west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "癫痫持续状态" 30 results
  • The clinical features and Video-EEG of Eyelid myoclonia-nonconvulsive status epilepticus in children

    ObjectiveTo study the clinical and EEG features, therapeutic response and prognosis of eyelid myoclonia-nonconvulsive status epilepticus (EM-NCSE) in children.MethodsCollected the clinical and EEG data of 3 children with EM-NCSE that were diagnosed in department of neurology in Qilu Children Hospital of Shandong university during the January in 2015 to August in 2016.Analysed the therapeutic response to antiepletic drugs(AEDs).ResultsAmong the three children, there were 2 girls and 1 boy.The age at the onset of the disease was from 6 to 10 years old.The average age of them is 8.67 years old.The clinical manifestations include mental confusion, dysphoria, winking and scrolling up the eyes.The typical vedio electroencephalography (VEEG) in the patients showed 3~6 Hz generalized spike and waves and polyspikes burst, especially in the frontal and the anterior temporal region.In addition, the eye closure and intermittent photic stimulation helped to induce discharges and clinical events as eyelid myoclonia (EM).ConclusionsEM-NCSE is one of the idiopathic and generalized epileptic disease and characterized by EM.Video EEG monitoring plays an important role in the diagnosis of this disease.The drugs of choice for treatment was diazepam.When the event was controlled, AEDs were effective for the following therapy.

    Release date:2017-05-24 05:46 Export PDF Favorites Scan
  • The aetiology and prognosis of convulsive status epilepticus: a study of 331 cases in Tibet Lhasa area

    Objectives Retrospective analysis of the Tibetan convulsive status epilepticus (CSE) for the aetiology, prognosis and its influencing factors in Tibet area. Methods Through electronic patient record, making “epilepsy”, “status epilepticus ”, “epileptic seizure” as keywords, convulsive status epilepticus patients in the People’s Hospital of Tibet Autonomous Region hospitalized from January 2015 to December 2020 were retrospectively observed, gathering their clinical data and aided examinations furthermore, and the prognoses were returned by telephone, meanwhile the functional status of those patients was assessed by the modified rankin scale. and the causes differ in gender, age, out-of-hospital antiepileptic treatment, family history of epilepsy and history of epilepsy were analyzed. The prognostic factors were analyzed by logistic regression. Results A total of 2 254 hospitalized patients with epilepsy were retrieved, including 331 CSE patients aged 14~84 years, 219 males and 112 females. There were 36 lost calls, 62 CSE deaths (21.01%), and 4 adverse outcomes (non-death)(1.7%).There were statistically significant differences in etiology of CSE in different ages and history of epilepsy (P<0.05), but there were no statistically significant differences in gender, out-of-hospital antiepileptic treatment, progression of refractory status epilepticus and family history of epilepsy. Cerebrovascular disease was the main cause of CSE in people aged 45 and over (54 cases), while the main cause of CSE in people aged under 45 was unknown (104 cases).Among the patients with previous history of epilepsy, the highest proportion was unknown cause [117 cases (48.8%)]; Among patients without a history of epilepsy, cerebrovascular disease [34 cases (37.4)] was the most common cause of CSE. Multivariate logistic regression analysis of prognostic factors of CSE showed that gender, age, GCS and electrolyte disorder had statistically significant effects on the death of CSE patients (P<0.05), while altitude and their duration and other factors had no statistically significant effects on the death of CSE patients (P>0.05). ConclusionsCerebrovascular disease is the leading cause of CSE in people aged 45 and over. Male, advanced age, low GCS score at discharge, and electrolyte disorder were risk factors.

    Release date:2022-06-27 04:41 Export PDF Favorites Scan
  • Study on the expression of NGB in hippocampus after status epliepticus in rats

