Diagnostic and Therapeutic Management of a First Unprovoked Seizure in Children and Adolescents With a Focus on the Revised Diagnostic Criteria for Epilepsy

被引：9

作者：

Sansevere, Arnold J. ^{[1
]}

Avalone, Jennifer ^{[1
]}

Strauss, Lauren Doyle ^{[2
]}

Patel, Archana A. ^{[1
]}

Pinto, Anna ^{[1
]}

Ramachandran, Maya ^{[3
]}

Fernandez, Ivan Sanchez ^{[3
]}

Bergin, Ann M. ^{[1
]}

Kimia, Amir ^{[4
]}

Pearl, Phillip L. ^{[1
]}

Loddenkemper, Tobias ^{[1
]}

机构：

[1] Harvard Med Sch, Boston Childrens Hosp, Div Epilepsy & Clin Neurophysiol, Dept Neurol, Boston, MA USA

[2] Wake Forest Med Sch, Dept Neurol, Wake Forest Baptist Hlth, Winston Salem, NC USA

[3] MIT, 77 Massachusetts Ave, Cambridge, MA 02139 USA

[4] Harvard Med Sch, Boston Childrens Hosp, Dept Emergency Med, Boston, MA USA

来源：

JOURNAL OF CHILD NEUROLOGY | 2017年 / 32卷 / 08期

关键词：

electroencephalography; epilepsy; neuroimaging; seizures; treatment; PSYCHOGENIC NONEPILEPTIC SEIZURES; QUALITY STANDARDS SUBCOMMITTEE; BRAIN COMPUTED-TOMOGRAPHY; NEW-ONSET; PRACTICE PARAMETER; AMERICAN-ACADEMY; EMERGENCY-DEPARTMENT; PEDIATRIC EMERGENCY; NEUROLOGY SOCIETY; RECURRENCE RISK;

D O I：

10.1177/0883073817706028

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

By definition, unprovoked seizures are not precipitated by an identifiable factor, such as fever or trauma. A thorough history and physical examination are essential to caring for pediatric patients with a potential first unprovoked seizure. Differential diagnosis, EEG, neuroimaging, laboratory tests, and initiation of treatment will be reviewed. Treatment is typically initiated after 2 unprovoked seizures, or after 1 seizure in select patients with distinct epilepsy syndromes. Recent expansion of the definition of epilepsy by the ILAE allows for the diagnosis of epilepsy to be made after the first seizure if the clinical presentation and supporting diagnostic studies suggest a greater than 60% chance of a second seizure. This review summarizes the current literature on the diagnostic and therapeutic management of first unprovoked seizure in children and adolescents while taking into consideration the revised diagnostic criteria of epilepsy.

引用

页码：774 / 788

页数：15

共 69 条

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