Seminars in Pediatric Neurology最新文献_第3页

Subacute sclerosing panencephalitis 亚急性硬化性全脑炎

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101207

Pradeep Kumar Gunasekaran , Arushi Gahlot Saini

Subacute sclerosing panencephalitis (SSPE) is a devastating neurodegenerative disorder due to a persistent mutated, wild-measles virus infection of the nervous system. While the acute infection is generally self-limiting, defective viral clearance can lead to the emergence of neurovirulent strains that undergo mutations within the host, evade immune surveillance, establishing chronic central nervous system (CNS) infection. It predominantly affects children and young adults although no age, including infants, is immune to SSPE. The characteristic neurological manifestations include progressive behavioral and cognitive decline, neuromotor impairment, myoclonus, vegetative state and death within 1-3 years of diagnosis, although prolonged stabilization and spontaneous resolution have been reported in a minority of patients. Despite global efforts towards measles elimination, SSPE remains a challenging problem in the low- and middle-income countries (LMICs) due to inadequate vaccine coverage. Limited health infrastructure, suboptimal surveillance, and limited availability of diagnostic tests hinders early diagnosis and management making SSPE a public health crisis. The measles outbreaks in high-income countries with developed vaccination programs are commonly due to international travel, immigration, and vaccine hesitancy, making it a global problem. The lack of effective antiviral therapy makes supportive and palliative care the primary management strategy once SSPE is confirmed. Recent research highlights potential therapeutic strategies, novel molecular approaches targeting mutant measles viruses, and enhanced public health measures to contain the outbreaks. However, these remain largely inaccessible in LMICs with measles endemicity and the high disease burden of SSPE. Urgent action is needed to bridge this gap by strengthening vaccination programs, implementing early diagnostic strategies, and enhancing access to emerging treatments. The current review discusses the various aspects of SSPE and the importance of preventive strategies for SSPE as relevant to LMIC. Without holistic efforts and a multi-pronged approach to eliminate measles and prevent SSPE, the disease shall remain a global threat.

亚急性硬化性全脑炎（SSPE）是一种毁灭性的神经退行性疾病，由于神经系统持续突变，野生麻疹病毒感染。虽然急性感染通常是自限性的，但有缺陷的病毒清除可导致神经毒性毒株的出现，这些毒株在宿主内发生突变，逃避免疫监视，建立慢性中枢神经系统（CNS）感染。它主要影响儿童和年轻人，尽管没有年龄，包括婴儿，对SSPE免疫。特征性神经学表现包括进行性行为和认知能力下降、神经运动障碍、肌阵挛、植物人状态和诊断后1-3年内死亡，尽管少数患者有长期稳定和自发消退的报道。尽管全球努力消除麻疹，但由于疫苗覆盖率不足，SSPE在低收入和中等收入国家仍然是一个具有挑战性的问题。有限的卫生基础设施、不理想的监测和有限的诊断测试的可用性阻碍了早期诊断和管理，使SSPE成为公共卫生危机。在疫苗接种计划发达的高收入国家，麻疹暴发通常是由于国际旅行、移民和疫苗犹豫，使其成为一个全球性问题。缺乏有效的抗病毒治疗使得支持性和姑息治疗成为SSPE确诊后的主要治疗策略。最近的研究强调了潜在的治疗策略，针对突变麻疹病毒的新分子方法，以及加强公共卫生措施以控制疫情。然而，在麻疹流行和SSPE高疾病负担的中低收入国家，这些仍然很大程度上无法获得。需要采取紧急行动，通过加强疫苗接种规划、实施早期诊断战略和提高新兴治疗方法的可及性来弥合这一差距。目前的综述讨论了SSPE的各个方面，以及与LMIC相关的SSPE预防策略的重要性。如果没有全面的努力和多管齐下的方法来消除麻疹和预防SSPE，该疾病将仍然是一个全球威胁。

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引用次数: 0

Pediatric Zika virus: The virus and its neurologic impact 小儿寨卡病毒：病毒及其对神经系统的影响

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101209

Diego A. Cruz-Vidal , Ana M. Cabal-Herrera , Christian A. Rojas

The Zika virus (ZIKV) is a mosquito-borne flavivirus, transmitted by the genus Aedes, and is prevalent in tropical areas. It co-exists and shares a vector with other flaviviruses, such as the dengue virus. Its infection usually leads to a febrile illness undistinguishable of other viruses. Zika virus raised to prominence during an epidemic in the Americas during 2015 and 2016, as the increase in cases coincided with an increase in neonates born with severe microcephaly. This led to the description of congenital Zika syndrome and the establishment of the potential for ZIKV to cause congenital defects and long term neurodevelopmental adverse outcomes.

