Editorial
Neonatal neurological advances
Avances en neurología neonatal
Rev Neurol 2000
, 31(7),
601–604;
https://doi.org/10.33588/rn.3107.2000328
Abstract
INTRODUCTION Notable changes have occurred in the field of neonatology in recent years. Logically, neonatal neurology has made a major contribution to this progress. DEVELOPMENT and
CONCLUSIONS Knowledge in the field of neonatal neurology has multiplied: fetal neurology has developed, fetal and neonatal welfare is better understood, and spectacularly modified by techniques of assisted ventilation. High resolution ultrasonography permits visualization of fetal cerebral anomalies, the treatment of hypoxic encephalopathy is advancing as is non-invasive cerebral hemodynamic monitoring. Neuroimaging techniques let us see not only the structure of the brain but also how it functions, to some extent. New antiepileptic drugs have appeared. Various treatable causes of neonatal convulsions have been identified. Infections and the incidence of hemorrhage in premature babies have fallen at the same time as new metabolic disease of neonatal onset (protein glycosilation, folinic-sensitive convulsions and adenylsuccinate deficiency) have been identified. Ethics committees for consensual decisions in neonatal intensive care units have become established. We emphasize the need for units for the follow-up of newborn babies with a risk of developing neurological complications, with programmes adapted to the needs of each individual centre
CONCLUSIONS Knowledge in the field of neonatal neurology has multiplied: fetal neurology has developed, fetal and neonatal welfare is better understood, and spectacularly modified by techniques of assisted ventilation. High resolution ultrasonography permits visualization of fetal cerebral anomalies, the treatment of hypoxic encephalopathy is advancing as is non-invasive cerebral hemodynamic monitoring. Neuroimaging techniques let us see not only the structure of the brain but also how it functions, to some extent. New antiepileptic drugs have appeared. Various treatable causes of neonatal convulsions have been identified. Infections and the incidence of hemorrhage in premature babies have fallen at the same time as new metabolic disease of neonatal onset (protein glycosilation, folinic-sensitive convulsions and adenylsuccinate deficiency) have been identified. Ethics committees for consensual decisions in neonatal intensive care units have become established. We emphasize the need for units for the follow-up of newborn babies with a risk of developing neurological complications, with programmes adapted to the needs of each individual centre
Resumen
Introducción Los cambios que se han producido en el campo de la neonatología en los últimos años han sido notables. Lógicamente la neurología neonatal ha contribuido sustancialmente a este progreso. Desarrollo y conclusiones. Los conocimientos en el campo de la neurología neonatal se han multiplicado: aparece la neurología fetal, se conoce mejor el estado de bienestar fetal y neonatal y se modifican espectacularmente las técnicas de ventilación asistida. La ultrasonografía de alta resolución permite visualizar en el feto anomalías cerebrales, se progresa en el tratamiento de la encefalopatía hipóxica y en la monitorización no invasiva de la hemodinámica cerebral. Las técnicas de neuroimagen nos permiten no solamente ver la estructura del cerebro sino, además, parte de su funcionalismo; aparecen nuevos fármacos antiepilépticos, se identifican diversas causas tratables de convulsiones neonatales, disminuyen las infecciones y la incidencia de hemorragia en el prematuro, al tiempo que se identifican nuevas enfermedades metabólicas de presentación neonatal (glicosilación de las proteínas, convulsiones folínico sensibles, deficiencia de adenilosuccinato). Se consolidan los comités de ética para tomar decisiones consensuadas en las Unidades de Cuidados Intensivos Neonatales y se insiste en la necesidad de disponer de unidades para el seguimiento del recién nacido de riesgo neurológico con programas adaptados a las necesidades de cada centro
Keywords
Ethics committee
Follow-up of risk
Hypoxic encephalopathy
Neonatal neurological advances
Neuroimaging
Seizures
Palabras Claves
Avances en neurología neonatal
Comité de ética
Convulsión
Convulsiones
Crisis
Crisis comicial
Crisis convulsiva
Crisis epiléptica
Diagnóstico por la imagen
Encefalopatía hipóxica
Escaner
Escaner cerebral
Imaginología
Mielografía
Neumoencefalografía
Neuroimagen
Neuroimaginología
Neurorradiología
Radiología
Radiología craneal
Radiología simple
Resonancia magnética nuclear
Riesgo
Seguimiento
SPECT
Tomografía axial computarizada
Tomografía axial computarizada helicoidal
Tomografía computarizada por emisión de fotón simple