A case of migraine misdiagnosed as epilepsy

Background:Migraine and epilepsy are both episodic disorders,with some overlapping symptoms,mechanisms and therapies.Clinically,there is a comorbid relationship between them.Some migraine patients may exhibit epileptic discharges by electroencephalogram(EEG)recording.Therefore,the two conditions are easily misdiagnosed.Case presentation:We reported a 16-year-old female patient who was admitted to our hospital due to repeated headaches with disturbance of consciousness.Epileptic discharge was recorded by long-term EEG.The patient had been misdiagnosed as epilepsy,and had no response to anti-seizure medicines(ASMs).We revised her diagnosis and prescribed ibuprofen in her acute episode and prophylactic medicine,including funarizine and amitriptyline in her interictal period.One week later,her headache disappeared.Conclusions:This patient manifested with altered levels of consciousness during headache episodes,and the abnormal EEG results lead to the misdiagnosis as epilepsy.Clinicians should be cautious to the distinction between migraine and epilepsy.

SFRP5 inhibits melanin synthesis of melanocytes in vitiligo by suppressing the Wnt/b-catenin signaling

Secreted frizzled-related protein 5(SFRP5)plays a pivotal role in regulating the development of many tissues and organs,however,as an inhibitor of Wnt signaling,the role of SFRP5 in vitiligo remains unknown.Hence,we speculated that SFRP5 might be associated with melanogenesis in melanocytes by regulating Wnt signaling in vitiligo.In this study,we found that SFRP5 was overexpressed in the skin lesions of patients with vitiligo.Compared with that in normal epidermal melanocytes(PIG1),the expression of SFRP5 was increased in vitiligo melanocytes(PIG3V).To investigate the effect of SFRP5 on melanin synthesis,PIG1 cells were infected with recombinant SFRP5 adenovirus(AdSFRP5),and PIG3V cells were infected with recombinant siSFRP5 adenovirus(AdsiSFRP5).The results showed that SFRP5 overexpression inhibited melanin synthesis in PIG1 cells through downregulation of microphthalmia-associated transcription factor(MITF)and its target proteins via suppression of the Wnt/b-catenin signaling pathway.Accordingly,SFRP5 silencing increased melanin synthesis and activated the Wnt signaling pathway in PIG3V cells.Moreover,SFRP5 overexpression also downregulated the transcriptional activity of T cell factor/lymphoid enhancer factor(TCF/LEF)in PIG1 cells.Furthermore,this inhibitory effect of SFRP5 on melanin synthesis was reversed by treatment with the b-catenin agonist,SKL2001.The inhibitory action of SFRP5 in pigmentation was further confirmed in vivo using a nude mouse model.Hence,our results indicate that SFRP5 can inhibit melanogenesis in melanocytes.Additionally,our findings showed that SFRP5 plays a vital role in the development of vitiligo,and thus may serve as a potential therapeutic target for vitiligo.

A Study on the Biocompatibility of MgO Coating Prepared by Anodic Oxidation Method on Magnesium Metal

Magnesium(Mg),is widely used for the bone repair in oral and orthopedic application due to excellent bioactivity,degradation and biocompatibility.However,the range of application is greatly limited because of the rapid degradation of Mg metal in the body.Surface modification is an effective method to enhance the corrosion resistance and reduce the degradation rate of Mg metal.In the present study,pure Mg metal(P-Mg)was subjected to alkali-heat treatment(AT-Mg)or anodic oxidation-heat treatment(AO-HT-Mg).Both AT-Mg and AO-HT-Mg had a layer of MgO on their surfaces after treatment.Then the effects of MgO coating on corrosion resistance,bioactivity,Mesenchymal Stem Cells’(MSCs)proliferation,adhesion and osteogenic differentiation,and the bone repair capability of Mg metal were investigated.We found both AT-Mg and AO-HT-Mg had stronger corrosion resistance than P-Mg.MSCs on both AT-Mg and AO-HT-Mg had higher expression of proteins and genes of ALP,OCN,Col-I and Runx2 than those on P-Mg.They also showed better bone repair property than P-Mg in vivo.In general,MgO layer formed by anodic oxidation-heat treatment had better resistance and biocompatibility than that produced by alkali-heat treatment.This study indicated the MgO coating not only improved the corrosion resistance of Mg metal,but also promoted the osteogenic differentiation of MSCs and bone regeneration.

