目的 观察托吡酯单药治疗各类癫痫的临床效果。 方法 回顾性分析2006年1月-2009年1月收治的50例各类癫痫患儿采用托吡酯治疗后的临床资料。 结果 发作完全控制者22例，占56.8%；发作减少≥75% 者8例，占20.0%；发作减少≥50%者10例，占22.7%，总有效率88.0%。无效10例，占12.0%。 结论 托吡酯单药治疗癫痫效果确切，完全控制率较高。
Currently, approximately one-third of epilepsy patients exhibit resistance to anti-seizure medications (Anti-seizure medications, ASMs), which can only alleviate symptoms, but cannot completely cure the condition. Consequently, the development of new ASMs from an understanding of epilepsy pathogenesis has emerged as an urgent social issue. The role of neuroinflammation in various neurological diseases has garnered significant attention as a popular research topic both domestically and internationally. Numerous studies have corroborated the involvement of neuroinflammation in the onset and progression of epilepsy. The biological target, Translocator protein 18 kDa (TSPO), is considered as a marker of neuroinflammation and is intricately involved in the entire neuroinflammatory response. Investigating the function of TSPO in epilepsy neuroinflammation can potentially uncover new treatment targets. At present, the exact mechanism of TSPO in epilepsy neuroinflammation remains unclear, thus necessitating a comprehensive summary and overview. This article reviewed the advancements made in TSPO research within the realm of neuroinflammation and its role in epileptic neuroinflammation, aiming to contribute novel insights for the identification of related targets and pathways for epilepsy treatment.
Cerebral amyloid angiopathy (CAA) is an age-dependent disease affecting older subjects. CAA is characterized by lobar intracerebral hemorrhage (ICH), lobar cerebral microbleeds (CMBs), nontraumatic subarachnoid hemorrhage, and cortical superficial siderosis (cSS), which is the main causes of spontaneous intracranial hemorrhage in the elderly. If a patient had experienced dementia, psychiatric symptoms, recurrent or multiple lobar hemorrhage, the possibility of CAA should be considered. Epilepsy can be associated with CAA. Literature studies had found that CAA-related inflammation are predisposing factors for the development of epilepsy. It is a unique subtype of CAA, which is a form of inflammation and a rare clinical manifestation of sporadic CAA. CAA-ri is a special type of central nervous system vasculitis. Once CAA patients had exhibited atypical clinical manifestations, such as headache, epilepsy, behavioral changes, focal neurological signs, consciousness impairment combined with asymmetric T2 weighted magnetic resonance imaging high signal lesions, clinicians had to consider it maybe CAA-ri. Although CAA- ri is rare, timely diagnosis is important because once seizure had occured, which may indicated the inflammation in CAA patients may had reached a very serious level. Therefore, timely identification and treatment are particularly important. Literature shows that most patients responded well to immunosuppressants. Because of its uncommon, researches on epilepsy in CAA mainly focused on case reports currently, and there were many controversies about its pathological mechanism, treatment and prognosis. This article mainly reviews the incidence rate , pathological mechanism, treatment and prognosis of epilepsy in CAA.
The present study is to explore the change process and distribution of phosphorylated DARPP-32 (p-DARPP-32) in rat brain including cortex, hippocampus and striatum and to further deduce whether p-DARPP-32 was possibly involved in epilepsy induced by repetitive low doses of pentylenetetrazol (PTZ). PTZ-induced epilepsy model in rat was established with 30 male SD rats randomly divided into 6 groups, control group and five trial groups [PTZ 1 h,PTZ 6 h,PTZ 24 h,PTZ 48 h and PTZ 72 h respectively, after onset of status epilepticus (SE)]. Immunohistochemistry and immunofluorescence double-labeling were used to detect the temporal time change and distribution of p-DARPP-32 expression and to analyze the coexpression of DARPP-32 and p-DARPP-32 in rat brain after the onset of PTZ-induced generalized SE. The results showed that there was a temporal time change of p-DARPP-32 expression in rat brain after the onset of SE. The number of p-DARPP-32-positive cells increased significantly and reached the peaks at the ends of 1 hour and 6 hours after the onset of SE, but decreased at the end of 24 hours. The moderate to strong p-DARPP-32-immunopositive neurons were observed in cortex, hippocampus and striatum, and located in cell cytoplasm and cell nucleus. Further immunofluorescence double-labeling revealed that denser colocalization of p-DARPP-32 and DARPP-32 in the neurons existed in the area mentioned above. Therefore, PTZ-induced SE may cause phosphorylation of DARPP-32 in rat brain. The temporal time change and distribution of p-DARPP-32 suggest that phosphorylation of DARPP-32 may be involved in PTZ-induced epilepsy in rat brain including cortex, hippocampus and striatum, and p-DARPP-32 may play a central role in the onset of SE.
