CLINICAL STUDY ON TREATMENT OF INFANTILE PRIMARY EPILEPSY WITH ACUPOINT CATGUT-IMPLANTATION THERAPY

Aim: To observe the therapeutic effect of acupoint catgut implantation therapy in the treatment of infantile primary epilepsy. Methods: A total of 63 cases of primary epilepsy children were randomly divided into medication group (n=32) and acupoint catgut implantation group (n=31) and treated respectively with Sodium Valproate 5-10 mg/kg/d and catgut implantation at Changqiang (GV 1), Jiuwei (CV 15), bilateral Xinshu (BL 15) and bilateral Zusanli (ST 36). Results: Following 60 days of treatment, the abnormal changes of electroencephlogram (EEG), the seizure frequency and duration and clinical symptoms were improved apparently in comparison with those of pre treatment, but no significant differences were found between the two groups (P>0.05). There was a significant difference between two groups in the cure rate of the short term effect (P<0.05), with the therapeutic effect of the treatment group being superior to that of medication group. Conclusion: Acupoint catgut implantation therapy has a good therapeutic effect in the treatment of primary infantile epilepsy.

Problems of Rational Therapy for Epilepsy during Pregnancy

Epilepsy is one of the most frequent neurological disorders. In these circumstances, more than 25% of the patients are women of reproductive age. The aim of our research was to analyze the effectiveness and safety of antiepileptic therapy in women with epilepsy during pregnancy and to analyze the pregnancies’ outcomes. We included in our research 121 pregnancies of 101 women aged at the moment of childbearing about 26.9 ± 4.57 years old. Idiopathic forms of epilepsy were predominant among all causes—47.1% (р < 0.01). Of all cases, 65.4% remained seizure-free from generalized tonic-clonic seizures (GTCS), including 69.6% of all idiopathic epilepsy cases and 68.6% among symptomatic ones. The antiepileptic drugs (AED) dosages were exceeding teratogenic level at the moment of conception in 54.7% of the cases. Worse control of epileptic seizures was associated with Benzobarbital (66.7%) and Lamotrigine (50.0%). Women with epilepsy did not receive specialized neurological therapy before conception in most cases, which leaded to the usage of AED teratogenic doses and less effectiveness of AED during pregnancy. It is necessary to plan the pregnancy and prescribe rational treatment for epilepsy starting at the stage of planning and during gestation in order to obtain a better seizures control and to decrease congenital disorders risk in fetus.

用TCD周疗方案对瘤负荷较高的多发性骨髓瘤患者进行治疗的效果观察

目的:观察用沙利度胺联合环磷酰胺与地塞米松(即TCD周疗方案)对瘤负荷较高的多发性骨髓瘤患者进行治疗的临床效果。方法:将2015年至2017年期间在乐山市人民医院肿瘤血液科接受治疗的20例瘤负荷较高的多发性骨髓瘤患者作为TCD组,用TCD周疗方案对其进行治疗。将2013年至2015年期间在该医院接受治疗的23例该病患者作为TD组,用沙利度胺联合地塞米松(即TD方案)对其进行治疗。治疗结束后,对比两组患者治疗的效果、骨痛缓解的情况和不良反应的发生情况。结果:在治疗1个周期后,与TD组患者相比,TCD组患者骨痛的完全缓解率较高,其骨痛缓解的平均时间较短,P<0.05。TCD组患者病情的缓解率明显高于TD组患者,P<0.05。在接受治疗期间,两组患者均未发生感染或死亡,也未出现IV级的血液学毒性反应。两组患者不良反应的发生率相比,P>0.05。结论:用TCD周疗方案对瘤负荷较高的多发性骨髓瘤患者进行治疗可明显减轻其骨痛的程度,降低其不良反应的发生率,提高其治疗的效果。

TCD在大脑中动脉闭塞静脉溶栓治疗中的应用

目的:探讨TCD在大脑中动脉闭塞静脉溶栓治疗中的作用。方法:把15例急性大脑中动脉血栓形成患者随机分成治疗组(8例)和对照组(7例),治疗组给予rt-PA静脉溶栓的同时开始低强度TCD监测并且持续2h,对照组单用rt-PA,接受安慰剂检测。2组治疗后评价临床疗效。结果:治疗组临床疗效、血管再通率及出血并发症与对照组相比有显著性差异(p(0.05)。结论:超声能促进溶栓,而持续性TCD检测,它能增加rt-PA诱导动脉再通而不会增加出血风险。

