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find Keyword "发作" 142 results
  • 癫痫发作期相关生物标志物的研究进展

    癫痫是一种由多种病因引起的慢性脑部疾病,以脑神经元过度放电导致反复性、发作性和短暂性的中枢神经系统功能失常为特征。临床上癫痫致病的原因及机制较为复杂,癫痫的诊断需要症状学及脑电图的支持。但是由于癫痫发作早期症状学较为隐匿且容易与其他发作性疾病相混淆,脑电图也可能表现为正常,因此,癫痫的早期诊断一般较为困难。回顾既往的研究报道,以癫痫发作期是否存在诊断性生物标志物为出发点,阐述与发作相关的血清学及脑脊液标记物,本综述主要关注癫痫发作期相关的蛋白、激素及炎症因子等方面,目的在于筛选出具有代表性的癫痫发作期相关生物标记物,为癫痫的早期诊断提供新的思路。

    Release date:2022-10-31 09:25 Export PDF Favorites Scan
  • An analysis on clinical characteristics of 36 epileptics with pregnancy

    ObjectiveTo investigate the clinical characteristics of epileptics with pregnancy and then provide reference for standardized management of epileptics with pregnancy. MethodsFrom June 2012 to June 2021, epileptics with pregnancy who delivered in Jinan Central Hospital were selected as the research subjects. The clinical data such as the application of Antiseizure medications (ASMs) during pregnancy, seizure frequency, pregnancy outcomes, delivery ways, offspring feeding ways and the incidence of complications were investigated and analyzed. ResultsAmong 36 epileptics with pregnancy, 20 cases (55.56%) were treated with ASMs alone, 5 cases (13.88%) were treated with combined medication, and 11 cases (30.56%) were treated without ASMs during pregnancy. 15 cases (41.67%) adhered to systematic application of ASMs, 17 cases (47.22%) did not adhere to systematic application of ASMs, and 4 cases (11.11%) had unknown medication history. The frequency of seizures increased in 5 cases, decreased in 7 cases and unchanged in 24 cases during pregnancy. Pregnancy outcomes: full-term delivery in 33 cases (91.67%), preterm delivery in 1 case (2.78%) and abortion in 2 cases (5.56%). Delivery mode: cesarean section in 31 cases (91.18%), vaginal delivery in 3 cases (8.82%). After delivery, 4 cases (11.76%) were fed with milk powder and 30 cases (88.24%) were breast-fed. Complications: There were 6 cases complicated with anemia (16.67%), 5 cases complicated with gestational hypertension (13.89%), 3 cases complicated with gestational diabetes (8.33%), 4 cases complicated with premature rupture of membranes (11.11%), 2 cases complicated with fetal growth restriction (5.56%), 2 cases complicated with oligohydramnios (5.56%), 3 cases complicated with fetal distress (8.33%) and 3 cases complicated with neonatal asphyxia (8.33%). ConclusionsThe proportion of epileptics with pregnancy who were systematically treated with ASMs was low and the seizures were poorly controlled. There is a lack of standardized management for such patients in clinical practice.

    Release date:2022-06-27 04:41 Export PDF Favorites Scan
  • 从病例看“自身免疫(相关)性癫痫” 在临床诊治中的挑战

    通过回顾性分析3例代表性临床病例的诊断、治疗及后期随访资料,以揭示目前有关“自身免疫(相关)性癫痫”在诊断和治疗方面存在的挑战和问题,并通过文献复习来探讨合理的应对策略。3例患者中,2例因反复癫痫发作就诊,在临床未明显提示免疫病因的情况下,多次送检相关抗体或启动免疫治疗。另1例患者临床除了癫痫发作,还有其他脑病表现,结合病史和影像所见高度提示免疫病因,最终经抗体检测阳性结果证实。3例患者的诊治经过提示,目前对“自身免疫(相关)性癫痫”诊断和治疗存在一定程度“过度化”情况。“自身免疫”和“癫痫”的关系较为复杂。自身免疫性脑炎中的癫痫发作和慢性自身免疫(相关)性癫痫之间的界限仍不清晰,缺乏可用于实际操作的标准(如生物标记物)是造成后者混乱临床诊疗现状的重要原因。现阶段,理清诸如“急性症状性发作”和“癫痫”等基本概念,仔细全面评估患者,尽早识别出自身免疫性脑炎中已经确定的、具有一定表型特征的综合征,以及使用可指导临床送检抗体或启动免疫治疗的相关评测量表,可帮助临床医生更加合理、有效地诊疗。

