Is Autonomic Nervous System Involved in the Epileptogenesis in Preterm Neonates?  

作　　者：Raffaele Falsaperla Giovanna Vialiti Janette Mailo Giovanni Corsello Martino Ruggieri 

机构地区：[1]Neonatal Intensive Care Unit,San Marco Hospital,University Hospital Policlinico-“G.Rodolico-San Marco,”Via Azeglio Ciampi,Catania 95100,Italy [2]Unit of Pediatrics and Pediatric Emergency,University Hospital Policlinico-“G.Rodolico-San Marco,”Via Azeglio Ciampi,Catania 95100,Italy [3]Division of Pediatric Neurology,University of Alberta,Stollery Children’s Hospital,8440-112 St NW,Edmonton,Alberta,Canada [4]Department of Maternal and Child Health,University of Palermo,Via del Vespro 129,Palermo 90127,Italy [5]Unit of Rare Diseases of the Nervous System in Childhood,Department of Clinical and Experimental Medicine,Section of Pediatrics and Child Neuropsychiatry,University of Catania,Catania 95124,Italy

出　　处：《Maternal-Fetal Medicine》2023年第3期173-181,共9页母胎医学杂志（英文）

摘　　要：Autonomic nervous system dysfunction has been described with focal and generalized epileptic seizures;occurring during their ictal,interictal,or postictal states.International League Against Epilepsy Seizure Classification Manual defines autonomic seizures as a distinct alteration of autonomic nervous system function involving cardiovascular,pupillary,gastrointestinal,sudomotor,vasomotor,and thermoregulatory functions.Autonomic seizures represent a great challenge for neonatologists and neurophysiologists;and distinguishing between ictal and non-ictal autonomic changes in neonates is rarely straightforward,especially in the premature ones.To avoid overdiagnosis and overtreatment,International League Against Epilepsy and the American Clinical Neurophysiology Society currently require electrographic correlation for any seizure diagnosis,including preterm neonates.There is very little scientific evidence about the pathophysiology of autonomic seizures.The data reporting on their incidence,clinical features,and diagnostic pathway is also insufficient.In this paper,we hypothesize that in the developing brain of preterm neonates,seizures involving deeper autonomic networks and subcortical structures might not propagate sufficiently to the cortex,and therefore the association of the seizures with specific ictal electrographic changes on surface electroencephalogram might be lacking.We propose considering autonomic seizures in the differential diagnosis of unexplained autonomic changes in neonates,especially preterm neonates,even in the absence of clear initial electrographic correlation.Unexplained autonomic changes could therefore be thought of as a“seizure alarm”in this population.

关 键 词：PREMATURE APNEA Autonomic seizures Brain Neonatal epilepsy NEONATES 

分 类 号：R714.2[医药卫生—妇产科学]