Sewage sludge ditch for recovering heavy metals can improve crop yield and soil environmental quality

The treatment and disposal of municipal sewage sludge(MSS)is an urgent problem to be resolved in many countries.Safely using the nutrients within MSS to increase crop yield and enhance the fertility of poor soil could contribute to achieving sustainable development.An indirect use of MSS in ditches alongside Pennisetum hybridum plants was studied in field plots for 30 months and the contents of heavy metals and macronutrients were monitored in soil,sludge and plant samples.We found that the yield of P.hybridum was significantly increased by 2.39 to 2.80 times and the treated plants had higher N content compared with no sludge.In addition,the organic matter(OM)and N contents in the planted soil increased significantly compared with the initial soil.The OM content in the planted soil of the MSS treatment was 2.9 to 5.2 times higher than that with no sludge,and N increased by 2.0 to 3.8 times.However,MSS had no significant effect on the N,P and K contents in the soil at the bottom of the MSS ditch,and the content of heavy metals(Cd,Pb,Cu and Zn)were also within the safe range.Moreover,the moisture content and phytotoxicity of MSS after this indirect use were reduced and the heavy metal contents changed little,which is favorable to the further disposal of recovered MSS.Therefore,this indirect use of MSS is beneficial to agricultural production,soil quality and environmental sustainability.

Research progress on the prediction of post-stroke epilepsy

Epilepsy is a common neurological disease that not only causes difficulties in the work and life activities of patients,but also brings complex social problems.Cerebrovascular disease is currently the main cause of epilepsy in the elderly.With the increased survival rate of patients after stroke,the incidence of epilepsy after stroke has also increased.Effective prediction of epilepsy after stroke is extremely crucial for the prognosis of patients,the initiation of antiepileptic therapy and the reduction of epileptic seizures.In this review,we summarize and compare the current models for the prediction of epilepsy after stroke,including the SeLECT prediction model,Post-Stroke Epilepsy Risk Scale(PoSERS),CAVE score,electroencephalogram(EEG)prediction model,and Scandinavian Stroke Scale(SSS)score,in order to provide reference for clinical practice and future research.Prediction models can be selected based on the clinical classification of cerebrovascular events.The SeLECT score prognostic model is a better choice for ischemic stroke,especially for the exclusive prediction of mild post stroke epilepsy.The CAVE score model is suitable for intra-cerebral hemorrhage patients.It is simple and offers high correlation between the risk factors and epilepsy.The PoSERS score simultaneously predicts ischemic and hemorrhagic stroke,and is superior to other methods in specificity as well as positive and negative prediction rate.The SSS score,which only measures stroke severity,is not strictly considered as a mature predictor,but it can be used as a first step screening tool.A growing number of large studies are under the way to identify risk factors of poststroke epilepsy(PSE)and to improve the inclusion of predictive indicators.New and advanced findings by EEG recordings may further improve the prediction of PSE.

