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

Search

find Keyword "痫性发作" 20 results
  • 心因性非痫性发作的精神相关长期预后

    探讨心因性非癫痫性癫痫发作(Psychogenic nonepileptic seizures,PNES)患者的长期心理状态、人格和健康相关生活质量(Health-related quality of life,HRQoL),并确定 PNES 预后的相关预测因子。选取在 Erlangen 癫痫中心的视频脑电图(VEEG)监测过程中被诊断为 PNES 的病例,病程 1~16 年。随访数据为心理症状问卷(贝克抑郁量表-II、症状清单-90-标准、分离症状问卷),人格特质(Freiburg 弗莱堡人格量表-修改版)和 HRQoL(36-项简短健康调查)。共纳入 52 例患者,平均年龄(40.5±14.0)岁,女性 75%,随访(5.3±4.2)年。在过去的 12 个月中,有 19 例(37%)患者 PNES 得到了缓解。持续性 PNES 患者在疾病首次发作(32.9 vs. 22.3 岁,P<0.01)和诊断(40.5 vs. 27.2 岁,P<0.001)时年龄较大,表现出较差的心理状态、较低的外向性人格和较低的生活满意度,同时 HRQoL 较非 PNES 患者更差。PNES 缓解患者在所有方面均处于正常范围内。PNES 的最佳缓解预测指标为发病时年龄较小和人格外向性。持续性 PNES 患者的预后较差,精神病理学指标较高且 HRQoL 较低,但可能因 PNES 的缓解而恢复正常。人格内向性高和年龄较大是持续性 PNES 的危险因素。

    Release date:2020-09-04 03:06 Export PDF Favorites Scan
  • 脑血管疾病继发癫痫:实验回顾和临床危险因素的荟萃分析

    癫痫发作可能发生在刚刚卒中发生以后或在很久以后。此外,癫痫也常发生在患有脑白质疏松的患者。尽管卒中后早期痫性发作被广泛研究,卒中后癫痫(Post-stroke epilepsy,PSE)和与脑白质疏松相关癫痫(Epilepsy associated with leukoaraiosis,EAL)研究较少。文章目的是回顾PSE和EAL相关病理生理学,预后和治疗情况。并进行了广泛的文献检索,以筛选关于PSE和EAL的动物实验和临床文章。同时,还对纳入研究中PSE和EAL发生的风险因素进行了系统的回顾分析。PSE是由于瘢痕组织内和其附近神经元兴奋性增加引起的。白质改变在EAL中的作用尚待阐明。荟萃分析显示皮质受累[ OR=3.71,95% CI (2.34, 5.90),P < 0.001],脑出血[ OR=2.41,95% CI (1.57, 3.70),P < 0.001]和早期痫性发作[ OR=4.43,95% CI (2.36, 8.32),P < 0.001]显著增加PSE发生风险。关于EAL,没有前瞻性、基于人群的研究评估不同变量对癫痫发作风险的影响。关于PSE治疗的研究相对有限。PSE药物控制效果通常良好。有关危险因素、预后和EAL治疗的资料较缺乏。PSE的病理生理学和危险因素是明确的,但在EAL中仍需进一步阐明。PSE和EAL的治疗依赖于临床医生的判断,并应在个人基础上进行调控。

    Release date:2017-05-24 05:46 Export PDF Favorites Scan
  • 医疗人员对心因性非痫性发作的观点研究:基于定性与定量研究的系统回顾

    近期一篇关于心因性非痫性发作(Psychogenic nonepileptic seizures,PNES)的系统分析表明,该类患者总是会有不愉快的就医经历,因此详细了解其中相互关系至关重要。文章旨在探究医疗人员对 PNES 的态度与看法。系统性检索截至到 2017 年 11 月前发表在 3 个主要数据库的文章(Web of Science、PubMed、CINAHL),并回顾 1997 年以后发表的定性或定量的方法学研究。基于扎根理论来解释数据,使用 Mixed Methods Appraisal Tool 进行质量评价。总共 30 篇独立文章,其中包含了至少 3 900 名专业人员的观点。在分析中出现了 5 个解释性概念:① 不确定性,医疗人员表示他们对 PNES 的许多方面都感到不确定,包括诊断和治疗;② 理解,医疗人员对 PNES 的理解是基于二元论,他们认为 PNES 与心理精神因素的关系极大;③ 挫折感与挑战性,对 PNES 患者的诊断治疗被认为是有挑战性的,并令人感到沮丧的;④ 责任,医疗人员对于“谁应该为 PNES 患者的治疗负责”是有争论的;⑤ 预后与残疾,与癫痫相比,医疗人员普遍认为 PNES 症状相对较轻,致残率也没有癫痫高,并且与自身的自制力有关。尽管有一些医师对 PNES 有较深刻的理解,但是仍有一部分医师的观点需要更新和提高。有一部分研究在调查中是直接询问医师“对 PNES 疾病的观点”,这样的研究存在局限性。此外,有一些学科专业的医师并没有被研究调查(如精神健康专业医师)。研究还表明,对医师们进行 PNES 额外教学训练是有必要的,但同时也需要改变医师们对 PNES 的态度。

    Release date:2019-05-21 08:51 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
  • Clinical Value of Video-electroencephalograph for Non-epileptic Seizures Disease in Children

    ObjectiveTo explore the clinical value of video-electroencephalograph (VEEG) for non-epileptic seizures disease in children. MethodsThe clinical data of 58 children with non-epileptic seizures (NES) diagnosed by VEEG from October 2010 to November 2012 were retrospectively analyzed. ResultsIn 50 out of 58 patients in the process of monitoring,the NES clinical onset was found while no synchronized epileptiform discharges was observed;in five patients with NES combined with epilepsy,no epileptiform discharges was found by VEEG at the clinical onset of NES;there were 3 patients with epileptiform discharges without seizures,who had no history of epilepsy,but non-synchronized clinical nonparoxysmal epileptiform discharges was found by VEEG monitoring. ConclusionVEEG is an effective diagnosis method for NES and seizures in children,which could be regarded as the gold standard for NES diagnosis.

