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find Keyword "癫痫持续状态" 30 results
  • 癫痫持续状态伴反复急性肾损伤一例

    Release date:2024-07-03 08:46 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
  • Clinical characteristics and prognostic factors of 33 children with status epilepticus

    Purpose To analyze the clinical characteristicsand prognostic factors of Status epilepticus (SE) in children. Methods The clinical data of 33 children with SE treated in Jinan Central Hospital Affiliated of Shandong University from January 2014 to June 2021 were collected, and their clinical characteristics were analyzed. Then, according to Glasgow prognosis scale, the children were divided into good prognosis group (n=20) and poor prognosis group (n=13). The age of first attack, duration of attack, type of attack and SE classification, EEG, cranial imaging and etiology were used to analyze the influencing factors of SE prognosis. Results 75.7% were 0 ~ 6 years old in the age of first attack, and 29 cases of convulsive status epilepticus accounted for 87.9% in the classification of seizure types. There were significant differences in age of first attack, duration of attack, EEG, history of mental retardation and etiology between the two groups (P<0.05); Logistic regression analysis showed that the age of first attack, duration of attack, history of mental retardation and EEG were independent factors affecting the prognosis. Conclusion Low age, especially ≤ 6 years old, is the high incidence of SE in children at first attack. Most children are symptomatic and have obvious incentives. Convulsive SE is the main type of SE in children. The age of first onset, duration of epilepsy, history of mental retardation, and EEG can affect the prognosis of SE.

    Release date:2022-02-24 02:04 Export PDF Favorites Scan
  • Aetiology of convulsive status epilepticus in adults

    ObjectiveTo investigate the etiology of patients with convulsive status epilepticus (CSE).MethodsBy taking epilepsy, seizure, status epilepticus, and epileptic seizure as keywords, the clinical data of epilepsy patients hospitalized in the First People’s Hospital of Longquanyi District of Chengdu and the People’s Hospital of Leshan from January, 2012 to December, 2017 were retrospectively collected from a retrieval system for electronic patient records. The collected CSE cases were screened by trained epilepsy specialists in strict accordance with inclusion criteria and exclusion criteria. The etiology of CSE, and the pathogenetic distinctions among patients with different ages, sexes, educational levels, places of residence, and histories of epilepsy were analyzed based on medical histories and accessory examinations. The prognostic factors for epilepsy were determined using logistic regression analysis.ResultsIn this study, a total of 852 hospitalized epilepsy cases were retrieved, among which 104 cases were CSE cases aged between 18 and 86, including 75 males and 29 females. There were 13 CSE deaths (12.5%). There were significant differences in the pathogeneses among CSE patients with different ages and histories of epilepsy (χ2=52.396, 18.354; P<0.05). However, no significant difference in CSE pathogeneses was observed among patients with different sexes, educational levels, or places of residence (P>0.05). Drug withdrawal or dose reduction was the leading cause of CSE in patients with a history of epilepsy (n=28, 57.1%), while cerebrovascular diseases (n=19, 34.5%) were common causes among those without a history. Among patients aged over 65, cerebrovascular diseases (n=17, 43.6%) were determined as the major causes of CSE, while for those aged under 65, drug withdrawal or dose reduction was the main pathogeny (n=20, 30.8%). Results obtained from multivariate logistic regression analysis on the prognostic factors for epilepsy showed that the duration of epileptic seizure significantly influenced the prognosis of patients [odds ratio=1.299, 95% confidence interval (1.074, 1.571), P=0.007], while there were no significant correlations between other factors and epilepsy prognosis (P>0.05).ConclusionsCerebrovascular diseases are the leading causes of geriatric CSE. Irregular medication of epilepsy patients is a prominent avoidable trigger for CSE.

    Release date:2019-04-22 04:14 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.

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  • 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
  • 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

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  • 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
  • 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
  • The dynamic expressional changes of neuronal growth and differentiation-associated miR-124a and miR-9 in the process of epileptogenesis

    ObjectiveTo explore the dynamic expression changes of neuronal growth and differentiation-associated miR-124a and miR-9 in the process of epileptogenesis. MethodsEstablish the lithium-pilocarpine induced status epilepticus (SE) rat model. Animal behavior change induced by SE as well as in the period of chronic epilepsy was observed by naked-eye or video-recording. Major time points for the study were chosen at 1d, 7d, 14d and 28d post-SE, on which the post-SE rats were decapitated and their hippocampal specimens were obtained. Total RNA from each specimen was extracted and qPCR was exploited to detect miR-124a and miR-9 expression in the specimens. Statistical analysis was used to show the dynamic expressional changes of miR-124a and miR-9 in rat hippocampus at 1d, 7d, 14d and 28d post-SE during the process of epileptogenesis. ResultsCompared with normal rats, the expression level of miR-124a in rat hippocampus did not show a significant difference at 1d post-SE, but it had shown markedly differences at 7d, 14d and 28d post-SE(P < 0.05), with a declining trend. Compared with normal rats, the expression level of miR-9 had demonstrated significant differences at 1d, 7d, 14d and 28d post-SE(P < 0.05)with a generally increasing trend, although there was slight fluctuation of expressional up-regulation at 7d post-SE. ConclusionNeuronal growth and differentiation-associated miR-124a and miR-9 had shown dynamic changes of down-regulation or up-regulation in the process of epileptogenesis. It can be suspected that miR-124a and miR-9 take part in hippocampal neurogenesis post-SE and be involved in epileptogenesis process.

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