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find Keyword "外伤后癫痫" 3 results
  • 白细胞介素-1β与外伤后癫痫发生的联系——一个遗传学和生物标记物的队列研究

    外伤后癫痫(Post-traumatic epilepsy, PTE)是创伤性脑损伤(Traumatic brain injury, TBI)后的一个主要的并发症, 但遗传变异在调节PTE发生中的作用尚不清楚。假设TBI诱导的炎症可能是导致癫痫发生的原因, 对白细胞介素-1β(Interleukin-1β, IL-1β)基因的遗传变异情况, 脑脊液和血清中IL-1β水平和IL-1β的脑脊液/血清比值能否预测TBI后PTE的发生进行了评估。共调查了256例中度至重度TBI后患PTE的成年白种人。对IL-1β标记和功能性单核苷酸多态性(SNPs)进行基因分型。对遗传变异性和PTE的发生进行评估。在调查患者中抽取一部分患者(n=59)在其外伤后1周内收集血清和脑脊液的IL-1β, 并评估它们与IL-1β基因变异及PTE的关系。临时配对IL-1β的脑脊液/血清比值以反映血清IL-1β水平对脑脊液IL-1β的影响。多变量分析显示随着时间推移, 高脑脊液/血清IL-1β比值与PTE风险增加有关(P=0.008)。rs1143634的多变量分析揭示了CT基因型与PTE风险增加有关(P=0.005)。CT基因型组其血清IL-1β水平较低(P=0.014), 脑脊液/血清IL-1β比值较高(P=0.093)。这是第一个揭示PTE风险中的IL-1β基因变异, 及TBI后IL-1β基因变异与血清IL-1β水平的关系和IL-1β比值与PTE风险的关系。根据这些发现, 提出基因和IL-1β比值与PTE的相关性可能归因于TBI恢复期的血脑屏障完整性的生物变异性包括。为进一步的研究提供了理论依据, 验证遗传变异性对TBI后IL-1β产生的影响, 评估造成脑脊液/血清IL-1β比值与PTE相关性的基因介导的信号传导机制, 及评估减少PTE的靶向IL-1β治疗。

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  • Analysis of influencing factors of cognitive impairment after post-traumatic epilepsy

    ObjectiveTo analyze the related factors of cognitive impairment in patients with post-traumatic epilepsy. MethodsFrom January 2016 to January 2019, 45 patients with post-traumatic epilepsy (epilepsy group) and 48 patients with physical examination (control group) at the Department of Neurosurgery, the 904th Hospital of PLA were analyzed retrospectively. Cognitive assessment were evaluated by the following scales: Montreal cognitive assessment (MoCA), Mini-mental state examination (MMSE), Audio verbal memory test (AVMT), Rey-osterrieth complex figure test (CFT) and Trail making test (TMT). Then we analyzed the influences of gender, age, course of disease, cause, type, degree and location of injury, seizure frequency and Anti-seizure medications (ASMs) on cognitive impairment. ResultsThe results showed that there were significant differences between the epilepsy group and the control group in all scales (P<0.01). Analysis of influencing factors in epilepsy group showed: MoCA and MMSE scores: there were statistical significance in the comparison of seizure frequency and injury degree (P<0.05); AVMT, CFT and TMT scores: there were statistical significance in the comparison of seizure frequency, injury degree and location, ASMs within the group (P<0.05). ConclusionPost-traumatic epilepsy can cause cognitive impairment. The more frequent epileptic seizures and the more severe the degree of trauma, the more serious the cognitive impairment. Different injury sites affect the scope of cognitive impairment, temporal lobe injury is easy to cause memory function decline, frontal lobe injury is easy to cause spatial structure and executive ability decline, at the same time, the combined use of ASMs has an impact on cognitive function.

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  • Neuropsychological evaluation of post-traumatic epilepsy

    ObjectiveTo analyze of the extent of neuropsychological damage in post-traumatic epilepsy patients. MethodsOne hundred and thirty-five patients treated at the Department of Neurosurgery, the 904th Hospital of PLA from January 2016 to December 2018 were analyzed retrospectively, including 94 males and 41 females, with an average age of (32.94 ± 9.51) years. They were divided into 3 groups: 40 patients with post-traumatic epilepsy (epilepsy group): 53 trauma patients without post-traumatic epilepsy (trauma group) and 42 patients with health examination (control group). Neuropsychological assessment using the following scales: Mini-mental State Examination (MMSE): Montreal Cognitive Assessment-Basic (MoCA-B): Audio Verbal Memory Test (AVMT): Rey-Osterrieth Complex Figure Test (CFT): Trail Making Test (TMT): Hamilton Depression Scale (HAMD): Activity of Daily Living (ADL). ResultsThe results of one-way ANOVA showed that there was significant difference between all scales of epilepsy group, trauma group and control group (P<0.01). MMSE and MoCA-B scores: Compared with trauma group, epilepsy group decreased significantly, but there was no significant difference between groups (P>0.05); Memory and spatial structure ability: AVMT short/long delayed memory, CFT recall and copy test results showed that epilepsy group decreased more significantly than trauma group, and there was statistical significance between groups (P<0.05); Executive ability: TMT-A and TMT-B showed that epilepsy group spent longer time than trauma group, and there was significant difference between groups (P<0.01); Depressive symptoms: HAMD scale showed significant difference between epilepsy group and trauma group (P<0.01): while there was no statistical difference between trauma group and control group (P>0.05); Activity of daily living: ADL scale results showed that there was no significant difference between epilepsy group and trauma group (P>0.05). ConclusionPost-traumatic epilepsy can aggravate the cognitive impairment of patients, mainly in the decline of memory, spatial structure and executive ability, and prone to depressive symptoms. At the same time of treating epilepsy seizures, patients with post-traumatic epilepsy should be screened and assessed early in neuropsychology to improve their quality of life and return to society as soon as possible.

    Release date:2022-02-24 02:04 Export PDF Favorites Scan
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