头穴与项穴丛刺治疗脑供血不足性眩晕TCD即时效应对比研究

目的比较头穴丛刺和项穴丛刺对脑供血不足性眩晕患者脑血流即时效应的影响。方法将57例脑供血不足性眩晕患者随机分成治疗组29例和对照组28例。治疗组采用头穴丛刺治疗,对照组采用项穴丛刺治疗。观察两组治疗前后经颅多普勒(transeranial doppler,TCD)所示大脑中动脉(MCA)、颈内动脉(ICA)、基底动脉(BA)、小脑后下动脉(PINCA)、椎动脉(VA)的收缩期血流速度(Vs)、舒张期血流速度(Vd)、平均血流速度(Vm)变化。结果治疗组治疗后各血管(MCA、ICA、BA、PINCA、VA)血流速度(Vs、Vd、Vm)与同组治疗前比较,差异均具有统计学意义(P<0.01,P<0.05)。对照组治疗后MCA、ICA、VA及PINCA血流速度与同组治疗前比较,差异均具有统计学意义(P<0.01)。对照组治疗后BA的Vs与Vm与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后各血管血流速度与对照组比较,差异均无统计学意义(P>0.05)。结论头穴丛刺和项穴丛刺均能即时改善患者大脑各低流速血管的Vs、Vd、Vm,两种刺法对各血管Vs、Vd、Vm改善程度相近。

Effects of music and music therapy on mood in neurological patients

Mood disorder and depressive syndromes represent a common comorbid condition in neurological disorders witha prevalence rate that ranges between 20% and 50% of patients with stroke, epilepsy, multiple sclerosis, and Parkinson's disease. Notwithstanding, these conditions are often under-diagnosed and under-treated in the clinical practice and negatively affect the functional recovery, the adherence to treatment, the quality of life, and even the mortality risk. In addition, a bidirectional association between depression and neurological disorders may be possible being that depressive syndromes may be considered as a risk factor for certain neurological diseases. Despite the large amount of evidence regarding the effects of music therapy(MT) and other musical interventions on different aspects of neurological disorders, no updated article reviewing outcomes such as mood, emotions, depression, activity of daily living and so on is actually available; for this reason, little is known about the effectiveness of music and MT on these important outcomes in neurological patients. The aim of this article is to provide a narrative review of the current literature on musical interventions and their effects on mood and depression in patients with neurological disorders. Searching on Pub Med and Psyc Info databases, 25 studies corresponding to the inclusion criteria have been selected; 11 of them assess the effects of music or MT in Dementia, 9 explore the efficacy on patients with Stroke, and 5 regard other neurological diseases like Multiple Sclerosis, Amyotrophic Lateral Sclerosis/motor neuron disease, Chronic quadriplegia, Parkinson's Disease, and Acquired Brain dysfunctions. Selected studies are based on relational and rehabilitative music therapy approaches or concern music listening interventions. Most of the studies support the efficacy of MT and other musical interventions on mood, depressive syndromes, and quality of life on neurological patients.

Arrhythmogenic epilepsy and pacing need: A matter of controversy

There is increasing awareness among the cardiology community regarding ictal bradyarrhythmias as a cause of loss of consciousness. A high degree of suspicion is necessary when diagnosing ictal bradyarrhythmias, and delay in diagnosing this condition may lead to morbidity associated with falls and trauma. Ictal bradyarrhythmias have also been suggested to be associated with sudden unexplained death in epilepsy, although evidence related to this association is limited. There is no guidelinedirected therapy for symptomatic ictal bradyarrhythmias due to a lack of randomized, controlled trials. Cardiac pacemaker therapy is commonly used for these patients; however, currently, there is no universal agreement on the pacing indications for these patients. In this review, we focus on the pathophysiology and clinical presentation of ictal bradyarrhythmias and then discuss the pacing need based on the available literature data.