    ObjectiveTo observe the dynamic changes of neuroglobin (NGB) expression in hippocampus after status epilepticus(SE) in rats, and to explore the role of NGB in epileptic seizures.Methods40 healthy male Sprague Dawley rats were randomly divided into two group according to random number table method:control group (n=5) and epilepsy model group(n=35).Epilepsy model group according to observation time was divided into:0h, 1h, 3h, 12h, 24h, 10d and 30d.Intraperitoneal injection Lithium-pilocarpine (20 mg/kg~127 mg/kg, Li-PC) to establish the rat model of SE.Observe the behavioral changes in rats with epilepsy.Nissl staining was used to detect the neuronal damage in hippocampus. Streptavidin-biotin-peroxidase complex immunohistochemical method was used to detect the expression level of NGB in hippocampus;ResultsAfter SE, the neurons in hippocampus were severely damaged with the progress of epileptic seizures, the number of surviving neurons in CA1, CA3 regions showed a near linear decline.Among them, the number of surviving neurons in (12h, 24h, 10d, 30d)CA1, (0h, 12h, 24h, 10d, 30d)CA3 and(12h, 24h, 10d, 30d) DG area were significantly lower than that of the control group (P < 0.05).The expression level of NGB in CA1, CA3 and DG region of hippocampus were increased after SE, and both of CA1 and DG were reached peak in 24h after SE, but was still higher than the control group.And the CA3 area showed a continue rising trend.Among them, CA1(24h, 10d, 30d), CA3(24h, 10d, 30d) and DG(12h, 24h, 10d, 30d) were higher than that of control group significantly (P < 0.05).In addition, it was found that there was a positive correlation between the number of surviving neurons in CA3 area and the expression level of NGB (R=0.306, P=0.011).ConclusionUp-regulation of NGB expression in hippocampus after status epilepticus, and was positively correlated with the number of neurons in the CA3 area, suggesting that up regulation of NGB expression may be a compensatory protective mechanism of ischemic injury induced by seizures, and participate in the protection of epilepsy related neuronal damage.

    Release date:2017-05-24 05:46 Export PDF Favorites Scan
  • 癫痫持续状态研究进展

    从国内外研究现状出发, 对癫痫持续状态(Status epilepticus, SE)的定义、流行病学和病因、发病机制、分类、诊断评估、治疗及预后等进行了全面阐述。有关SE定义的历史变迁, 从理论性定义到实用性定义均给出了明确界定, 其中实用性定义为适应人们对SE病理生理机制的进一步理解和满足临床容易操作需要不断更新。国际抗癫痫联盟(ILAE)已对强直-阵挛SE、复杂部分发作SE和失神SE实用性定义给出了明确规定。并对SE的流行病学及病因进行了探讨, 多种神经系统及全身性病理生理改变可导致SE, 发作自我维持与自我终止的平衡破坏是SE发生的必要条件, 发作导致神经系统兴奋性和抑制性系统失衡, 后者反过来又促进发作持续。有关SE分类一直备受关注, 几经变迁, 最新方案重新按惊厥性和非惊厥性分为两大类。诊断需依靠脑电图监测, 尤其非惊厥类型, 典型癫痫发作且持续时间足够长, 可无需脑电图监测证据。神经影像及实验室检查有助于发现病因。SE为神经科急症, 尽早控制发作, 并应与详细的病史采集同时进行, 院前积极给药明显增加SE控制率, 咪达唑仑和苯二氮卓类为首选药物。对难治性SE及早应用麻醉药物, 可减少并发症及死亡率, 提高控制率

    Release date: Export PDF Favorites Scan
  • The investigation of diagnosis and treatment for status epilepticus in some hospitals of China

    Objective To investigate the diagnosis and treatment of status epilepticus in hospitals of different levels and the knowledge of status epilepticus in clinical physicians, in order to better guide clinical education in the future. Methods From August 2014 to August 2015, a questionnaire was designed and used to investigate the general situation of the hospital, the diagnosis of status epilepticus and the clinical practice among trainee doctors and students in the epilepsy training class in the Neurological Intensive Care Unit and the Department of Neurology of West China Hospital, Sichuan University. The results of the investigation were statistically analyzed. Results Ninety questionnaires were distributed, and all the questionnaires were retrieved with validity. The number of investigated physicians was 42 (46.7%) from the Department of Neurology, 6 (6.7%) from the Department of Neurosurgery, 30 (33.3%) from the Intensive Care Unit and 12 (13.3%) from other departments. Twenty-seven (30.0%) physicians were from class Ⅲ grade A hospitals, 31 (34.4%) from class Ⅲ grade B hospitals, and 32 (35.6%) from class Ⅱ grade A hospitals. All the class Ⅲ hospitals and 53.1% of class Ⅱ hospitals had electroencephalograph monitoring facilities. The proportion of status epilepticus patients ranged from 0.5% to 10.0% in different hospitals. There were great differences in the identification and treatment of convulsive status epilepticus among different hospitals. Conclusions Status epilepticus is a common emergency. Questionnaire survey is an effective means to reflect the difference in identifying and treating the emergency among different departments and hospitals. It can guide clinical education and promote the identification and treatment of the emergency more accurately in doctors of all levels.