Temporal lobe epilepsy is the most common type of epilepsy in clinic. In recent years, many studies have found that patients with temporal lobe epilepsy have different degrees of influence in executive function related fields. This influence may not only exist in a certain field of executive function, but may be affected in several fields, and may be related to the origin site of seizures. However, up to now, there is no unified standard for the composition of executive function, and it is widely accepted that the three core components of executive function are working memory, inhibitory control and cognitive flexibility/switching. In addition, the International League Against Epilepsy proposed a new definition in 2010, and epilepsy is a brain network disease. There is a close relationship between brain neural network and cognitive impairment. According to the cognitive field, the brain neural network can be divided into six types: default mode network, salience network, executive control network, dorsal attention network, somatic motor network and visual network. In recent years, there has been increasing evidence that four related internal brain networks are series in a range of cognitive processes. The executive dysfunction of temporal lobe epilepsy may be related to the changes of functional connectivity of neural network, and may be related to the left uncinate fasciculus. This article reviews the research progress related to executive function in temporal lobe epilepsy from working memory, inhibitory control and cognitive flexibility, and discusses the correlation between the changes of temporal lobe epilepsy neural network and executive function research.
ObjectiveTo investigate the effect of acoustic earplugs combined with sedative drugs on improving the success rate of MRI examinations in children with epilepsy, and to provide an effective clinical evidence for MRI examination in children with epilepsy for the future.MethodsSeventy-four children with epilepsy who came to the Second Affiliated Hospital of Guangzhou Medical University, between July 2016 and February 2018 were included in this research. To test the effectiveness of acoustic earplugs on children with epilepsy in improving MRI success rates, participants were divided into two groups randomly. The control group only took the drug and withont using the acoustic earplugs. The observation group used both the drug and acoustic earplugs. The comparing the success rate of MRI examination between the two groups.ResultsThe observed group (with the acoustic earplugs) showed a success rate of 97.29% (36/37), the control group (without the acoustic earplugs) showed a success rate of 18.91% (7/37). The success rate of the observed group was higher than the control group (P<0.05) significantly.ConclusionsThe use of acoustic earplugs combined with sedative drugs is effective in improving the success rate of MRI examination in children with epilepsy and can be widely used in clinical practice.
ObjectiveTo analyze the risk factors of cognitive dysfunction in patients with epilepsy, and provide evidence for clinical prevention and treatment.MethodsDuring the period from January 1, 2018 to January 31, 2019, 101 patients with epilepsy who were admitted to the epilepsy specialist clinic of the General Hospital of Ningxia Medical University were included in this study. The cognitive function of the patients was evaluated by the Mini-mental State Examination (MMSE) scale and patients were divided into cognitive impairment group and normal cognitive function group according to the MMSE. Single factor and logistic regression analysis were used to find the differences of influencing factors between the two groups.Results① There were 27 cases of cognitive dysfunction in 101 patients with epilepsy, the incidence of cognitive impairment was 26.7%; ② Univariate analysis showed that the course of disease, frequency of seizures, seizure forms, anti-epileptic drugs (AEDs) and abnormal rate of electroencephalogram (EEG) existed significant differences between the two groups (P<0.05). ③ Logistic regression showed that course of disease, frequency of seizures and AEDs multidrug therapy were independent risk factors for cognitive dysfunction in patients with epilepsy (P<0.05).ConclusionCourse of disease, frequency of seizures and AEDs multidrug therapy are independent risk factors for cognitive dysfunction in patients with epilepsy.
ObjectiveTo investigate the effect of high-dose hormone pulse therapy on children with epilepsy and sleep status epilepticus.Methods60 children were randomly divided into control group (30 cases) and study group (30 cases) according to the admission sequence. The control group was treated with antiepileptic drugs (according to clinical electroencephalogram or syndrome), and the study group was treated with methylprednisolone sodium succinate [20 mg/(kg·d) × 3 days, once a month, for 6 months]. During the period, antiepileptic drugs were taken normally. After 6 months, the curative effect, abnormal EEG and side effects were compared.ResultsAfter 6 months of treatment, the clinical conditions of the two groups were significantly improved (effective rate: control group: 19/30 vs. study group: 26/30), and the clinical efficacy (26/30) and EEG improvement (26/30) of the study group were better than those of the control group (P<0.05), weight gain can be improved by diet control and reasonable exercise.ConclusionHormone pulse therapy for children with epilepsy and sleep status epilepticus in the control of clinical seizures and improve the effect of abnormal EEG, recommended.
ObjectiveAnalyzing the seizure and cognitive outcome after different treatment by observation of a large group of intractable child epilepsy patients under 15 years old. MethodsCollecting data of children with Intractable epilepsy from Apirl 2008 to December 2013 in Sanbo Brain Hospital, Capital Medical University. Three historical cohorts of intractable child epilepsy defined by the final treatment including medication, curative operation and palliative operation depending on the surgical assessment and the families intension was retrospectively observed. 1 year and 3 years follow-up postoperatively were conducted including seizure outcome and cognitive outcome. ResultsThe curative operation group had significant better seizure free rate, and cognitive statement than medication group. And, the seizure free and cognitive outcome were better in palliative operation group than the medication group. ConclusionsEarly surgical intervention is highly recommended for intractable epilepsy chilelren in order to improve both the seizure and cognitive prognosis.