寨卡病毒（ZIKV）是一种蚊媒黄病毒，由伊蚊属传播，在热带地区流行。它与其他黄病毒（如登革热病毒）共存并共享一个载体。它的感染通常会导致与其他病毒无法区分的发热性疾病。2015年和2016年，寨卡病毒在美洲流行期间引起了人们的关注，因为病例的增加与出生时患有严重小头畸形的新生儿的增加同时发生。这导致了对先天性寨卡综合征的描述，并确立了寨卡病毒可能导致先天性缺陷和长期神经发育不良后果。

引用次数: 0

Chikungunya virus infection: A scoping review highlighting pediatric systemic and neurologic complications 基孔肯雅病毒感染：强调儿童系统和神经系统并发症的范围审查

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101213

Rosana Huerta Albarrán , Amanda Weber , Martha Avilés Robles , Juan Pablo Appendino

Chikungunya virus (CHIKV), a mosquito-borne alphavirus, has emerged as a significant global health concern, particularly due to its neurological complications in pediatric populations. This scope review summarizes current understanding of CHIKV virology, epidemiology, transmission dynamics, and clinical manifestations, with an emphasis on neurologic sequelae in neonates and children. We explore the mechanisms of neuroinvasion, describe central and peripheral nervous system involvement, and outline diagnostic strategies and therapeutic approaches. Although supportive care remains the mainstay of management, novel antiviral agents and vaccines are under active investigation. Understanding age-specific presentations and long-term outcomes is essential to mitigate the impact of this neurotropic virus.

基孔肯雅病毒（CHIKV）是一种蚊子传播的甲病毒，已成为一个重大的全球卫生问题，特别是由于其在儿科人群中的神经系统并发症。这篇综述综述了目前对CHIKV病毒学、流行病学、传播动力学和临床表现的了解，重点是新生儿和儿童的神经系统后遗症。我们探讨神经侵犯的机制，描述中枢和周围神经系统的累及，并概述诊断策略和治疗方法。虽然支持治疗仍然是治疗的主要手段，但新的抗病毒药物和疫苗正在积极研究中。了解年龄特异性表现和长期结果对于减轻这种嗜神经病毒的影响至关重要。

引用次数: 0

Exploring the burden of West Nile Virus in resource limited regions: Challenges and implications for pediatric neurology 探索西尼罗病毒在资源有限地区的负担：对儿科神经病学的挑战和影响

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101208

Alcy Torres , Irving Zhao , Jombo Namushi , Gwen Kandawasvika

West Nile Virus (WNV) is a vector-borne pathogen that poses significant public health challenges worldwide, particularly in regions with limited resources. While the virus is endemic in many parts of the globe, its impact on low-income countries remains disproportionately high due to inadequate healthcare infrastructure, limited surveillance systems, and lack of public health awareness.

This article explores the burden of WNV in these resource-constrained regions, focusing on the epidemiology, socio-economic consequences, and healthcare challenges faced by affected populations. It discusses the multifactorial factors contributing to the spread of WNV, including climate change, urbanization, and weak mosquito control measures.

Additionally, the article examines the implications for healthcare systems, such as the overwhelming demand for medical resources, limited diagnostic capacity, and gaps in effective treatment and prevention strategies. The article emphasizes the need for enhanced surveillance, early detection systems, and integrated public health strategies tailored to low-resource settings. It also calls for international collaboration and funding to improve research, prevention, and response mechanisms in these vulnerable regions.

