頁籤選單縮合
題 名 | 一般小兒科醫師眼中之小兒常見抽搐=Common Seizure Disorders in Children: A General Pediatrician's Perspective |
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作 者 | 黃朝慶; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷 期 | 38:增刊B 民86.11 |
頁 次 | 頁24-28 |
分類號 | 417.5845 |
關鍵詞 | 小兒抽搐; |
語 文 | 中文(Chinese) |
英文摘要 | Witnessing a child ’ s first seizure is frightening. Seizures are also the most common neurological manifestation seeking medical help from pediatricians. However, many of these paroxysmal attacks are not seizures, or even not epileptic seizures. The first question for pediatrician to ask is! § Is this attack a seizure?! ‥ if the answer is yes, the next question will be! § Is this attack an epileptic seizure?! ‥. Form epidemiological point of view, seizure disorders in children can be categorized int provoked seizures and unprovoked seizures. Provoked seizures are seizures in response to fever, an insult to the central nervous system, e.g., meningitis, head trauma, or in association with a systemic insult e.g., hypoglycemia. Unprovoked seizures are seizure not directly caused by acute by acute insults to central nervous system or by metabolic or toxic disturbances. Provoked seizures can be caused by febrile convulsion and acute symptomatic seizures. Febrile convulsion is the most common seizure disorder in children, and its cumulative incidence in Taiwan is about 2.3%. The mean age onset is 20.5 months, □ and about 30% □ of them will have another febrile convulsion before three years of age. About 3-6% □ of them will subsequently develop epilepsy. Routine electroencephalogram (EEG) examination for febrile convulsion essentially cannot provide valuable information conc erning differential diagnosis, seizure recurrence and occurrence of epilepsy. The cumulative incidence of acute symptomatic seizures is about 0.47%. Bacterial meningitis and traumatic brain injury are the two most common causes of acute symptomatic seizures in infants between one and 6 months of age. Seizures associated with acute gastroenteritis and seizures caused by encephalopathy/encephalitis are the common causes of seizures in children between age of 13 and 36 moths. Between 0.5 and 1% □ of children experience a single unprovoked seizure episode without recurrence. Unprovoked seizure can be idiopathic or remote symptomatic. The definite risk factor for seizure recurrence are abnormal neurological examination and abnormal EEG, the possible risk factor include partial seizure, family history of epilepsy. Duration of seizure and age onset do not alter the risk of recurrence. And children with multiple seizures occurring within a 24 hour period have the same recurrence risk as children with only one seizure. Detailed seizure history, complete neurological examination and EEG work up, and careful assessing the risk factor of seizure recurrence are important in evaluating and treating children with unprovoked seizures. |
本系統中英文摘要資訊取自各篇刊載內容。