    Release date:2017-05-18 01:09 Export PDF Favorites Scan
  • Prognositic factors in status epilepticus and prognosis evaluation

    ObjectiveTo analyze the prognosis factors in status epilepticus and confirm the external validity of the Status Epilepticus Severity Score (STESS) prediction functions for outcome in patients with statusepilepticus. MethodsRetrospectively, collecting prognosis factors in status epilepticus of 50 patients. These factors include gender, age, SE aetiology, seizure type at SE onset, history of prior seizures or epilepsy, level of consciousness, duration of SE, albumin and infection. Using STESS score to evaluate the prognosis of patients, then evaluate the effectiveness of the STESS score. Results1. Single factor analysis:age,history of prior seizures or epilepsy, level of consciousness and infection were prognosis factors in status epilepticus (P<0.05). Gender, SE aetiology, seizure type at SE onset and albumin were not prognosis factors (P>0.05). Multivariablelogistic regression models selected two factors:duration of SE (OR3.645), level of consciousness (OR2.877). 2. 28 status epilepticus patient in the STESS 0-2 group were all alive. 10 status epilepticus patients in the STESS 3-6 group were died (45.4%), 12 patient were alive (54.6%). There were significant differences among the prognostic of patienst in different groups (P<0.01). The receiver operating characteristic curve for prediction of death by the STESS Score had an area under the curve of 0.92. The optimal cut-off point is 3. ConclusionAge, history of prior seizures or epilepsy, level of consciousness, duration of SE and infection were prognosis factors in status epilepticus. Level of consciousness and duration of SE were the directly related factors of the prognosis of status epilepticus. STESS score performed reasonable prognositic role on our patients with status epilepticus.

    Release date: Export PDF Favorites Scan
  • Prognostic analysis of status epilepticus

    Objective To study the factors that affect the prognosis of status epilepticus (SE) and to improve the understanding of clinicians. Methods A retrospective analysis of 57 patients with SE witch from the General Hospital of Ningxia Medical University and Cardio-cerebrovascular Disease Hospital were carried out to collect their clinical data. The data were analyzed by SPSS 17.0 software. The prognosis of the patients was assessed by the Status epilepticus severity score (STESS) scale. Results A total of 57 patients were included, 53 cases improved, 4 cases were automatically discharged. Telephone follow-up showed that 4 cases of automatic discharge were dead. The mortality rate of SE was 7.02%. The most common cause of SE was acute cerebrovascular disease (17.54%), followed by intracranial infection (10.53%); The most common incidence were the occasional medication, self-medication, withdrawal (15.79%). Age, state of consciousness and concurrent infection were associated with prognosis (improvement/death) (P<0.05). STESS score of 0 to 2 points were 45 patients, all improved; score of 3 to 5 points were 12 patients, 8 patients improved, 4 patients died. There were significant differences in the prognosis between the two groups (P<0.05). Conclusions Age, state of consciousness, concurrent infection were related to prognosis, more than 65 years, the state of consciousness for the sleeping or coma had the poor prognosis. STESS scale can predict the prognosis of patients effectively.

    Release date:2023-05-04 04:20 Export PDF Favorites Scan
  • 基于红藻氨酸和劳拉西泮联合给药的新型人类获得性颞叶癫痫动物模型

