ObjectiveThe aim of this study is to identify clinical and electroencephalographic features associated with refractoriness to the initial antiepileptic drug in typical benign childhood epilepsy with centrotemporal spikes (BECTS). MethodsA total of 87 children with typical BECTS were retrospectively reviewed in the analyses.The patients were subdivided into two groups:patients whose seizures were controlled with monotherapy, and those requiring two medications. 63 childrenachieved seizure-freedom with monotherapy, while 24 received two medications for seizure control. ResultsDiffusing foci at the follow-up EEG and delayed treatment (duration > 1 year) are two main risk factors associated with more refractory cases (P < 0.001). Delayed diagnosis (37.1%) and non-adherence to treatment (57.2%) contributed to delayed treatment. ConclusionsOur findings suggested that diffusing foci on EEG and delayed treatment are associated with more frequent seizures and refractoriness in BECTS. Diagnostic delays and non-adherence hindered timely care, which may represent opportunities for improved intervention.
ObjectiveTo investigate the quality of life of family caregivers of patients with Alzheimer's disease (AD) and to explore the related factors. MethodsTwenty family caregivers of patients with Alzheimer's disease were surveyed with short form 36 health survey questionnaire between October 2013 and August 2014. ResultsThe subjects who were over 60 years old had lower scores in the dimensions of physical functioning, role limitations due to physical problem and role limitations due to emotional problem than those below 60 years old. Female subjects scored better than male subjects in the dimension of vitality. The sons and daughters had higher scores than the wives and husbands in the dimensions of physical functioning, role limitations due to physical problem and role limitations due to emotional problem. The subjects whose patients had medical insurance scored better than those whose patients with no insurance. The differences above were all statistically significant. The scores of caregivers with senior middle school edudation or above were higher than the caregivers with lower education level in the dimensions of mental health, vitality and general health perceptions. ConclusionThe quality of life of the family members of AD patients is obviously affected by many factors. It is very important to implement planned, targeted, reasonable and effective interventions to enhance the quality of life of these people.
目的 利用磁共振弥散张量成像技术（DTI）对右侧难治性颞叶癫痫（TLE）患者术前及术后脑白质各向异性分数（FA）进行纵向随访研究，并对其与病程等临床症状之间的相关性进行分析，探讨右侧TLE患者的脑白质FA变化模式。 方法 2008年7月－2009年8月纳入10例右侧难治性TLE患者。对每个受试者采用GE 3.0 T磁共振及8通道头线圈扫描，所有DTI图像通过单次回波平面成像序列采集。采用基于体素分析的SPM8软件对受试患者术前术后FA图进行配对t检验，观察难治性TLE患者脑白质变化模式。采用Pearson相关计算FA变化幅度与病程等临床症状之间的相关性，经比较校正后P值＜0.05的区域为有统计学意义的区域。 结果 右侧TLE患者FA值降低的区域包括左侧颞下回、双侧额中回及左侧壳核、右侧楔叶。FA升高的区域包括左侧海马旁回、左侧颞叶、右侧额下回和左侧中央旁小叶。相关分析发现，右侧TLE患者右侧额下回FA变化值与发病年龄呈负相关，左侧颞下回FA变化值与术后随访间隔时间呈负相关。 结论 右侧难治性TLE患者手术治疗后大脑白质变化不仅局限于颞叶，还涉及颞叶外结构。