医学课件-惊厥

1、Acute convulsion in Children JIANG Li Professor Doctorial tutor Department of Neurology Children s Hospital of CMU contents Definitions Causes of acute convulsion Febrile seizures Exams and Tests for convulsion Treatment of acute convulsion Acute convulsion in Children Definitions Epileptic Seizures 癫痫发作 manifestation of transient excessive abnormal hypersynchronous discharges of cortical neurons Clinical signs or symptoms of seizures depend on the location of the epileptic discharges in the cor

2、tex and the extent and pattern of the propagation of the epileptic discharge in the brain May be manifested as a motor sensory autonomic cognitive or psychic disturbance manifestation is apparent either to the subject or an observer Different types of seizures may occur in different parts of the brain and may be localized affect only a part of the body or widespread affect the whole body Acute convulsion in Children Definitions Convulsive seizures 惊厥性癫痫发作 convulsion 惊厥 is a subtype of epileptic

3、seizure in which abnormal motor activity occurs noted by uncontrollable muscle jerking Epilepsy 癫痫 a chronic disorder of the brain characterized by recurrent unprovoked epileptic seizures Acute convulsion in Children 癫痫发作癫痫发作 痫性发作 痫性发作 epileptic seizures epileptic seizures 或或 seizuresseizures l大脑皮层神经元异常同步放电引起的暂时性脑 功能异常 临床可有多种发作症状 包括运动 感觉异常 行为 认知 植物神经功能障碍等 l分为惊厥性痫样发作 惊厥 非惊厥性痫样 发作 l发作性 并有自限性 大多短暂 l可发生于急性疾病 慢性疾病 惊厥 Convulsion 神经元异常放电 神经元异常放电 起源于大脑皮层运动区起源于大脑皮层运动区 脑功能障碍基本表现 抽搐 全身或局脑功能障碍基本表现 抽搐 全身或局 部

4、骨骼肌的不自主收缩 部骨骼肌的不自主收缩 可伴有不同程度意识障碍可伴有不同程度意识障碍 定定 义义 excessive abnormal discharges of cortical neurons Epileptic Seizures convulsive seizure convulsion nonconvulsive seizure Acute epileptic seizure provoked in acute disorders epilepsy recurrent unprovoked epileptic seizures Acute convulsion in Children 癫痫发作 惊厥 癫痫 癫痫发作 Epileptic Seizures 发作性大脑皮层功 能异常所引起的多种临床症状 惊厥 convulsion 伴有骨骼肌强烈 不自主收缩 的痫性发作 癫痫 epilepsy 临床呈长期反复痫性发作的疾病 过程 Acute convulsion in Children Characteristics of acute convulsion in children

5、High incidence 4 6 in the children younger than 6yr Easily with prolonged convulsion or status convulsion Status convulsion 惊厥持续状态 a convulsion lasting longer than 30 minutes or repeated convulsion without a return to normal in between them usually with minim or subtle seizure in the babies Seizures may occur for many causes Acute convulsion in Children contents Definitions Seizure Convulsion Epilepsy Causes of acute convulsions Febrile seizuresFebrile seizures Exams and Tests for convulsion Tre

6、atment of acute convulsion Acute convulsion in Children Common causes of acute convulsion CNS infection Meningitis or encephalitis Febrile convulsions Febrile seizuresFebrile seizures Head trauma CNS malformations Brain tumors Metabolic disorders Hypoglycemia Hyponatremia hypernatremia Hyperosmolar states Hypocalcemia Idiopathic or cryptogenic epilepsy Acute convulsion in Children Classification of the causes of convulsion infectious diseases infectious diseases other disorders other disorders I

7、ntracranialIntracranial diseasedisease Bacterial Meningitis Tuberculous meningitisTuberculous meningitis Viral meningitis encephalitis fungal meningitis parasitic disease brain abscess Head trauma CNS malformations Brain tumors epilepsy ExtracranialExtracranial diseasedisease Febrile convulsions Infectious toxic Infectious toxic encephalopathyencephalopathy Anoxia ischemia Metabolic disorders Hypoglycemia Hyponatremia Hypernatremia Hypocalcemia ToxicosisToxicosis rodenticide organic pesticide Ac

8、ute convulsion in Children Intracranial infection Usually with infectious symptoms fever drowsiness irritation delirium Recurrent severe prolonged seizure Common occur in early stage or the most serious stage of disease Usually with the disturbance of impairment of consciousness With the manifestations of intracranial hypertension Useful lab test CSF Causes of acute seizures 颅外感染 中毒性脑病 大多见于严重细菌感染过程中大多见于严重细菌感染过程中 与感染和毒素导致的脑水肿有关与感染和毒素导致的脑水肿有关 临床特征 原发疾病极期临床特征 原发疾病极期 反复惊厥发作反复惊厥发作 伴有意识障碍与颅内压增高症状伴有意识障

9、碍与颅内压增高症状 脑脊液检查仅压力增高脑脊液检查仅压力增高 惊厥病因惊厥病因 感染性感染性 contents Definitions Seizure Convulsion Epilepsy Causes of acute convulsion Febrile seizuresFebrile seizures 热性惊厥 热性惊厥 Exams and Tests for convulsion Treatment of acute convulsion Acute convulsion in Children General Introduction An event in infancy or childhood usually occurring between three months and five years of age associated with fever but without evidence of intracranial infection or an identifiable neurological disorder Febrile seizures ar

10、e the most common seizure disorder in childhood affecting 2 5 of children Febrile seizuresFebrile seizures General Introduction Associated with upper respiratory infection otitis media viral syndrome Genetic predisposition clearly contributes to the occurrence of this disorder Be divided into simple febrile seizures complex febrile seizures Among children with febrile seizures about 70 80 have only simple febrile seizures others have complex febrile seizures Febrile seizuresFebrile seizures Feat

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