    红藻氨酸(Kainic acid,KA)是一种有效的谷氨酸类似物,用于诱导啮齿动物的神经退行性变和颞叶癫痫(TLE)。KA 可诱发严重的、持续的癫痫发作,即惊厥性癫痫持续状态(convulsive Status epilepticus,cSE),没有药物干预的情况下通常是致命的。在过去 30 年里,使用 KA 来建立人类癫痫动物模型毫无疑问被证明是有价值的,但显著的可变性和死亡率一直使结果变得不确定。这些问题很可能是 cSE 导致的,这是一种本质上可变且无法控制的全或无反应。然而,cSE 与人类疾病的相关性尚不确定,因为大多数癫痫患者从未经历过这种情况。该研究试图构建一种简单的、基于 KA 的 TLE 动物模型,以避免 cSE 及其混淆因素。成年雄性 Sprague-Dawley 大鼠分别接受皮下注射 KA(5 mg)和劳拉西泮(0.25 mg),剂量分别约为 15.0 mg/kg 和 0.75 mg/kg。持续的视频脑电图(VEEG)被用来监测急性癫痫的发作和检测自发性癫痫发作。免疫细胞化学、Fluoro-Jade B 染色和 Timm 染色被用来描述急性和慢性神经病理学改变。急性局灶海马癫痫发作在约 30 min 后开始并在几小时后自行终止。广泛的海马神经变性在 4 d 之后发现。在所有动物中自发性的局灶海马癫痫发作平均 12 d 之后开始。典型的海马硬化和苔藓纤维出芽的形成是长期神经病理学的特征。发病率和死亡率均为 0%。我们发现在联合注射低剂量苯二氮卓类药物时,KA 全身性给药的作用可局限于海马。这意味着劳拉西泮可以阻止痉挛性癫痫发作,而没有真正阻止癫痫电活动。这个创新的、无 cSE 的动物模型,可靠地模拟了获得性颞叶内侧癫痫所定义的特征:海马硬化和在长时间无癫痫发作后自发的海马起源的癫痫发作,并不伴显著的发病率、死亡率或无反应者。

    Release date:2019-03-21 11:04 Export PDF Favorites Scan
  • Clinical features, treatment and prognosis of Rasmussen encephalitis in 21 children

    ObjectiveTo summarize the clinical phenotype, electrophysiological characteristics, imaging characteristics, surgical treatment and prognosis of Rasmussen encephalitis (RE), so as to deepen the understanding of the disease. MethodsThe clinical data of patients with RE who underwent surgical therapy from October 2014 to October 2019 at Children's Epilepsy Center in Peking University First Hospital were retrospectively reviewed. Demographic characteristics, seizure forms, electroencephalogram (EEG), cranial nuclear magnetic resonance (MRI), operative methods as well as surgical outcomes evaluated by Engel classification during follow-up of the subjects were collected and analyzed. ResultsTotally 21 pediatric patients were enrolled, including 8 males and 13 females. The age at onset was (5.0±2.0) years old, the age at the time of surgery was (6.9±2.7) years old, and the disease duration at the time of surgery was (1.7±1.3) years. Twenty (20/21, 95.2%) patients had focal motor seizures, and 10 (10/21, 47.6%) patients had 2 or 3 forms of focal motor seizures. Fifteen patients (15/21, 71.4%) had epilepsia partialis continua (EPC), which occurred (0.7±0.6) years after the onset. All patients had hemiplegia, which appeared at (0.9±0.6) years after the onset. All patients showed a slow rhythm at their affected hemispheres during the EEG monitoring and 4 of them also showed slow rhythm at the contralateral hemispheres as the disease progressed. All patients had epileptiform discharges at the involved hemisphere, and 6 patients also had independent epileptiform discharges on the contralateral side. All 21 patients underwent hemispheric disconnection. The duration of follow-up was 2 to 7 years, and all patients achieved Engel class I after the surgery. The neurological dysfunction recovered to varying degrees during the postoperative period. ConclusionRE mostly occurs around the school age. Focal motor seizures are the main manifestations and the most common onset symptoms. With the progress of the disease, the condition of patients worsened gradually. The EEG of patients was mainly characterized by broad slow wave and spike wave in the affected hemisphere. Some patients can also have bilateral involvement, which was obviously asymmetrical. Through surgical treatment, the patients all achieved good results in terms of seizures and development.

    Release date:2022-10-31 09:25 Export PDF Favorites Scan
  • 新发难治性癫痫持续状态的诊治研究进展

    新发难治性癫痫持续状态(New-onset refractory status epilepticus,NORSE)是一种临床表现或综合征,不伴活动性癫痫或其他急性或慢性结构、代谢或中毒原因。发热感染相关癫痫综合征(Febrile infection-related epilepsy syndrome,FIRES)是 NORSE 起病时伴或不伴发热的一种 RSE 亚型。共识定义及其他情况包括婴儿偏身惊厥-偏瘫及癫痫综合征、超级 RSE 等。NORSE 的治疗是一件巨大的临床挑战和极低成功率。早期生酮饮食是最佳疗效和最具潜力的治疗。本文旨在阐明其临床特征、术语、流行病学、病理机制、诊断困局及治疗方法。

    Release date:2021-12-30 06:08 Export PDF Favorites Scan
3 pages Previous 1 2 3 Next

Format

Content