Seizures in neonates represent a neurologic emergency requiring prompt recognition, determination of etiology, and treatment. Yet, the definition and identification of neonatal seizures remain challenging and controversial, in part due to the unique physiology of brain development at this life stage. These issues are compounded when considering seizures in premature infants, in whom the complexities of brain development may engender different clinical and electrographic seizure features at different points in neuronal maturation. In extremely premature infants (< 28 weeks gestational age), seizure pathophysiology has not been explored in detail. This review discusses the physiological and structural development of the brain in this developmental window, focusing on factors that may lead to seizures and their consequences at this early time point. We hypothesize that the clinical and electrographic phenomenology of seizures in extremely preterm infants reflects the specific pathophysiology of brain development in that age window.

中文翻译：

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癫痫发作多早发生？极端早产儿大脑发育的病理生理学考虑。

新生儿癫痫发作代表神经系统紧急情况，需要迅速识别，病因确定和治疗。然而，新生儿癫痫发作的定义和鉴定仍然具有挑战性和争议性，部分原因是这一生阶段大脑发育的独特生理学。考虑早产婴儿的癫痫发作时，这些问题变得更加复杂，因为大脑发育的复杂性可能会在神经元成熟的不同点引起不同的临床和电图发作特征。在极早产儿（胎龄小于28周）中，癫痫的病理生理学尚未得到详细探讨。这篇评论讨论了在这个发育窗口中大脑的生理和结构发育，在此早期时间集中于可能导致癫痫发作的因素及其后果。我们假设极早产儿癫痫发作的临床和电子照相现象学反映了该年龄窗内大脑发育的特定病理生理学。