西尼罗河病毒（WNV）是一种媒介传播的病原体，在世界范围内，特别是在资源有限的地区，对公共卫生构成重大挑战。虽然该病毒在全球许多地区流行，但由于卫生保健基础设施不足、监测系统有限以及公众卫生意识缺乏，其对低收入国家的影响仍然过高。本文探讨了这些资源受限地区的西尼罗河病毒负担，重点关注受影响人群面临的流行病学、社会经济后果和卫生保健挑战。它讨论了导致西尼罗河病毒传播的多因素因素，包括气候变化、城市化和蚊虫控制措施薄弱。此外，本文还研究了对医疗保健系统的影响，例如对医疗资源的巨大需求、有限的诊断能力以及有效治疗和预防策略方面的差距。这篇文章强调需要加强监测、早期发现系统和针对低资源环境的综合公共卫生战略。它还呼吁国际合作和资助，以改善这些脆弱地区的研究、预防和应对机制。

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引用次数: 0

Cerebral malaria 脑型疟疾

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101206

Douglas G. Postels , Thembi Katangwe-Chirwa

Cerebral malaria is the most lethal form of Plasmodium falciparum infection. The disease is defined clinically as an otherwise unexplained coma in someone with malaria parasitemia. One in 6 children with cerebral malaria dies and many survivors are left with neurologic, cognitive, or behavioral sequelae. Acute seizures are common and increasing numbers of them during the index illness are associated with a greater likelihood of adverse outcomes. Optimal treatment pathways for children with cerebral malaria have been standardized but the search for an adjunctive therapy that decreases cerebral malaria mortality or morbidity has, so far, remained elusive. After hospital discharge, care gaps for survivors continue in the diagnosis and management of educational challenges, behavioral abnormalities, and epilepsy, especially in the rural settings where malaria incidence is highest. In the past decade, science has elucidated much about cerebral malaria pathogenesis. Observational studies using magnetic resonance imaging, electroencephalogram, and transcranial doppler have all provided insight on the pathway from the initial infection transmitted by a mosquito, to death. Findings from each of these high technology modalities are also associated with outcomes in children with cerebral malaria. We review the epidemiology, clinical features, diagnostic considerations, optimal clinical care pathways, neurological sequalae, and existing care gaps in the management of cerebral malaria and its complications.

脑型疟疾是恶性疟原虫感染的最致命形式。该病在临床上被定义为疟疾寄生虫病患者出现不明原因的昏迷。患有脑疟疾的儿童中有六分之一死亡，许多幸存者留下了神经、认知或行为后遗症。急性发作是常见的，在指数疾病期间增加的数量与更大的不良后果的可能性相关。脑型疟疾儿童的最佳治疗途径已经标准化，但迄今为止，寻找降低脑型疟疾死亡率或发病率的辅助疗法仍然难以实现。出院后，幸存者在诊断和管理教育挑战、行为异常和癫痫方面仍然存在护理差距，特别是在疟疾发病率最高的农村地区。在过去的十年里，科学已经阐明了很多关于脑型疟疾发病机制的知识。使用磁共振成像、脑电图和经颅多普勒的观察性研究都提供了从蚊子传播的最初感染到死亡的途径。每一种高技术模式的发现也与脑型疟疾患儿的预后有关。我们回顾了流行病学、临床特征、诊断注意事项、最佳临床护理途径、神经系统后遗症以及脑疟疾及其并发症管理中的现有护理差距。

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引用次数: 0

Neurological disorders related to pediatric dengue infection 与小儿登革热感染相关的神经系统疾病

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101210

Manuel Vides-Rosales , Diego Vides-Tesorero , Jaime Twanow

In the last decade, Dengue virus has become a major public health concern, with increasing numbers of infections, hospitalizations, and deaths worldwide. The Aedes mosquito vector’s migration, aided by adaptation to climate change has allowed Dengue virus to spread into temperate regions. The major impact of the disease occurs in regions with limited resources, creating a significant burden for these countries. There is a growing body of information characterizing the neurological disorders related to pediatric Dengue infection. In addition to reviewing Dengue virus structure, disease diagnostic criteria and current WHO guidelines, this article discusses the neuropathogenic mechanisms of infection, and the resultant impact on the central and peripheral nervous systems. Our group has created a framework correlating the presentation of neurologic disorders to Dengue virus phases of infection. There is an urgent need for epidemiological analysis and a systematic approach to catalogue the emerging reports of pediatric neurological disorders related to dengue virus infection. We propose that key regional and professional stakeholders could foster educational advances and improve preventative, diagnostic and therapeutic care of pediatric patients impacted by Dengue virus.

