国际抗癫痫联盟新生儿癫痫发作分类特别工作组专家建议解读(2021年)

Interpretation for the International League Against Epilepsy task force on neonatal seizure expert (2021)

癫痫发作是新生儿期最常见的神经危重症,多为急性脑损伤导致的症状性癫痫发作,单纯电发作更多见。新生儿癫痫发作不易纳入国际抗癫痫联盟(ILAE)制定的新生儿癫痫发作的分类方案,为此ILAE专门成立了新生儿癫痫发作特别工作组,对2017年ILAE癫痫发作和癫痫的分类中涉及新生儿的内容进行修订。新生儿分类方案特别强调了脑电图在新生儿癫痫发作诊断中的作用,以及与该年龄组相关的癫痫发作分类。成人和年长儿童癫痫类型主要取决于临床特征,许多新生儿仅有电发作,因此电发作也纳入了分类方案。无脑电图相应改变的临床事件不属于癫痫发作。新生儿期癫痫发作均为局灶性起源,不再分为局灶性和全面性发作。癫痫发作可以分为异常运动(自动症、阵挛性、肌阵挛性、强直性)和非运动发作(自主神经、行为停滞)或序贯发作。新的分类方法可对新生儿癫痫发作进行更详细地分类。

Seizure is the most common neurological critical disease in the neonatal period,most of which is symptomatic.Seizure is usually caused by acute brain injury,and only electrical seizure is more commonly seen.Neonatal seizures are not easy to be included in the epilepsy classification established by the International League Against Epilepsy(ILAE).As a result,a Neonatal Seizures Task Force was established by the ILAE to develop a modification of the 2017 ILAE classification of seizures and epilepsies.The neonatal classification framework emphasizes the role of electroencephalography(EEG)in the diagnosis of neonatal seizure,which includes a classification of seizure types especially in newborns.The type of seizure in adults and older children mainly depends on clinical characteristics,while many newborns only have electric seizures.Therefore,electric seizures are included in the classification scheme.Clinical events without corresponding EEG changes are not included.Neonatal seizures are all focal seizures,and focal and generalized seizures are unnecessarily to be categorized.Seizures can be classified by abnormal motor episodes(automata,clonic,myoclonic,tonic)and non-motor episodes(autonomic,behavioral changes)or sequential presentation.The new classification can be used to more specifically classify neonatal seizures.