Epilepsias y Discapacidades Neurológicas en el Niño by Desiderio Pozo Lauzán Albia Josefina Pozo Alonso

By Desiderio Pozo Lauzán Albia Josefina Pozo Alonso

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La dosis máxima no debe exceder de 40 mg/kg. Sin embargo, en la encefalopatía hipóxica-isquémica algunos especialistas recomiendan una dosis máxima hasta 50 mg/kg. Dosis de mantenimiento: 3 a 4 mg/kg/día (en 2 subdosis). 2. v. Cantidad en plasma: 15 a 25 µg/mL. Dosis de mantenimiento: 4 a 8 mg/kg/día. En 2 subdosis. 3. Fosfenitoína. Es una prodroga fosforilada de la fenitoína. La dosis es similar a la de la fenitoína. Se aplica por vía parenteral. Al inicio se reportaron escasos efectos adversos cardíacos y la irritación en el sitio de la inyección era poco frecuente.

Crisis tónica. Se manifiesta por el aumento del tono postural con contracciones musculares tónicas. Puede afectar los músculos flexores o extensores de forma simétrica. También ocurren crisis tónicas axiales con extensión de la cabeza, cuello y tronco. El electroencefalograma ictal muestra actividad rápida de bajo voltaje o ritmos rápidos de 9 a 10 ciclos/s o más, disminuye en frecuencia y aumenta en amplitud. El electroencefalograma interictal muestra descargas más o menos rítmicas de ondas agudas y ondas lentas, a veces asimétricas.

La asociación de crisis infantiles familiares benignas a una coreoatetosis paroxística constituye un síndrome diferente, que está ligado al cromosoma 16p. Las crisis infantiles familiares benignas se caracterizan por la aparición de crisis focales entre los 3 y 12 meses de edad. Existen antecedentes familiares de crisis similares que ocurrien a la misma edad. Las crisis se manifiestan por desviación de la cabeza y de los ojos, hipertonía generalizada y posteriormente sacudidas bilaterales de los miembros.

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