Tall gastrodis tuber combined with antiepileptic drugs repairs abnormal perfusion foci in focal epilepsy

One hundred patients with focal epilepsy were recruited for the present study and their seizures controlled with antiepileptic drugs. The patients then orally received a capsule of tall gastrodis tuber powder, a traditional Chinese drug, and underwent single photon emission computed tomography, long-term electroencephalogram, and CT/MRI. Blood drug levels were monitored throughout the study. Before treatment with tall gastrodis tuber, 35 of the 100 cases had abnormal CT/MRI scans; 79 cases had abnormal single photon emission computed tomography images; 86 cases had abnormal electroencephalogram; and a total of 146 abnormal perfusion foci were observed across the 100 subjects. After treatment, the number of patients with normal single photon emission computed tomography images increased by 12; normal electroencephalogram was observed in an additional 27 cases and the number of patients with epileptiform discharge decreased by 29 （34% of 86）; the total number of abnormal perfusion foci decreased by 52 （36%） and changes in abnormal loci were visible in 65 patients. These changes indicate that the administration of tall gastrodis tuber in combination with antiepileptic drugs repairs abnormal perfusion foci in patients with focal epilepsy Our results demonstrate that traditional Chinese drugs can repair abnormal perfusion foci and, as such, are a promising new pathway in the treatment of focal epilepsy.

A SURVEY OF EPILEPSY TREATED WITH ACUPUNCTURE AND MOXIBUSTION IN RECENT YEARS

In this paper,we have introduced the developing tendencies and features of the treat-ment of epilepsy with acupuncture and moxibustion.studies on the naechanism of the therapeutic ef-fect.the evaluation of the clinical effect and some problems in the last 10 years.Moreover,we haveput forward our opinions for improving the treatment in future.

TCD对椎动脉型颈椎病针刺疗效的评估

目的 :对椎动脉型颈椎病针刺疗效作出客观、科学、量化的评估。方法 :70例患者随机分为治疗组42例 ,对照组28例 ,治疗组每天针刺1次 ,10天为一疗程 ,共1～3个疗程 ;对照组在未经治疗一个月后 ,用TCD检测椎基底动脉MV(平均血流速度 )的改善情况。结果 :治疗组MV明显改善 ,P<0 01 ;对照组MV无改善 ,P>0 05。结论 :针刺疗法能明显改善椎基底动脉血供 ,TCD是一种科学。

Mono-Therapy versus Poly-Therapy: Ten Years Indian Experience on Various Seizure Disorders

Objectives: To find out prescription patterns and seizure freedom with different mono-, duo- and poly-therapies used in various seizure disorders in Indian setting. Material and Methods: Subjects with seizures, not responding to first antiepileptic drug, were evaluated prospectively for a period of 6 months. Patients on various dual antiepileptic drugs (AEDs) prescriptions were prospectively analyzed for 1) the pattern and frequency of different duo-therapies;2) etiological profile of patients in duo-therapy prescription;and 3) frequency of seizure freedom on various duo-therapy groups. Results: Among 2542 patients, 293 (11.5%) lost in follow-up and thus, 2249 (88.5%) were followed. 1324 (58.9%) had seizure freedom on mono-therapy, 532 (23.7%) required duo-therapy and only 45 (2%) were better controlled on poly-therapy. Among the subjects, who were on mono-therapy, Carbamazepine/Oxcarbazepine was the most commonly prescribed in 1285 (50.55%) patients as first drug followed by Valproate compound and Phenytoin. The most common duo-therapy used was combination of Valproate with Lamotregine, followed by Phenytoin and Phenobarbitone. Other mono-therapy and combinations are given in this paper. Conclusions: Duo-therapy was required and found to be effective in 23.7% of Indian patients with epilepsy. Selection of appropriate two drug combination is based on individual approach and overall clinical profile of patient.

