地西泮终止大鼠晚期癫痫持续状态的效果观察

Diazepam in Treatment of Late Status Epilepticus Induced by Lithium and Pilocarpine in Rat Model

目的观察大鼠癫痫持续状态(SE)4h以后时间窗时,地西泮终止其发作的疗效。方法SD雄性大鼠,随机分为3组:对照组、持续棘波发放期(3期,1h)给药组和晚期周期性痫性波发放期(5期,PED,4h)给药组。采用氯化锂-匹罗卡品化学药物诱发大鼠SE,行为学观察和脑电图(EEG)记录持续到SE开始后5h。结果3组中SE1、2期的时长没有统计学差异,但地西泮能明显缩短SE3、4期的时长。即使在SE5期,给予地西泮后绝大多数SE大鼠能成功地终止其行为学和EEG上的痫性发作。结论(1)地西泮终止SE4h以后发作的效果比早期更为容易,提示癫痫持续的时间越长越不容易终止发作的结论在SE早期适用,可能并不适用于SE晚期;(2)在大鼠SE模型,海马与皮质EEG一样,也显现出5个特异性波形期。

Objective The aim ofthe present study was to investigate the efficacy of diazepam （DZP） treatment given at two different phases of status epilepticus （SE） in a lithium -pilocarpine rat model： during continuous ictal discharges （CIDs, phase 3）, and during late periodic epileptiform discharges （ late PEDs, phase 5）. Methods SD rats were randomly divided into three groups ： Group A （ given DZP during CIDs, phrase 3, 1 h）, Group B （ given DZP during late PEDs, phrase 5, 4h）, and a control group. Changes in cortical and hippocampal electroencephalographs （EEGs） were observed continuously during the phases of SE, as well as at 24th, 36th, 48th, and 72nd hours after SE onset. We compared the rats （treated with DZP during CIDs and late PEDs） with the control rats who were not treated with DZP. Results In all three groups, hippocampal and cortical EEGs displayed five distinct phases of SE. There was no significant difference in the duration of phases 1 and 2 among the three groups. Although DZP administration during CIDs did not terminate CIDs in most rats, it did significantly shorten the duration of phases 3 and 4 of SE. Importantly, DZP given during phase 5 successfully ended behavioral and electrographic seizures in most rats. Conclusion Hippocampal and cortical EEGs displayed five distinct phases of SE that were similarly responsive to DZP treatment. Termination of electrographic seizures with DZP treatment was more effective in the last phase of SE （late PEDs） than in phase 3 （CIDs）. These findings suggest that the conclusion may refer to early phrase of SE but may not to late phrase that the longer epileptic seizure lasts, the more difficult termination can be.