    Release date:2022-09-06 03:50 Export PDF Favorites Scan
  • 癫痫、痫性发作、体育锻炼和运动:ILAE 运动与癫痫工作组的报告

    癫痫患者(People with epilepsy,PWEs)通常被建议不要参与体育运动和锻炼,主要是因为恐惧、过度保护,以及对与此类活动有关的具体利益和风险的无知。现有证据表明,体育锻炼和积极参与体育运动除了有广泛的身体及心理社会效益外,可能会有利于癫痫的控制。国际抗癫痫协会(ILAE)运动与癫痫工作组共同提出的这一共识提供了 PWEs 参与体育活动的一般性指导意见,并提出了不同运动的医疗健康证明的发放建议。如果发生痫性发作,运动会根据潜在的伤害或死亡风险分为三类:第一类,没有重大额外风险的运动;第二类,对 PWEs 有适度风险的运动,但不承担风险;第三类,具有重大风险的运动。在提供 PWEs 是否可以参与具体活动的建议时,应考虑的因素包括体育类型、癫痫发生概率、癫痫类型和严重程度、癫痫的促发因素、平常痫性发作的时间,以及患者接受一定程度风险的态度。由于获得了额外数据,运动与癫痫工作小组将此文件视为一项不断更新的工作。

    Release date:2018-01-20 10:51 Export PDF Favorites Scan
  • Automatic epileptic seizure detection algorithm based on dual density dual tree complex wavelet transform

    It is very important for epilepsy treatment to distinguish epileptic seizure and non-seizure. In this study, an automatic seizure detection algorithm based on dual density dual tree complex wavelet transform (DD-DT CWT) for intracranial electroencephalogram (iEEG) was proposed. The experimental data were collected from 15 719 competition data set up by the National Institutes of Health (NINDS) in Kaggle. The processed database consisted of 55 023 seizure epochs and 501 990 non-seizure epochs. Each epoch was 1 second long and contained 174 sampling points. Firstly, the signal was resampled. Then, DD-DT CWT was used for EEG signal processing. Four kinds of features include wavelet entropy, variance, energy and mean value were extracted from the signal. Finally, these features were sent to least squares-support vector machine (LS-SVM) for learning and classification. The appropriate decomposition level was selected by comparing the experimental results under different wavelet decomposition levels. The experimental results showed that the features selected in this paper were different between seizure and non-seizure. Among the eight patients, the average accuracy of three-level decomposition classification was 91.98%, the sensitivity was 90.15%, and the specificity was 93.81%. The work of this paper shows that our algorithm has excellent performance in the two classification of EEG signals of epileptic patients, and can detect the seizure period automatically and efficiently.

    Release date:2022-02-21 01:13 Export PDF Favorites Scan
  • 儿童癫痫的 50 年随访研究:医疗结局、发病率和药物治疗

    描述儿童癫痫的长期预后,尤其侧重于癫痫发作缓解、复发、药物治疗、相关神经系统功能障碍、死亡率和死亡原因。针对 1962 年—1964 年间基于人群总数为 195 例癫痫发作儿童队列的一项前瞻性纵向研究。数据均通过医疗记录和调查问卷收集。来自最初队列 94% 的随访数据显示,无智力或神经功能障碍的患儿,无癫痫发作的长期预后最好。这些患儿发病较晚,癫痫发作的持续时间较短,且通常不使用药物。他们中仅少数曾复发。全面性而非局灶性癫痫,通常较少复发,持续用药更短。 “真正发病”组,即在 1962 年—1964 年间纳入的发病患儿,无癫痫发作的长期预后最好,90% 在 50 年后癫痫无发作。尽管该组中仅 10% 在随访时仍有发作,但 22% 仍使用抗惊厥药物,且常使用传统药物—苯巴比妥或苯妥英钠作为抗癫痫药物之一。整个组的标准化死亡率(Standardized mortality ratio,SMR)为 2.61,且在有无其他神经系统缺陷的患者之间无差异。年轻的死亡患者部分有神经系统损伤,部分死于癫痫相关的情况,而年龄较大的患者死亡通常由非癫痫相关疾病导致。发病组中无患者死于癫痫猝死(Sudden unexpected death in epilepsy,SUDEP)。我们 12 年的随访和以往的报道相比,儿童癫痫患者的 50 年长期随访总体显示出更好的癫痫无发作结局。文章报道了癫痫发作较低的复发率,癫痫发作的缓解并不意味着药物治疗的终止,SUDEP 相关的死亡率也低于以往的报道。

