ObjectiveTo study the clinical features of children with seizures as core symptoms of neuronal surface antibody syndromes. MethodsThe clinical data of neuronal surface antibody syndromes between December 2015 and December 2016 were obtained and analyzed. All children presented to hospital with seizures as core symptoms. ResultsThere were 1 male and 9 females in this study. The ages ranged from 3 years to 13 years. The disease course was between 3 and 14 days. All children presented to hospital with seizures as core symptoms.Two children had tonic seizures. one had tonic-clonic seizure. Seven had partial seizures. Among them, six children had status epilepticus and cluster attack. The other symptoms in the course of the disease were psychiatric symptoms and extrapyramidal symptoms.The anti-NMDAR antibody were found in 9 patients' CSF and blood. The LGI1 antibody was found in one patients' CSF and blood.The EEG test of 7 patients showed slow wave and sharp slow wave. Two showed spike wave. One showed slow wave.The MRI test of one patient showed abnormal. Ten cases were treated with IVIG and methylprednisolone during acute stage. The patients had been followed up for 3 to 6 months. Eight of them recovered completely. Two cases had seizures. Two cases diagnosed with anti-NMDAR related epilepsy received sound effects after treated with cyclophosphamide. ConclusionsConvulsion may be the first common symptom of neuronal surface antibody syndromes in children. Immune factors should be screened when children with acute seizures and status epilepticus. Accompanying psychiatric symptoms, autoimmune epilepsy should be considered. The most common neuronal surface antibody in children with neuronal surface antibody syndromes is NMDAR antibody. EEG usually shows slow wave and sharp slow wave during seizures. Brain MRI is usually normal. Immunotherapy is effective in the majority of patients as the first line treatment. When the first-line treatment failed, second-line immunotherapy such as cyclophosphamide shock therapy on a regular basis is helpful.
ObjectiveTo summarize the clinical characteristics of epilepsy comorbid with tic disorders in children, and discuss its diagnosis, treatment and management. MethodsThe clinical data of 12 epileptic children comorbid with tic disorders treated in Wuhan children's Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from December, 2018 to June, 2021 was collected retrospectively. The clinical characteristics, EEG, MRI, treatment, prognosis of epileptic children comorbid with tic disorders were analyzed and summarized. ResultsThere were 12 epileptic children comorbid with tic disorders in total, 11 males, 1 female, average (10.0±2.9) years old. The onset age of epilepsy was ranged from 0.6 to 11 years old, average (6.5±3.3) years old. The onset age of tic disorders ranged from 3.5 to 11 years old, average (7.2±2.0) years old. The epileptic seizure types included focal seisures (Focal, 8 cases), atypical absence seizures(AAS, 2 cases), myoclonic seizure (MS, 1 case), generalized tonic-clonic seisures (GTCS, 3 cases). The epileptic syndromes included benign epilepsy with centrotemporal spikes (BECT, 2 cases), Dravet syndrome (1 case), juvenile myoclonic epilepsy(JME, 1 case), temporal lobe epilepsy (TLE, 1 case).The average oral antiepileptic seizure drug was 1, including lamotrigine(LTG), valproic acid(VPA), oxcarbazepine(OXC), levetiracetam(LEV), topiramate(TPM) and Perampanel. The clinical course of tic disorders ranged from 0.5 to 3.0 years, average (1.5±0.9) years. The clinical types included provisional tic disorder (PTD, 4 cases), chronic tic disorder (CTD, 5 cases, all of which were motor tics) and Tourette syndrome (TS, 3 cases). The severity of tic disorders was mild up to the last follow-up. In addition to tic disorders, other comorbidities included attention deficit and hyperactivity disorder (ADHD, 2 cases), 1 children was mixed type, 1 children was hyperactive impulse dominated type, psychomotor development disorder(3 cases), enuresis (1 case) and emotional disorder (1 case). There were interictal epileptiform discharges in 12 children with EEG, including focal discharges(7 cases, 1 EEG showed that focal discharges originated from the right temporal region), multiple discharges (5 cases, 1 EEG showed that multiple discharges originated from the right centro-temporal region), and clinical seizures were monitored in 6 cases (3 cases of focal seizures, 2 cases of atypical absence seizures, and 1 case of myoclonic seizure). Magnetic resonance imaging (MRI) of head showed no obvious abnormalities. The follow-up time was ranged from 0.5 to 3.0 years. Up to the last follow-up (2022.01.01), 8 cases of epilepsy had been controlled and 4 cases of tic disorders were cured. The prognosis of epilepsy comorbid with tic disorders in most children was good. ConclusionsThe prognosis of epilepsy comorbid with tic disorders in most children is good, the types of epileptic seizures and epileptic syndromes are various. Prognosis of these chidren mainly depends on the control of epileptic seizures, the severity of tics and existence of other neuropsychiatric comorbidities. Therefore, drug treatment mainly focuses on controlling the epileptic seizures, and the impact of comorbidities on children can not be ignored. The clinical management needs regular follow-up, timely evaluation and corresponding interventions.
ObjectiveTo investigate the effects of hippocampal long-term potentiation (LTP) on cognitive dysfunction in immature epileptic rats. MethodsImmature epileptic rats were established by intraperitoneal injection of lithium chloride-pilocarpine (li-pilo). Racine classification standard modified by Becker was used to evaluate behavior of epileptic seizure, and the survival rats within RacineⅣmagnitude were selected in the experiment. The function of learning and memory of epileptic rats when they were adult was assessed using Morris water maze experiment, and their independent exploratory behavior was evaluated by the open-field test. Field potential was recorded by electrophysiological technology to detecte whether hippocampal LTP was essential of cognitive dysfunction. ResultsThe function of learning and memory was significantly impaired when compared with controls(n=8, t=10.86, P < 0.05;n=8, t=9.98, P < 0.05). In addition, independent exploratory behavior was significantly reduced when compared with controls(n=8, t=12.89, P < 0.05). Besides, CA1 hippocampal LTP induced by high-frequency stimulation presented the significant inhibition in epileptic rats with cognitive dysfunction when compared with controls(Slope:n=8, t=13.32, P < 0.05;Amplitude:n=8, t=20.02, P < 0.05). ConclusionInhibition of CA1 hippocampal LTP may be implicated in cognitive dysfunction of epileptic rats.