    Release date: Export PDF Favorites Scan
  • 心因性非癫痫性发作影像学检查方法的应用进展

    心因性非癫痫性发作(Psychogenic non-epileptic seizures,PNES)是阵发性疾病,临床症状与癫痫十分相似,临床上 PNES 确诊的金标准是视频脑电图(VEEG)。近年来,随着影像学技术的发展,一些影像学检查方法也已用于 PNES 的辅助诊断。回顾近年的相关文献,对 PNES 的影像学检查方法的应用进展进行综述。

    Release date:2018-03-20 04:09 Export PDF Favorites Scan
  • Efficacy of low to moderate doses of levetiracetam as initial monotherapy in adult patients with partial epilepsy

    Objective To explore the efficacy of low to moderate doses of levetiracetam in adult patients with newly diagnosed partial epilepsy and possible predictors for poor treatment response. Methods We retrospectively analyzed the clinical data of patients treated in West China Hospital from March 2011 to December 2015 whose clinical data were input into the Epilepsy database. Patients with newly diagnosed partial epilepsy and whose initial anti-epileptic drug was levetiracetam were screened out for this study. Their clinical data, especially responses to the treatment of levetiracetam were reviewed. Results Ninety-six patients were included in this study. Seventy-one of them achieved seizure-free for a complete year after initial treatment of levetiracetam. Forty-eight patients (50.0%) achieved seizure-free with levetiracetam monotherapy; 23 patients (24.0%) achieved seizure-free for one year with levetiracetam combination therapy. Sixty-nine (97.2%) of the 71 patients achieved seizure-free with low to moderate doses of levetiracetam (500 to 1 500 mg/day), with or without combination of other antiepileptic drugs. High baseline seizure frequency before initial therapy was an independent predictor of poor levetiracetam response in this multivariate logistic regression mode (P=0.019). Conclusions Low to moderate levetiracetam is both effective and well tolerated in newly diagnosed partial epilepsy patients. High baseline seizure frequency before initial therapy is an independent predictor of poor levetiracetam response.

    Release date:2017-05-18 01:09 Export PDF Favorites Scan
  • Analysis of clinical features of non-epileptic psychotic seizures in Tibetan population

    ObjectiveTo analyze the clinical features of psychogenic non-epileptic seizures (Psychogenic nonepileptic seizures, PNES) in Tibetan population in Tibet, so as to help clinicians identify the disease.MethodsRetrospective analyzed the clinical data of patients with PNES in the Department of Neurology, People's Hospital of Tibet Autonomous Region from June 2016 to December 2018.ResultsIn general clinical data, there were significant differences between male and female patients in the results of video electroencephalogram (EEG) monitoring the non-epileptic seizures (P< 0.05). There were no significant differences in mean age, mean onset time, family history of epilepsy, head injury and marital status between male and female patients (P> 0.05). There was no significant difference in symptoms between male and female, but there were differences among different age groups (P> 0.05). In the onset age, the main manifestation was young women, but there was no significant difference in the onset of PNES among different age groups.ConclusionsThere was significant differences between male and female PNES petients, but no significant differences in onset time, marriage and family history of epilepsy between the male and female patients with PNES in Tibet. The clinical manifestations of PNES were different in different ages of patients in Tibet.

    Release date:2020-01-09 08:49 Export PDF Favorites Scan
  • 心因性非癫痫性发作的诊断和鉴别诊断

    心因性非癫痫性发作(Psychogenic non-epileptic seizures,PNES)是转换障碍疾病最常见的临床表现之一,其临床症状和癫痫发作(Epileptic seizure,ES)十分相似,但发作时没有异常的脑电活动。在日常临床工作中,PNES 常被误诊为癫痫,并给予不恰当的治疗,给患者带来极其不利的后果,且有增加死亡率的风险。因此,早期明确诊断是治疗 PNES 的关键。回顾近年文献,对 PNES 的诊断方法及与其他疾病的鉴别诊断方法进行综述,以期尽早对 PNES 明确诊断,给予恰当的治疗。

    Release date:2018-01-20 10:51 Export PDF Favorites Scan
  • 新型抗癫痫药物在控制孕期痫性发作的效能

    评估新型抗癫痫药物(AEDs)——拉莫三嗪、托吡酯与左乙拉西坦在患者妊娠期中控制痫性发作的效能。分析在澳大利亚登记数据库中应用AEDs控制痫性发作的癫痫患者中1 534例次患者妊娠的数据。在澳大利亚癫痫登记的数据中,接受单种AED治疗的1 111例次妊娠的患者中,妊娠期使用左乙拉西坦控制发作的患者的痫性发作控制率与服用传统AEDs如卡马西平、丙戊酸的发作控制率相近;优于拉莫三嗪、托吡酯在孕期的发作控制率。左乙拉西坦作为控制癫痫患者的妊娠期发作的药物有应用前景。

    Release date: Export PDF Favorites Scan
2 pages Previous 1 2 Next

Format

Content