    Release date:2021-01-07 02:57 Export PDF Favorites Scan
  • 癫痫患者更换抗癫痫药物后的预后分析:一项配对的前瞻性研究

    一系列单队列研究已对癫痫患者更换抗癫痫药物(AEDs)预后进行了分析。研究以对照研究方式第一次探究了这个问题,针对服用所有类型的AEDs的控制不佳和癫痫无发作的癫痫患者,通过配对前瞻性研究方法对这些结果作进一步补充。研究回顾9个月内所有的门诊患者以确定单药治疗局灶性癫痫患者。并将更换AEDs的患者作为病例组,维持原来单药治疗方案作为对照组。分别针对发作现状(前6个月内是否有癫痫发作)、目前AEDs和控制不佳的AEDs数量对病例组和对照组进行配对,并在6个月后评估结果。病例组中癫痫无发作患者(n=12) 在6个月随访期间癫痫发作复发率为16.7%,对照组为2.8%(n=36,P=0.11)。病例组中控制不佳癫痫患者(n=27) 在6个月随访期癫痫发作缓解率为37%,对照组为55.6%(n=27,P=0.18)。控制不佳癫痫患者中治疗失败的药物在2种或2种以上的患者更不容易在6个月内达到病情缓解(P=0.057)。AEDs的药理机制和改变AEDs剂量均对癫痫预后无影响。研究进一步对癫痫无发作患者进行评估,更换药物的患者比维持原药物治疗患者癫痫发作的复发风险高14%。与维持原来药物方案相比,更换AEDs对控制不佳癫痫患者来说并不可能更易获得缓解,说明癫痫缓解是疾病的自发性改变,而非药物作用。

    Release date:2017-09-26 05:09 Export PDF Favorites Scan
  • 癫痫的围发作期成像及基于成像治疗癫痫研究进展

    急性缺血性脑卒中是需要在时间窗内做出重要治疗决策的神经科急症,但癫痫围发作期常常模仿卒中或者其他疾病的表现,因此,癫痫围发作期的成像识别可明确癫痫是发作还是卒中,避免错误诊治带来的风险;基于成像的癫痫治疗可以更精准治疗癫痫起源灶,微创治疗能减少开颅手术带来新的医源性创伤,本文对癫痫围发作期成像和基于成像癫痫治疗的新进展进行综述。

    Release date:2020-05-19 01:07 Export PDF Favorites Scan
  • The effect of epileptic seizure on the empathy ability of patients with epilepsy