中医辨治癫痫研究进展

癫痫为小儿较常见的系统疾病,根据病因可将其分为惊痫、痰痫、风痫、瘀痫、虚痫。临证以中医内治法为主,辨证配合外治法可增强疗效。此文对癫痫的病因病机、辨证及内外治法等进行归纳。现代医学的治疗方法仍停留在终止发作层面,中医学的整体观念和辨证论治思想在治疗癫痫上具有独特的优势,达到患儿身心健康的治疗目标,提高患儿的生活质量。

癫痫患儿围手术期主要照顾者心理韧性管理方案的构建与应用

目的:构建难治性癫痫患儿围手术期主要照顾者心理韧性管理方案并探讨其应用效果,以促进该临床实践的科学化和规范化。方法:运用文献分析、焦点小组讨论和专家函询法构建基于认知行为疗法的主要照顾者心理韧性管理方案。采用便利抽样法,选取2022年10月至2023年9月收治的160例难治性癫痫患儿主要照顾者为研究对象,按患儿手术日期分为对照组和观察组(各80例),为避免组间干扰,研究对象交替入组,每2个月轮换一次。对照组患儿主要照顾者采用常规心理韧性护理方案,观察组患儿主要照顾者采用构建的心理韧性管理方案。两组干预时长均为患儿入院至出院后1个月。比较干预前后两组患儿主要照顾者的负性情绪、心理韧性、照顾负担及生活满意度的差异。结果:观察组患儿复诊当日主要照顾者焦虑自评量表评分、抑郁自评量表评分和照顾者负担评分低于对照组,Connor-Davidson心理弹性量表各维度评分及生活满意度指数A评分高于对照组,差异均有统计学意义(P<0.05)。结论:实施基于认知行为疗法的难治性癫痫患儿围手术期主要照顾者心理韧性管理方案可改善癫痫患儿主要照顾者的心理韧性。

针刺联合中药治疗儿童癫痫的疗效观察及对脑电图和智力水平的影响

目的观察针刺联合癫痫促效方治疗儿童癫痫的临床疗效及对患者脑电图和智力水平的影响。方法将80例儿童癫痫患者随机分为对照组(40例)和研究组(40例)。对照组予常规抗癫痫治疗,研究组在对照组治疗基础上予针刺联合癫痫促效方治疗。比较两组临床疗效、脑电图改善率和不良反应发生率,观察两组治疗前后癫痫发作情况(发作频次和症状持续时间)、中医证候积分、简易精神状态检查量表(mini-mental state examination,MMSE)评分和韦氏儿童智力量表中文修订版(Wechsler intelligence scale for children-revised in China,WLSC-CR)评分的变化,观察两组治疗前后血清炎症因子和认知功能损害相关指标水平的变化。结果研究组总有效率高于对照组(P<0.05),脑电图改善率高于对照组(P<0.05)。治疗1个月后和治疗后,研究组癫痫发作频次低于对照组(P<0.05),症状持续时间短于对照组(P<0.05),中医证候积分低于对照组(P<0.05),WLSC-CR评分中总智商、语言智商和操作智商评分均高于对照组(P<0.05),MMSE评分高于对照组(P<0.05)。治疗1个月后和治疗后,研究组血清丙二醛(malondialdehyde,MDA)、白介素-1β(interleukin-1β,IL-1β)、白介素-6(interleukin-6,IL-6)、高迁移率族蛋白B1(high mobility group box-1,HMGB1)和基质金属蛋白酶-9(matrix metalloprotein-9,MMP-9)水平均低于对照组(P<0.05),血清超氧化物歧化酶(superoxide dismutase,SOD)和水通道蛋白4(aquaporin 4,AQP4)水平高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在常规抗癫痫治疗基础上,针刺联合癫痫促效方治疗儿童癫痫可提高临床疗效,降低癫痫发作频率,缩短癫痫发作时间,改善脑电图,提高患者智力水平,下调炎症反应和应激反应。

赋能心理护理联合音乐疗法在癫痫患儿药物治疗依从性中的应用效果

目的探讨赋能心理护理联合音乐疗法在癫痫患儿药物治疗依从性中的应用效果。方法选取2020年10月—2022年10月于医院接受治疗的88例癫痫患儿为研究对象,按照组间基线资料均衡可比的原则分为对照组和观察组,每组44例。对照组患儿给予常规护理干预,观察组患儿在对照组常规护理的基础上给予赋能心理护理联合音乐疗法干预,比较两组患儿药物治疗依从性及生活质量。结果护理干预后,观察组患儿药物治疗依从性要高于对照组,差异具有统计学意义(P<0.05);观察组患儿疗效优于对照组,差异具有统计学意义(P<0.05);观察组癫痫儿童生活质量量表(QOLCE)各个维度评分及总分均高于对照组,差异均具有统计学意义(P<0.05)。结论赋能心理护理联合音乐疗法能够有效提高癫痫患儿药物治疗依从性,缓解病情,患儿情感功能及其自我认识、社会功能、使患儿愿意与同伴交往,促进精神健康,从而改善生活质量。

