摘要
Objective Measuring the serum concentrations of adrenocorticotropic hormone （ACTH） and cortisol in epileptic seizures during sleep to investigate their link to the EEG changes. Methods Pre-surgical evaluation was performed by videoEEG monitoring using 24 channel recording. Thirty six epilepsy patients could be attributed to two groups： 28 patients had spontaneous seizures, and the other 8 patients whose seizures were induced by bemegride. Another 11 persons with confirmed psychogenic non-epileptic seizures （PNES） served as control group. Blood samples were obtained at five points： wake （08：00 a.m.）, sleep （00：00 a.m.）, and shortly before, during and after an epileptic seizure. The serum ACTH and cortisol were measured and analyzed by chemiluminescent immunoassay. Results The levels of ACTH and cortisol in serum underwent significant changes： declining below the average sleep-level shortly before seizures, increasing during seizures, and far above the average wake-level after seizures （P 〈 0.001）. Such changes did not occur in the control group （P 〉 0.05）. The ACTH and cortisol levels had no significant difference between spontaneous group and bemegride-induced group （P 〉 0.05）. Conclusion The serum concentrations of ACTH and cortisol during sleep seizures are linked with pre-ictal and ictal EEG changes in epilepsy patients.
目的探讨睡眠癫痫患者临床发作时血清促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)和皮质醇的变化及其与脑电波变化之间的联系。方法采用24导video-EEG对睡眠癫痫患者进行脑电监测,并对其发作前瞬时的EEG进行分析,采用化学发光免疫法在清醒时、睡眠时、发作前瞬间、发作时和发作后的5个时间点测定血清中ACTH和皮质醇的浓度。在36例睡眠癫痫患者中,28例为自然发作,8例为贝美格诱发发作。用11例假性心因性癫痫发作患者作为对照组。结果睡眠癫痫发作前、中、后血清ACTH和皮质醇的浓度有显著差异(P<0.001),发作前瞬间降低,发作时升高,发作后明显升高;假性癫痫发作对照组的血清ACTH和皮质醇浓度在发作时无明显变化(P>0.05);贝美格诱发发作组与自然发作组间ACTH和皮质醇比较无显著差异(P>0.05)。结论睡眠癫痫患者血清ACTH和皮质醇与癫痫发作前和发作时的脑电变化有密切关系。
