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find Keyword "惊厥" 23 results
  • 小儿烧伤惊厥的原因分析及干预措施

    目的 探讨小儿烧伤并发惊厥的原因及护理措施。 方法 回顾性分析2010年3月-2012年2月收治的35例患儿烧伤并发惊厥的临床病历资料。 结果 小儿烧伤惊厥的原因有休克、高热、电解质紊乱、烧伤毒血症、脑缺氧脑水肿,各种原因之间相互影响。本组35例患儿中,惊厥持续时间30 s~5 min不等,34例治愈,1例因多器官功能衰竭死亡,所有患儿随病情而好转。 结论 小儿烧伤后并发惊厥的原因较多,在治疗和护理过程中应随时把握病情变化,正确处理患儿高热、电解质紊乱等,一旦发生惊厥应采取及时有效的救护措施,防止意外发生。

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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
  • 作后血氨水平作为惊厥性癫痫发作的生物标志物:一项前瞻性研究

    有报道指出全面性惊厥性癫痫发作(Generalized convulsive seizures,GCS)后出现短暂性高血氨症(Transient hyperammonemia,THA),没有足够的证据证实与癫痫的关系。文章的目的是确定发作后THA是否可以区分不同类型的发作,如使用视频脑电图(VEEG)监测确认脑电变化。在前瞻性队列中,筛选了所有进入癫痫监测单元并同意接受研究的成年患者(> 18岁)。血氨的基础值以及在发作(所有患者)的60 min内、发作后24 h(只要有可能)的血氨水平均被检测。根据VEEG,将患者进行分组,分别为GCS、心因性惊厥性非痫性发作(Psychogenic nonepileptic seizures with convulsions,PNES-C)或局灶性癫痫发作(Focal seizures,FS)。使用描述性统计和参数/非参数方法分析数据。纳入患者78例,13例为GCS、8例为FS、9例为PNES-C。这些组在性别(P=0.04) 和血氨基础值(P=0.02) 方面是不同的,但年龄无差异。三组之间发作后血氨水平较血氨基础值的变化差异有统计学意义(P=0.004)。区分GCS与其他组差异的发作后血氨水平ROC曲线下面积为0.88[95%CI (0.69, 0.96)],表明检测血氨水平是一种很好的用来区分GCS与其他发作的试验。血氨水平≥80μmol/L可以准确为80%的患者分类(灵敏度53.9%,特异性100%)。VEEG监测为THA与GCS癫痫发作之间的关联提供了客观证据,并为今后关于确定发作后血氨水平作为GCS的廉价诊断试验作用的研究奠定了基础。

    Release date:2017-07-26 04:06 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
  • A QUIPS analysis of related factors of poor outcome in children with convulsive status epilepticus

    ObjectiveUsing Quality in prognosis studies (QUIPS) analysis, this paper systematically reviewed the factors influencing the poor outcome of children with convulsive status epilepticus (CSE).MethodsTo longitudinal cohort studies on the prognostic evaluation of CSE mortality and mobidity in children.The retrieval time was from January 2008 to November 2019, and three system reviewers PUBMED, EMBASE, COCHRANE and other databases were used to search for literatures related carried out literature extraction and quality evaluation. According to the QUIPS analysis method, the included literatures were scored, the quality grade was divided, and the analysis variables of medium/high quality literatures with statistical significance were selected to draw a conclusion.ResultsQUIPS analysis was used to assess the literature quality, 17 medium/high quality literatures were included, and the factors with statistical significance (P<0.05) mentioned at least twice or more in≥2 medium/high quality literatures were selected, which were considered as important risk factors affecting prognosis.These factors include: etiology, age, duration of convulsion, refractory CSE, neuroimaging abnormalities.ConclusionFive risk factors indicating poor outcome of CSE in children were summarized. Due to the heterogeneity of various literature studies, Meta-analysis has not been completed, so it has certain limitations.

    Release date:2021-04-25 09:50 Export PDF Favorites Scan
  • Progress in the study of the correlation between febrile convulsions and refractory epilepsy

    Febrile seizures (FS) are one of the most common neurological disorders in pediatrics, commonly seen in children from three months to five years of age. Most children with FS have a good prognosis, but some febrile convulsions progress to refractory epilepsy (RE). Epilepsy is a common chronic neurological disorder , and refractory epilepsy accounts for approximately one-third of epilepsies. The etiology of refractory epilepsy is currently complex and diverse, and its mechanisms are not fully understood. There are many pathophysiological changes that occur after febrile convulsions, such as inflammatory responses, changes in the blood-brain barrier, and oxidative stress, which can subsequently potentially lead to refractory epilepsy, and inflammation is always in tandem with all physiological changes as the main response. This article focuses on the pathogenesis of refractory epilepsy resulting from post-febrile convulsions.

