Robin M. Litten, Amy L. Patterson, Amy L. McGregor, Basanagoud Mudigoudar, Nitish Chourasia
{"title":"新生儿自主性癫痫发作的临床表现、病因和治疗反应：病例系列","authors":"Robin M. Litten, Amy L. Patterson, Amy L. McGregor, Basanagoud Mudigoudar, Nitish Chourasia","doi":"10.1002/cns3.20046","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Neonatal autonomic signs such as apnea, cyanosis, pallor, and desaturation rarely occur as isolated ictal phenomena and require a high degree of clinical suspicion in combination with continuous video electroencephalogram (vEEG) to establish a diagnosis.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We review the clinical profile, etiology, and treatment response in five neonates who presented with apnea as the primary seizure semiology.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Ictal apneic episodes were confirmed on continuous vEEG in all five infants within 24–48 h of symptom onset. Seizure etiologies included structural, infectious, and genetic, including a neonate with <i>ANKRD11</i>-associated KBG syndrome, in which ictal apnea has not been previously described. Acute seizures resolved in all neonates following treatment with a single or combination of antiseizure medications.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Abrupt onset and clustering episodes of apnea and oxygen desaturation in term infants should raise suspicion for epileptic seizures. Genetic testing should be considered as part of the diagnostic evaluation for autonomic seizures of unknown etiology. Early diagnosis and treatment of neonatal autonomic seizures may lead to excellent treatment response in the acute setting.</p>\n </section>\n </div>","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 4","pages":"312-319"},"PeriodicalIF":0.0000,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20046","citationCount":"0","resultStr":"{\"title\":\"Clinical spectrum, etiology, and treatment response in neonatal autonomic seizures: A case series\",\"authors\":\"Robin M. Litten, Amy L. Patterson, Amy L. McGregor, Basanagoud Mudigoudar, Nitish Chourasia\",\"doi\":\"10.1002/cns3.20046\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Neonatal autonomic signs such as apnea, cyanosis, pallor, and desaturation rarely occur as isolated ictal phenomena and require a high degree of clinical suspicion in combination with continuous video electroencephalogram (vEEG) to establish a diagnosis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We review the clinical profile, etiology, and treatment response in five neonates who presented with apnea as the primary seizure semiology.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Ictal apneic episodes were confirmed on continuous vEEG in all five infants within 24–48 h of symptom onset. Seizure etiologies included structural, infectious, and genetic, including a neonate with <i>ANKRD11</i>-associated KBG syndrome, in which ictal apnea has not been previously described. Acute seizures resolved in all neonates following treatment with a single or combination of antiseizure medications.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Abrupt onset and clustering episodes of apnea and oxygen desaturation in term infants should raise suspicion for epileptic seizures. Genetic testing should be considered as part of the diagnostic evaluation for autonomic seizures of unknown etiology. Early diagnosis and treatment of neonatal autonomic seizures may lead to excellent treatment response in the acute setting.</p>\\n </section>\\n </div>\",\"PeriodicalId\":72232,\"journal\":{\"name\":\"Annals of the Child Neurology Society\",\"volume\":\"1 4\",\"pages\":\"312-319\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-11-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20046\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of the Child Neurology Society\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/cns3.20046\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of the Child Neurology Society","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cns3.20046","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Clinical spectrum, etiology, and treatment response in neonatal autonomic seizures: A case series
Background
Neonatal autonomic signs such as apnea, cyanosis, pallor, and desaturation rarely occur as isolated ictal phenomena and require a high degree of clinical suspicion in combination with continuous video electroencephalogram (vEEG) to establish a diagnosis.
Methods
We review the clinical profile, etiology, and treatment response in five neonates who presented with apnea as the primary seizure semiology.
Results
Ictal apneic episodes were confirmed on continuous vEEG in all five infants within 24–48 h of symptom onset. Seizure etiologies included structural, infectious, and genetic, including a neonate with ANKRD11-associated KBG syndrome, in which ictal apnea has not been previously described. Acute seizures resolved in all neonates following treatment with a single or combination of antiseizure medications.
Conclusions
Abrupt onset and clustering episodes of apnea and oxygen desaturation in term infants should raise suspicion for epileptic seizures. Genetic testing should be considered as part of the diagnostic evaluation for autonomic seizures of unknown etiology. Early diagnosis and treatment of neonatal autonomic seizures may lead to excellent treatment response in the acute setting.
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