟缓是最常见的神经系统疾病(50.8%)。胎龄或出生体重与不良结局之间的相关性不显着。病因,Apgar评分,出生时需要复苏,脑电图本底,新生儿癫痫持续状态,颅脑影像表现,抗癫痫治疗的类型/持续时间以及对急性治疗的反应都是神经系统预后的重要预后因素。新生儿癫痫发作会对早产和足月婴儿造成神经系统后遗症的威胁。尽管由于新生儿学和诊断方法的改善,新生儿癫痫发作中公认的病因因素数量有所增加,但围产期窒息仍是最常见的因素。

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