    Release date:2023-09-07 11:00 Export PDF Favorites Scan
  • Correlation of inflammatory cytokines with clinical manifestations and prognosis in children with febrile seizures.

    ObjectiveTo explore the effects of cytokines on Febrile seizures (FS) in children with febrile seizures (Febrile seizures), febrile seizures duration and prognosis, and to explore the correlation between cytokines and the clinical manifestations and prognosis of FS. MethodsA retrospective analysis was performed on 121 children with FS (77 cases in the simple FS group and 44 cases in the complex FS group) who were treated in the pediatrics department of the Maternal and Child Health Hospital of Inner Mongolia Autonomous Region from January 2021 to October 2022 as the experimental group, including 71 males and 50 females, with a male-to-female ratio of 1.42:1, according to the type of attack (93 cases in the comprehensive group, 44 cases in the complex FS group). The focal group (28 cases) and convulsion duration (91 cases in <5 min group and 30 cases in ≥5 min group) were divided into groups, and 127 cases of children with fever but no convulsions were compared with the control group. In addition, 121 children with FS were followed up for 1 year by neurology specialist outpatient department and telephone follow-up. According to the follow-up, they were divided into the first course group, the relapse group and the secondary epilepsy group, so as to further explore the correlation between cytokines and the prognosis of children with FS. ResultsExperimental group compared with control group: Serum IL-1β (1.38 pg/mL), IL-2 (2.26 pg/mL), IL-4 (1.53 pg/mL), IL-6 (10.51 pg/mL), IL-10 (3.09 pg/mL), IL-12p70 (1.74 pg/mL), TNF-α (2.11 pg/mL), IFN-γ (46.56 pg/mL), IL-1β (1.38 pg/mL), IL-1β (1.26 pg/mL), IL-4 (1.53 pg/mL), IL-6 (10.51 pg/mL), IL-10 (3.09 pg/mL), IL-12P70 (1.74 pg/mL), TNF-α (2.11 pg/mL), IFN-γ (46.56 pg/mL). IFN-α (25.92 pg/mL) levels were higher, and the differences were statistically significant (P<0.05). There was no significant difference between the simple group and the complex group (P>0.05). <5 min group compared with control group: serum levels of IL-2 (2.32 pg/mL), IL-4 (1.53 pg/mL), IL-6 (9.65 pg/mL), IL-12p70 (1.74 pg/mL), TNF-α (2.11 pg/mL), IFN-γ (44.63 pg/mL), IFN-α (29.67 pg/mL) were higher, and the differences were statistically significant (P<0.05). Compared with control group, the levels of IL-2 (2.06 pg/mL), IL-6 (14.67 pg/mL), IL-12p70 (1.97 pg/mL), IFN-γ (58.56 pg/mL) and IFN-α (17.50 pg/mL) in ≥5 min group were higher, and the differences were statistically significant (P<0.05). ROC curve analysis showed that serum IFN-α had a high predictive value for FS onset, the cut-off point was 8.64pg/ml, and the sensitivity and specificity were 75.63% and 76.38%, respectively. There was no significant difference between the first course of disease group, relapse group and secondary epilepsy group. ConclusionSerum proinflammatory cytokines IL-1β, IL-2, IL-6, IL-12p70, TNF-α, IFN-γ, IFN-α and anti-inflammatory cytokines IL-4 and IL-10 are involved in the pathogenesis of FS. There was no correlation between the simplicity and complexity of serum cytokines. IL-2, IL-6, IL-12p70, IFN-γ, IFN-α were positively correlated with the duration of convulsion. When serum IFN-α>8.64 pg/ml, the possibility of FS attack increased.

    Release date:2024-03-07 01:49 Export PDF Favorites Scan
  • Effect of Lidocaine-induced Seizure on Spatial Learning Memory in Rats