在过去十年中，登革热病毒已成为一个主要的公共卫生问题，全世界感染、住院和死亡人数不断增加。伊蚊媒介的迁移，在适应气候变化的帮助下，使登革热病毒传播到温带地区。该病的主要影响发生在资源有限的区域，给这些国家造成重大负担。越来越多的信息描述了与小儿登革热感染有关的神经系统疾病。除了回顾登革病毒结构、疾病诊断标准和目前的世卫组织指南外，本文还讨论了感染的神经致病机制以及对中枢和周围神经系统的影响。我们的小组创建了一个框架，将神经系统疾病的表现与登革热病毒感染阶段联系起来。目前迫切需要进行流行病学分析，并采用系统方法对与登革热病毒感染有关的儿科神经系统疾病的新报告进行编目。我们建议，关键的区域和专业利益攸关方可以促进教育进步，改善受登革热病毒影响的儿科患者的预防、诊断和治疗护理。

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引用次数: 0

Viral and parasitic infections of the nervous system: Impact on resource-limited healthcare systems and suggestions on how to address them 神经系统的病毒和寄生虫感染：对资源有限的卫生保健系统的影响以及如何解决这些问题的建议

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101201

Jorge Vidaurre , Pedro Weisleder

Affecting every country to some degree, disparities in healthcare access are a global challenge. Healthcare systems in low- and middle-income countries (LMICs) are, however, particularly fragile and more vulnerable to the unpredictable demands that arise from both natural and man-made disasters. Resource availability in the healthcare systems of LMICs is often inconsistent and, in many cases, insufficient to meet the needs of the local population. One major health concern in LMICs is the high burden of parasitic and viral infections of the nervous system, illnesses that cause significant morbidity and mortality. Over the past 50 years, several LMICs in tropical and subtropical regions have experienced an emergence, re-emergence, or upswing in arthropod-borne viral diseases such as dengue, chikungunya, and Zika. Herein we propose a series of practical and universally applicable solutions aimed at both reducing healthcare demand and strengthening at-risk healthcare systems in LMICs.

医疗保健获取方面的差距在一定程度上影响到每个国家，是一项全球性挑战。然而，低收入和中等收入国家（LMICs）的卫生保健系统特别脆弱，更容易受到自然灾害和人为灾害带来的不可预测需求的影响。中低收入国家卫生保健系统的可用资源往往不一致，在许多情况下，不足以满足当地人口的需求。低收入和中等收入国家的一个主要健康问题是神经系统寄生虫和病毒感染的高负担，这些疾病会导致严重的发病率和死亡率。在过去50年中，热带和亚热带地区的几个低收入国家经历了登革热、基孔肯雅热和寨卡等节肢动物传播的病毒性疾病的出现、重新出现或上升。在此，我们提出了一系列实用和普遍适用的解决方案，旨在减少医疗保健需求和加强中低收入国家的风险医疗保健系统。

引用次数: 0

Pediatric Neurocysticercosis. Burden of pediatric neurological disorders in resource-limited regions 小儿脑囊尾蚴病。资源有限地区儿童神经系统疾病负担

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101211

Bolivar Quito-Betancourt , Monica Cajas-Palomino , Manuel Vides-Tesorero , Arturo Carpio