miRNA-let-7i modulates status epilepticus via the TLR4 pathway

Background:Status epilepticus(SE)is a neurological emergency associated with high mortality and morbidity.Many SE episodes cannot be quickly and effectively terminated with current medications.miRNA-Let-7i,a member of the miRNA-Let-7 family,has been found to be associated with a variety of brain pathophysiological and neurological diseases.However,its role in SE remains elusive and requires further clarification.Methods:The expression of miRNA-Let-7i was detected in temporal lobe epilepsy(TLE)patients and SE model rats using the real-time quantitative polymerase chain reaction(RT-qPCR)method.Behavioral assays were performed in pilocarpine-induced SE model,and a whole-cell current clamp technique was employed to examine neuronal excitability.Neuronal apoptosis was evaluated by Nissl staining and terminal deoxynucleotidyl transferase-mediated dUTP end-labeling(TUNEL)assays.Results:The expression of miRNA-Let-7i was significantly reduced in the cortex and hippocampus of SE rats.The miRNA-Let-7i agomir and antagomir effectively regulated the levels of miRNA-Let-7i.In particular,the agomir significantly reduced the degree of SE and prolonged the latent period of SE,whereas the antagomir increased the degree of seizures and shortened the latent period.In addition,the agomir significantly decreased the frequency of action potentials,while the antagomir significantly increased it.Nissl staining and TUNEL assays demonstrated that the agomir increased the survival and decreased the apoptosis,while the antagomir had the opposite effects.In addition,a Toll-like receptor 4(TLR4)inhibitor rescued the effects of antagomir on SE behavior and expression of IL-6 and TNF-α.Similar results on miRNA-Let-7i expression and effects of TLR4 inhibition were found in brain tissues of TLE patients.Conclusions:The miRNA-Let-7i−TLR4 regulatory pathway is involved in SE,which provides insights into the pathogenesis of SE.

Preparation and application of novel chitosan-cellulose composite materials to adsorb Pb(Ⅱ)and Cr(Ⅵ)ions from water

This paper reported the preparation and application of novel chitosan-cellulose composite absorbents for the adsorption of Pb(II)and Cr(VI)ions in water.First,oxycellulose or dialdehyde cellulose(DAC)was prepared by sodium periodate oxidation of microcrystalline cellulose(MCC).Second,based on the mechanism of the Mannich reaction,a chitosan/cellulose-based adsorbent(TSFCD)was produced through a cross-linking reaction of thiosemicarbazide(TS)with DAC and chitosan(CS),which was designed specifically for the adsorption of Cr^(6+)ions from water.Similarly,another chitosan/cellulose-based adsorbent(DBFCM)was also prepared with 2,5-dithiobiurea(DB)as the cross-linking agent for the adsorption of Pb^(2+)ions in water.The adsorption performance of TSFCD and DBFCM for Cr^(6+)and Pb^(2+)ions,respectively,was investigated under various process conditions.Variables included adsorption temperature,time,initial metal ion concentration,pH,and adsorbent dosage.The adsorption kinetics of TSFCD and DBFCM were studied,and isothermal models were developed.Results showed that the adsorption amount increased with the increase of the reaction time,and reached a maximum at about 300 min for the TSFCD/Cr^(6+)system,and at about 240 min for DBFCM/Pb^(2+)system.The adsorption performance of TSFCD for Cr^(6+)and DBFCM for Pb^(2+)improved at higher temperature,and leveled off at 40℃ and 50℃,respectively.In addition,the removal rate of Cr^(6+)increased from 49.96%to 70.22%when the TSFCD dosage increased from 0.5 g/L to 3.5 g/L.Similarly,the removal rate of Pb^(2+)increased from 22.23%to 99.45%with the increase of DBFCM dosage from 0.5g/L to 5.0g/L.The adsorption processes of Pb^(2+)and Cr^(6+)were in line with the pseudo-second-order kinetic and the Langmuir isothermal model.

Seizures and epilepsy secondary to viral infection in the central nervous system

Viral infection in the central nervous system(CNS)is a common cause of seizures and epilepsy.Acute symptomatic seizures can occur in the context of almost all types of acute CNS viral infection.However,late unprovoked seizures and epilepsy may not be frequent after viral infection of the CNS.The incidence of seizures and epilepsy after CNS viral infection is mainly dependent on the brain region of infection.It remains to be determined whether treatment of CNS viral infection using antiepileptic drugs(AEDs)can prevent seizures and subsequent epilepsy in patients,particularly with regard to the timing,drug choice and dosage,and duration of AEDs.The postoperative outcome of seizures in patients with intractable epilepsy caused by viral encephalitis primarily depends on the epileptogenic zone.In addition,neuroinflammation is known to be widely involved in the generation of seizures during CNS viral infection,and the effects of anti-inflammatory therapies in preventing seizures and epilepsy secondary to CNS viral infection require further studies.In this review,we discuss the incidence,mechanisms,clinical management and prognosis of seizures and epilepsy secondary to CNS viral infection,and summarize common CNS viral infections that cause seizures and epilepsy.