    目的 研究利多卡因对海马的神经毒性是否会对大鼠空间学习记忆能力产生影响,并探讨大鼠空间学习能力的变化与海马CA3区锥体细胞数目的相关性。 方法 将成年Wistar雄性大鼠随机分为基础值组(n=7)和利多卡因惊厥组(n=40)。基础值组大鼠静脉给予生理盐水后使用Y迷宫测定大鼠的空间学习能力。利多卡因惊厥组大鼠尾静脉持续输注利多卡因造成惊厥,待大鼠恢复正常运动以后放入鼠笼重新饲养。并于惊厥后第1、3、5、7天从中随机抓取大鼠测试其空间学习能力以及组织学改变。根据对应天数将利多卡因惊厥组的40只大鼠随机细分为Day-1、Day-3、Day-5、Day-7亚组,每亚组10只。所有大鼠在测定空间学习能力之后立即处死,取出大脑并做石蜡包埋,冠状面切片后进行组织学检测,显微镜下评估海马CA3区锥体细胞状态。 结果 ① 基础值组和Day-1、Day-3、Day-5、Day-7亚组大鼠的Y迷宫穿梭次数分别为(25.2 ± 3.7)、(27.1 ± 8.1)、(36.9 ± 9.9)、(38.7 ± 10.6)、(40.6 ± 16.3)次,除Day-1亚组与基础值组比较差异无统计学意义(P>0.05)外,其余各亚组与基础值组差异均有统计学意义(P<0.05);② 与基础值组单位面积(10.3 ± 4.5)个(异常锥体)细胞比较,利多卡因惊厥组大鼠海马CA3区异常锥体细胞数增加,Day-1、Day-3、Day-5、Day-7亚组计数值分别为13.0 ± 7.2、15.6 ± 5.0、19.6 ± 8.1、18.1 ± 5.1,且与大鼠Y迷宫穿梭次数呈正相关(r=0.711,P<0.05)。 结论 利多卡因引起的惊厥使成年大鼠海马依赖性空间学习能力下降,利多卡因的神经毒性引起的海马异常锥体细胞增多可能是造成这一现象的一种原因。

    Release date:2016-09-08 09:13 Export PDF Favorites Scan
  • Nursing care of a patient with nonconvulsive status epilepticus accompanied by disturbance of consciousness

    According to their seizure patterns and EEG findings, status epilepticus can be divided into convulsive status epilepticus (CSE) and nonconvulsive status epilepticus (NCSE). Patients with NCSE have well-established EEG abnormalities without typical convulsive convulsions and only altered mental status or mild motor symptoms. Due to its atypical clinical symptoms, NCSE is prone to delayed diagnosis, misdiagnosis, or missed diagnosis, resulting in irreversible brain tissue damage, severe impairment of consciousness, function, and behavior, and even death in NCSE patients. It is of great significance to actively prevent seizures, identify symptoms early, and standardize treatment to improve the prognosis of NCSE patients. At present, there is no relevant standard and consensus on NCSE diagnosis and care. Here, we reported a patient with NCSE who admitted to the Epilepsy Center of Beijing Tiantan Hospital on June 21, 2024. After precise treatment and nursing, the patient's symptoms were well controlled, his condition was stable, and he was followed up for 1 month after discharge, and the prognosis was good. This case report aimed to provide some clinical suggestions to related disease.

    Release date:2025-03-19 01:37 Export PDF Favorites Scan
  • The aetiology and prognosis of convulsive status epilepticus: a study of 331 cases in Tibet Lhasa area

    Objectives Retrospective analysis of the Tibetan convulsive status epilepticus (CSE) for the aetiology, prognosis and its influencing factors in Tibet area. Methods Through electronic patient record, making “epilepsy”, “status epilepticus ”, “epileptic seizure” as keywords, convulsive status epilepticus patients in the People’s Hospital of Tibet Autonomous Region hospitalized from January 2015 to December 2020 were retrospectively observed, gathering their clinical data and aided examinations furthermore, and the prognoses were returned by telephone, meanwhile the functional status of those patients was assessed by the modified rankin scale. and the causes differ in gender, age, out-of-hospital antiepileptic treatment, family history of epilepsy and history of epilepsy were analyzed. The prognostic factors were analyzed by logistic regression. Results A total of 2 254 hospitalized patients with epilepsy were retrieved, including 331 CSE patients aged 14~84 years, 219 males and 112 females. There were 36 lost calls, 62 CSE deaths (21.01%), and 4 adverse outcomes (non-death)(1.7%).There were statistically significant differences in etiology of CSE in different ages and history of epilepsy (P<0.05), but there were no statistically significant differences in gender, out-of-hospital antiepileptic treatment, progression of refractory status epilepticus and family history of epilepsy. Cerebrovascular disease was the main cause of CSE in people aged 45 and over (54 cases), while the main cause of CSE in people aged under 45 was unknown (104 cases).Among the patients with previous history of epilepsy, the highest proportion was unknown cause [117 cases (48.8%)]; Among patients without a history of epilepsy, cerebrovascular disease [34 cases (37.4)] was the most common cause of CSE. Multivariate logistic regression analysis of prognostic factors of CSE showed that gender, age, GCS and electrolyte disorder had statistically significant effects on the death of CSE patients (P<0.05), while altitude and their duration and other factors had no statistically significant effects on the death of CSE patients (P>0.05). ConclusionsCerebrovascular disease is the leading cause of CSE in people aged 45 and over. Male, advanced age, low GCS score at discharge, and electrolyte disorder were risk factors.

    Release date:2022-06-27 04:41 Export PDF Favorites Scan
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