Neurocysticercosis (NCC) is caused by the parasitic tapeworm Taenia solium, which frequently infects the central nervous system of children and adults. Diagnosis involves a thorough medical history, with an emphasis on the epidemiological conditions of the affected individuals. Understanding the parasite's life cycle and the host's immune response is for a deeper comprehension of their mutual interaction. The most common clinical manifestations include seizures, headaches, increased intracranial pressure, cranial nerve involvement, cognitive dysfunction, radicular and spinal compression symptoms, and ultimately, vision loss, depending on the locations of the lesions. It is essential to know the neuroradiological findings and how they can correlate with the viability and evolutionary stages of the parasite. Since seizures are noted as the most prevalent symptom in the pediatric population, it is crucial to understand how to manage them and the associated symptoms, such as inflammation and other complications. When appropriate, conducting immunological tests and utilizing molecular assays are vital to determine the specificity and sensitivity of these methods in aiding the diagnosis of NCC, especially when neuroimaging results are inconclusive. NCC is classified as active, transitional, or inactive to guide the selection of appropriate treatment options, including antiseizure medications, antiparasitic drugs, anti-inflammatory medications, and surgery when necessary. This document also aims to explore the differences in the natural history of this condition in pediatric populations compared to adults. Prevention and education are the most effective strategies for combating this infection, particularly in underdeveloped areas.

神经囊虫病（NCC）是由寄生绦虫猪带绦虫引起的，它经常感染儿童和成人的中枢神经系统。诊断包括全面的病史，重点是受影响个体的流行病学状况。了解寄生虫的生命周期和宿主的免疫反应是为了更深入地理解它们之间的相互作用。最常见的临床表现包括癫痫发作、头痛、颅内压升高、脑神经受累、认知功能障碍、神经根和脊柱压迫症状，并最终出现视力丧失，这取决于病变的位置。至关重要的是要知道神经放射学的发现，以及它们如何与寄生虫的生存能力和进化阶段相关联。由于癫痫发作是儿科人群中最普遍的症状，因此了解如何控制癫痫发作及其相关症状（如炎症和其他并发症）至关重要。在适当的情况下，进行免疫学测试和利用分子分析对于确定这些方法在帮助诊断NCC时的特异性和敏感性至关重要，特别是在神经影像学结果不确定的情况下。NCC分为活动性、过渡性和非活动性，以指导适当治疗方案的选择，包括抗癫痫药物、抗寄生虫药物、抗炎药物和必要时的手术。本文还旨在探讨与成人相比，儿童人群中这种疾病的自然史差异。预防和教育是防治这种感染的最有效战略，特别是在欠发达地区。

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引用次数: 0

Neuro-ophthalmic sequelae of pediatric brain tumors 小儿脑肿瘤的神经眼后遗症

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-04-01 DOI: 10.1016/j.spen.2025.101182

Evguenia Ivakhnitskaia , Dhristie Bhagat

Brain tumors are a leading cause of mortality and morbidity in the pediatric population. Neuro-ophthalmic symptoms can be a consequence of the disease process, as well as a feature of long-term complications from treatment. Compressive lesions of the visual pathway lead to changes in visual acuity and field defects. Double vision and strabismus can be some of the earliest clues of underlying posterior fossa tumors, which frequently cause hydrocephalus and manifest as optic nerve edema on neuro-ophthalmic examination due to increased intracranial pressure. Persistent complaints of blurry vision in combination with nonspecific neurologic concerns warrant ophthalmoscopy to appreciate optic nerve appearance and magnetic resonance imaging as the earliest steps in the investigation of possible compressive or infiltrative malignancies. In many cases, treatment of pediatric brain tumors relies on maximal surgical resection and radiation, which can have permanent consequences not only affecting the patients’ visual function but also their neurologic development. This review will summarize the neuro-ophthalmic presentations and consequences of pediatric tumors affecting the brain, highlighting classic neuro-ophthalmic correlates and describing the known sequelae of tumor progression or treatment.

脑肿瘤是儿童死亡率和发病率的主要原因。神经眼症状可能是疾病过程的结果，也是治疗长期并发症的特征。视觉通路的压缩性病变导致视力的改变和视野缺损。复视和斜视可能是潜在后窝肿瘤的早期线索，常引起脑积水，并在神经眼科检查中因颅内压升高而表现为视神经水肿。持续的视力模糊和非特异性的神经系统问题，需要眼科检查来观察视神经的外观和磁共振成像，作为调查可能的压缩性或浸润性恶性肿瘤的最早步骤。在许多情况下，儿童脑肿瘤的治疗依赖于最大限度的手术切除和放疗，这不仅会影响患者的视觉功能，还会影响他们的神经发育。这篇综述将总结影响大脑的儿童肿瘤的神经眼科表现和后果，突出经典的神经眼科相关因素，并描述肿瘤进展或治疗的已知后遗症。

