신생아 경련성 질환의 항경련제 요법
Anticonvulsant Therapy in Neonate
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The immature neonatal brain is susceptible to the development of seizures. Seizures occur in 1% to 5% of infants during the neonatal period. Neonatal seizures are most commonly associated with serious acute illnesses, such as hypoxic-ischemic encephalopathy, birth trauma, metabolic disturbances, or infections. Thus, newborn infants with seizures are at risk for neonatal death and survivors are at risk for neurologic impairment, developmental delay, and subsequent epilepsy. Experimental data have also raised concerns about the potential adverse effects of the currently used anticonvulsants in neonates on brain development. Therefore, in the management of neonatal seizures, confirmatory diagnosis and optimal, but shorter, duration of anticonvulsant therapy is essential. Nevertheless, there has been substantial progress in understanding the developmental mechanisms that influence seizure generation and responsiveness to anticonvulsants. The currently used therapies have limited efficacy and the treatment of neonatal seizures has not significantly changed in the past several decades, This review includes an overview of current approaches to the treatment of neonatal seizures.
Abstract
The immature neonatal brain is susceptible to the development of seizures. Seizures occur in 1% to 5% of infants during the neonatal period. Neonatal seizures are most commonly associated with serious acute illnesses, such as hypoxic-ischemic encephalopathy, birth trauma, metabolic disturbances, or infections. Thus, newborn infants with seizures are at risk for neonatal death and survivors are at risk for neurologic impairment, developmental delay, and subsequent epilepsy. Experimental data have also raised concerns about the potential adverse effects of the currently used anticonvulsants in neonates on brain development. Therefore, in the management of neonatal seizures, confirmatory diagnosis and optimal, but shorter, duration of anticonvulsant therapy is essential. Nevertheless, there has been substantial progress in understanding the developmental mechanisms that influence seizure generation and responsiveness to anticonvulsants. The currently used therapies have limited efficacy and the treatment of neonatal seizures has not significantly changed in the past several decades, This review includes an overview of current approaches to the treatment of neonatal seizures.
참고문헌 (30)
- Ronen GM, "The epidemiology of clinical neonatal seizures in Newfoundland: a population-based study", J Pediatr, 134, pp.71~75 (1999)
- Bassan H, "Neonatal seizures: dilemmas in workup and management", Pediatr Neurol, 38, pp.415~421 (2008)
- Bartha AI, "Neonatal seizures: multicenter variability in current treatment practices", Pediatr Neurol, 37, pp.85~90 (2007)
- Guillet R, "Prophylactic phenobarbital administration after resolution of neonatal seizures: survey of current practice", Pediatrics, 122, pp.731~735 (2008)
- Carmo KB, "Drug treatment of neonatal seizures by neonatologists and paediatric neurologists", J Paediatr Child Health, 41, pp.313~316 (2005)
- Wheless JW, "Treatment of pediatric epilepsy: European expert opinion, 2007", Epileptic Disord, 9, pp.353~412 (2007)
- Volpe JJ, "Neurology of the newborn. 5th ed", pp.203~244 (2008), WB Saunders Co
- Ben-Ari Y, "Basic developmental rules and their implications for epilepsy in the immature brain", Epileptic Disord, 8, pp.91~102 (2006)
- Velísková J, "Seizures in the developing brain", Epilepsia, 45(8), pp.6~12 (2004)
- Haut SR, "Susceptibility of immature and adult brains to seizure effects", Lancet Neurol, 3, pp.608~617 (2004)
- Holopainen IE, "Seizures in the developing brain: cellular and molecular mechanisms of neuronal damage, neurogenesis and cellular reorganization", Neurochem Int, 52, pp.935~947 (2008)
- Clancy RR, "Occult neonatal seizures", Epilepsia, 29, pp.256~261 (1988)
- Murray DM, "Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures", Arch Dis Child Fetal Neonatal Ed, 93, pp.F187~F191 (2008)
- Alfonso I, "Similar brain SPECT findings in subclinical and clinical seizures in two neonates with hemimegalencephaly", Pediatr Neurol, 19, pp.132~134 (1998)
- Boylan GB, "Phenobarbitone, neonatal seizures, and video-EEG", Arch Dis Child Fetal Neonatal Ed, 86, pp.F165~F170 (2002)
- Bittigau P, "Antiepileptic drugs and apoptotic neurodegeneration in the developing brain", Proc Natl Acad Sci USA, 통권 : 99, pp.15089~15094 (2002)
- Calandre EP, "Cognitive effects of long-term treatment with phenobarbital and valproic acid in school children", Acta Neurol Scand, 81, pp.504~506 (1990)
- Farwell JR, "Phenobarbital for febrile seizures--effects on intelligence and on seizure recurrence", N Engl J Med, 322, pp.364~369 (1990)
- Riva D, "Discontinuation of phenobarbital in children: effects on neurocognitive behavior", Pediatr Neurol, 14, pp.36~40 (1996)
- Sulzbacher S, "Late cognitive effects of early treatment with phenobarbital", Clin Pediatr (Phila), 38, pp.387~394 (1999)
- Ben-Ari Y, "GABA: a pioneer transmitter that excites immature neurons and generates primitive oscillations", Physiol Rev, 87, pp.1215~1284 (2007)
- Clancy RR, "The newborn drug development initiative workshop: Summary proceedings from the neurology group on neonatal seizures", Clin Ther, 28, pp.1342~1352 (2006), Neurology Group on Neonatal Seizures
- Boylan GB, "Second-line anticonvulsant treatment of neonatal seizures: a video-EEG monitoring study", Neurology, 62, pp.486~488 (2004)
- Silverstein FS, "Neonatal seizures", Ann Neurol, 62, pp.112~120 (2007)
- Meador KJ, "In utero antiepileptic drug exposure: fetal death and malformations", Neurology, 67, pp.407~412 (2006)
- Gamstorp I, "Neonatal convulsions treated with continuous, intravenous infusion of diazepam", Ups J Med Sci, 87, pp.143~149 (1982)
- Hu KC, "Continuous midazolam infusion in the treatment of uncontrollable neonatal seizures", Acta Paediatr Taiwan, 44, pp.279~281 (2003)
- Bonati M, "Thiopental efficacy in phenobarbital-resistant neonatal seizures", Dev Pharmacol Ther, 15, pp.16~20 (1990)
- Alfonso I, "Intravenous valproate dosing in neonates", J Child Neurol, 15, pp.827~829 (2000)
- Gal P, "Valproic acid efficacy, toxicity, and pharmacokinetics in neonates with intractable seizures", Neurology, 38, pp.467~471 (1988)