    Objective To explore the damage, damage model and influence factors of the empathy ability on patients with epilepsy by the Chinese version of interpersonal reaction index scale (IRI-C). Methods Eighty-eight non-symptomatic epilepsy patients who were from the First Affiliated Hospital of Dalian Medical University and 100 healthy controls were included in the study from March 2015 to January 2016. Patients with serious cognitive impairment and severe anxiety or depression were ruled out through neural psychology background screening (Montreal Cognitive Assessment, Hamilton anxiety and depression scale) due to their influence on empathy scores. Thereafter the empathy ability was compared between epilepsy patients and healthy controls using the IRI-C, and the effect of seizure type on empathy ability was analyzed. According to the epileptic seizure types of generalized tonic-clonic seizure (GTCS), patients were divided into 3 groups: non-GTCS group (simple or complex partial seizure, n=17), pure GTCS group (only primary GTCS attack, n=23) and SGS group (partial onset secondary GTCS,n=48). The control group included 100 healthy participants. In order to ensure the balance of sample size, 30 samples are randomly selected from SGS and control groups respectively for statistical analysis. Then patients were divided in two groups according to whether he/she has complex partial seizure (CPS), and 30 patients in each group. Statistical analysis was performed using SPSS18.0 software package. Results ① The total IRI-C Empathy scores, Cognitive empathy (CE) and two factors of the patients in epilepsy group were lower than those in control group (P<0.05), while there was no statistical difference in Emotional Empathy (EE) and two factors between groups (P>0.05). ②ANOVA showed the points of CE (include two factors) and total scores of empathy mean different between the four groups (P<0.05), and EE (include two factors) scores were no statistically significant differences between the four groups (P>0.05). The CE scores were differences between the GTCS group, pure GTCS group and SGS group. The scores of the perspective-taking was statistically significant differences (P<0.05) between the pure GTCS group and the SGS group. The scores of perspective-taking of SGS group were lower than the other groups (P<0.05) . In other words, the scores of the perspective-taking of SGS group were lower than those of the other three groups, and the CE scores were lower than the GTCS group and the control group. ③ The opinion selection, imagination, CE and total empathy score of CPS group were all worse than that of non-CPS group (P<0.05). Conclusions The empathy ability of epilepsy patientswere impaired in CE, but reserved in EE Epileptic subtype CPS and GTCS were risk factors of the decline in empathy ability in epilepsy patients.

    Release date:2018-05-22 02:14 Export PDF Favorites Scan
  • Effects of bacterial lysates on lung function and serum IgE in mice with acute exacerbation of asthma

    Objective To investigate the effects of a mixed bacterial lysate (OM-85 BV) on lung function and serum IgE in asthmatic mice under acute attack, and to explore the therapeutic effect of OM-85 BV on acute attack and the application value of OM-85 BV in non-acute attack. Methods A total of 30 SPF Kunming mice aged 4 to 6 weeks were randomly divided into 3 groups, namely a blank control group (Group A), an asthma model group (Group B), and an OM-85 BV intervention group (Group C). The mice in groups B and C were sensitized by intraperitoneal injection of ovalbumin on day 1, 8 and 15, respectively. From day 22, the asthma model was stimulated by inhalation of 5% ovalbumin every day for 30 min for 5 consecutive days. The mice in group C were treated with OM-85 BV dissolved in normal saline from day 1, and each mouse was gavaged continuously for 10 days. The intraperitoneal injection, intragastric administration and aerosol inhalation reagent of mice in group A were all replaced by normal saline, while the intragastric administration of mice in group B was replaced by normal saline. One hour after the last stimulation, the mice were anesthetized, their lung function was measured, blood was collected from the eyeballs and then they were sacrificed, and the blood was centrifuged and the serum was separated and stored. Hematoxylin and eosin staining was used for pathological examination. Serum IgE was determined by enzyme-linked immunosorbent assay. Results Compared with group A, forced vital capacity in 0.15 second (FEV0.15), FEV0.15/forced vital capacity (FVC) and peak expiratory flow (PEF) of mice in group B were significantly decreased. The lung function of group C was improved compared with group B. In group B, the pathological manifestations were dysplasia and collapse of bronchial epithelium, infiltration of inflammatory cells, mainly lymphocytes and eosinophils, a small amount of mucus and shed epithelial cells in the tracheal lumen, and significant thickening of airway wall. The asthma mouse model was well established. The pathological manifestations of airway in group C were less severe than those in group B, the thickness of airway wall was reduced, and the inflammatory cells were also significantly reduced. The serum IgE concentration in groups B and C increased, and the IgE level in group C decreased significantly compared with group B. The differences were statistically significant (all P<0.05). Conclusions Exogenous administration of OM-85 BV in asthmatic mice can effectively reduce the concentration of serum IgE, alleviate airway inflammation, reduce eosinophil infiltration, and improve the pulmonary function performance of asthmatic mice during acute attack, showing that FEV0.15/FVC, FEV0.15 and PEF indicators are significantly improved. OM-85 BV can alleviate the symptoms of bronchial asthma in the acute attack of mice, improve the physiological function of the lung during the acute attack, inhibit airway inflammation, and have certain application value in the stable asthma control.

    Release date:2023-04-28 02:38 Export PDF Favorites Scan
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