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引用次数: 0

Epilepsy in patients with pediatric brain tumors: Etiology, treatment & management 小儿脑肿瘤患者的癫痫：病因、治疗和管理

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Seminars in Pediatric Neurology

Pub Date : 2025-04-01 DOI: 10.1016/j.spen.2025.101187

Anna Ku, Abdolreza Esfahanizadeh

Central nervous system (CNS) tumors are the most common solid tumor type seen in the pediatric population and may present with a variety of neurological presentations, with seizure being the second most common. Supratentorial tumors commonly associated with seizures include low-grade gliomas such as pilocytic astrocytoma, subependymal giant cell astrocytoma (SEGA), gangliogliomas, and dysembryoplastic neuroepithelial tumors (DNET).

The etiology of seizures in pediatric brain tumor patients is often multifactorial, often the result of multimodal therapy and possible contributions from surgery, radiation therapy, chemotherapy, and other metabolic disturbances. Seizures can also be secondary to mass effect, hydrocephalus, or metastases. Additionally, tumor characteristics including its location in the temporal lobe, the presence of mixed neuronal and glial components, and the tumor's size and growth rate influence the likelihood of seizures.

Pediatric patients with a first lifetime unprovoked seizure should undergo further testing including electroencephalogram (EEG). MRI imaging is not warranted in all cases but should be strongly considered for children with focal presentation or EEG finding to identify possibly secondary causes such as brain tumors. The EEG can identify background activity alterations, epileptiform activity, and/or seizure activity, but sensitivity and specificity are limited and therefore, should be used in conjunction with neuroimaging like an MRI for a comprehensive evaluation.

Anti-seizure medication (ASM) is not recommended to be started in patients with a brain tumor without seizures, but rather only in patients that were identified with brain tumor who presented with seizures. ASM choices are influenced by patient's co-morbidities, drug interactions with chemotherapy, and the patient's tolerance to potential adverse drug reactions. With its limited drug-drug interactions, the most commonly used ASM is levetiracetam. Ultimately, gross total resection of the tumor if feasible is often favored for both diagnostic and therapeutic benefits, as well as seizure control.

中枢神经系统（CNS）肿瘤是儿科人群中最常见的实体肿瘤类型，可能表现为多种神经学表现，癫痫发作是第二常见的。通常与癫痫发作相关的幕上肿瘤包括低级别胶质瘤，如毛细胞星形细胞瘤、室管膜下巨细胞星形细胞瘤（SEGA）、神经节胶质瘤和胚胎发育异常神经上皮肿瘤（DNET）。小儿脑肿瘤患者癫痫发作的病因通常是多因素的，通常是多模式治疗的结果，可能是手术、放射治疗、化疗和其他代谢紊乱的结果。癫痫发作也可继发于肿块效应、脑积水或转移。此外，肿瘤的特征，包括其在颞叶的位置，混合神经元和胶质成分的存在，肿瘤的大小和生长速度影响癫痫发作的可能性。首次发作的儿童患者应接受进一步的检查，包括脑电图（EEG）。并非所有病例都需要MRI成像，但应强烈考虑有局灶性表现或脑电图发现的儿童，以确定可能的继发原因，如脑肿瘤。脑电图可以识别背景活动改变、癫痫样活动和/或癫痫发作活动，但敏感性和特异性有限，因此，应与MRI等神经影像学结合使用，以进行全面评估。抗癫痫药物（ASM）不推荐在没有癫痫发作的脑肿瘤患者中开始使用，而只推荐在确定有癫痫发作的脑肿瘤患者中使用。ASM的选择受患者的合并症、药物与化疗的相互作用以及患者对潜在药物不良反应的耐受性的影响。由于药物相互作用有限，最常用的ASM是左乙拉西坦。最终，如果可行的话，总的肿瘤全切除术通常有利于诊断和治疗，以及控制癫痫发作。

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引用次数: 0