GABAergic Interneuron Cell Therapy for Drug-Resistant Epilepsy

Epilepsy,one of the most common central nervous system disorders,affects about 70 million people of all ages worldwide[1].It is characterized by hyperactive neuronal networks,resulting from imbalanced excitatory and inhibitory activity.Despite the development of multiple next-generation anti-seizure medicines,one-third of epilepsy patients are still drug-resistant[2].

金属离子在难治性癫痫发病机制中的研究进展

癫痫是一种常见的由大脑异常电活动引起的慢性神经系统疾病,其发病机制尚未完全阐明。近年来有越来越多研究证明,大脑中的铁、锌、铜参与癫痫的发生发展过程,可能通过影响相应的离子通道的功能、膜电位的平衡、动作电位的传导、氧化还原等方面,进而影响神经元的兴奋性和信号传导。本文中我们就此进行综述,旨在增进我们对癫痫发病机制的理解,为寻找基于金属离子防治癫痫策略提供新思路。

家庭二元正念干预方案在学龄期癫痫患儿中的应用研究

目的 探讨基于家庭系统理论的二元正念干预对学龄期癫痫患儿情绪行为问题和照顾者负性情绪的改善效果。方法 采用便利抽样法,将60对学龄期癫痫患儿及照顾者按照住院时间分为对照组和干预组各30对。对照组实施神经内科常规护理,干预组在常规护理基础上实施基于家庭系统理论的二元正念干预。于干预前、干预结束时、干预后3个月,采用长处与困难问卷、焦虑自评量表、抑郁自评量表分别评估两组患儿情绪行为得分,照顾者焦虑、抑郁水平。结果 干预后两组患儿长处与困难问卷5个因子得分及照顾者焦虑、抑郁得分比较,差异有统计学意义(均P<0.05)。结论 基于家庭系统理论的二元正念干预可有效改善癫痫患儿情绪行为问题,缓解照顾者的焦虑和抑郁情绪。

Recent advances and current status of gene therapy for epilepsy

Background Epilepsy is a common neurological disorder with complex pathogenic mechanisms,and refractory epilepsy often lacks effective treatments.Gene therapy is a promising therapeutic option,with various preclinical experiments achieving positive results,some of which have progressed to clinical studies.Data sources This narrative review was conducted by searching for papers published in PubMed/MEDLINE with the following single and/or combination keywords:epilepsy,children,neurodevelopmental disorders,genetics,gene therapy,vectors,transgenes,receptors,ion channels,micro RNAs(miRNAs),clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated protein(Cas)9(CRISPR/Cas9),expression regulation,optogenetics,chemical genetics,mitochondrial epilepsy,challenges,ethics,and disease models.Results Currently,gene therapy research in epilepsy primarily focuses on symptoms attenuation mediated by viral vectors such as adeno-associated virus and other types.Advances in gene therapy technologies,such as CRISPR/Cas9,have provided a new direction for epilepsy treatment.However,the clinical application still faces several challenges,including issues related to vectors,models,expression controllability,and ethical considerations.Conclusions Here,we summarize the relevant research and clinical advances in gene therapy for epilepsy and outline the challenges facing its clinical application.In addition to the shortcomings inherent in gene therapy components,the reconfiguration of excitatory and inhibitory properties in epilepsy treatment is a delicate process.On-demand,cell-autonomous treatments and multidisciplinary collaborations may be crucial in addressing these issues.Understanding gene therapy for epilepsy will help clinicians gain a clearer perception of the research progress and challenges,guiding the design of future clinical protocols and research decisions.

Novel Mechanism,Drug Target and Therapy in Epilepsy

Epilepsy,which is characterized by unprovoked seizures and has a prevalence of nearly 1%,is becoming one of the leading causes of disability and death globally[1].The exact mechanisms behind epilepsy are still unknown,which contributes to the inadequate efficacy of anti-seizure medications(ASMs)that mainly target membrane ion channels and neurotransmission[2].