Features of animal models of complex partial epilepsy established through unilateral,bilateral and alternate-side kindling at hippocampus of rats

BACKGROUND： Electrical stimulation kindling model, having epilepsy-inducing and spontaneous seizure and other advantages, is a very ideal experimental animal model. But the kindling effect might be different at different sites. OBJECTIVE： To compare the features of animal models of complex partial epilepsy established through unilateral, bilateral and alternate-side kindling at hippocampus and successful rate of modeling among these 3 different ways. DESIGN： A randomized and controlled animal experiment SETTING： Department of Neurology, Qilu Hospital, Shandong University MATERIALS： Totally 60 healthy adult Wistar rats, weighing 200 to 300 g, of either gender, were used in this experiment. BL-410 biological functional experimental system （Taimeng Science and Technology Co. Ltd, Chengdu） and SE-7102 type electronic stimulator （Guangdian Company, Japan） were used in the experiment. METHODS： This experiment was carried out in the Experimental Animal Center of Shandong University from April to June 2004. After rats were anesthetized, electrode was implanted into the hippocampus. From the first day of measurement of afterdischarge threshold value, rats were given two-square-wave suprathreshold stimulation once per day with 400 μA intensity, 1ms wave length, 60 Hz frequency for 1 s duration. Left hippocampus was stimulated in unilateral kindling group, bilateral hippocampi were stimulated in bilateral kindling group, and left and right hippocampi were stimulated alternately every day in the alternate-side kindling group. Seizure intensity was scored： grade 0： normal, 1： wet dog-like shivering, facial spasm, such as, winking, touching the beard, rhythmic chewing and so on; 2： rhythmic nodding; 3： forelimb spasm;4： standing accompanied by bilateral forelimb spasm;5： tumbling, losing balance, four limbs spasm. Modeling was successful when seizure intensity reached grade 5. t test was used for the comparison of mean value between two samples. MAIN OUTCOME MEASURES： Comparison of the successful rate of modeling, the times of stimulation to reach intensity of grade 5, the lasting time of seizure of grade 3 of rats in each group. RESULTS： Four rats of alternate-side kindling group dropped out due to infection-induced electrode loss, and 56 rats were involved in the result analysis. The successful rate of unilateral kindling group, bilateral kin- dling group and alternate-side kindling group was 55%（11/20）,100%（16/16）and 100%（20/20）, respective- ly. The stimuli to reach the grade 5 spasm were significantly more in the bilateral kindling group than in the unilateral kindling group [（30.63±3.48）, （19.36±3.47）times, t=8.268, P 〈 0.01], and those were significantly fewer in the alternate-side kindling group than in the unilateral kindling group [（ 10.85±1.98）times, t=-8.744, P 〈 0.01]. The duration of grade 3 spasm was significantly longer in the bilateral kindling group than in the unilateral kindling group [（9.75±2.59）, （3.21 ±1.58）days,t=-8.183,P 〈 0.01], Among 20 successful rats of al- ternate-side kindling group, grade 5 spasm was found in the left hippocampi of 11 rats, but grade 3 spasm in their right hippocampi; Grade 5 spasm was found in the right hippocampi of the other 9 rats, grade 4 spasm in the left hippocampus of 1 rat and grade 3 of 8 rats. CONCLUSION ： The speed of establishing epilepsy seizure model by alternate-side kindling is faster than that by unilateral kindling, while that by bilateral kindling is slower than that by unilateral kindling. The successful rate is very high to establish complex partial epilepsy with alternate-side or bilateral kindling. Epilepsy seizure established by alternate-side kindling has antagonistic effect of kindling and the seizure duration of grade 3 spasm is prolonged.

Epilepsy Properties and Seizure Suppression in a Severe Motor and Intellectual Disabilities

Purpose: In hospitalized patients with severe motor and intellectual disabilities (SMID), we analyzed the association of the SMID class to factors such as the prevalence of epilepsy, frequency of seizures and number of concomitantly used anti-epileptic drugs (AEDs), and evaluated the usefulness of addition of the new AEDs (gabapentin, topiramate, lamotrigine and levetiracetam) to the treatment regimen. Results: The prevalence of epilepsy in the study population was about 60%. There were 39.5% who were free of epileptic seizures during the 6-year survey period and remained well-controlled with medication. As the SMID increased in severity, the frequency of seizures increased, the number of concomitantly used AEDs increased, and the tendency towards addition of new AEDs became more marked. About the use situation of new AED and old AED, this comparison revealed a tendency towards addition of a new AED when the seizures were poorly controlled in response to concomitant use of multiple old AEDs. The frequency of seizures and the number of concomitantly used AEDs were higher in patients with SMID of high severity than in those with SMID of low severity. Analysis of the time-course of the frequency of seizures before and after the addition of new AEDs revealed a significant reduction in the frequency of seizures following the addition of the new AEDs (P > 0.001). Conclusions: These results suggest that the new AEDs are useful in the management of SMID-associated epilepsy, because of their effect of reducing the frequency of SMID-associated seizures and their high tolerability.

A Comparison of Fractal Dimensions of EEG Time Series of Partial Epilepsy

In order to develop a new diagnostic method for partial epilepsy using fractaldimension measurement of theory of nonlinear dynamics, two kinds of EEG fractaldimensions (correlation dimension Dc and wave form dimension Dw) were calculatedand compared. It was observed that most of the EEG fractal dimension values of Dcand Dw at the epileptic electrodes were smaller than those at the non-epilepticelectrodes. The results showed that the fractal dimension could be a special parameterto diagnose epilepsy diseases and are worthy to study further.

Regulation of specific abnormal calcium signals in the hippocampal CA1 and primary cortex M1 alleviates the progression of temporal lobe epilepsy

Temporal lobe epilepsy is a multifactorial neurological dysfunction syndrome that is refractory,resistant to antiepileptic drugs,and has a high recurrence rate.The pathogenesis of temporal lobe epilepsy is complex and is not fully understood.Intracellular calcium dynamics have been implicated in temporal lobe epilepsy.However,the effect of fluctuating calcium activity in CA1 pyramidal neurons on temporal lobe epilepsy is unknown,and no longitudinal studies have investigated calcium activity in pyramidal neurons in the hippocampal CA1 and primary motor cortex M1 of freely moving mice.In this study,we used a multichannel fiber photometry system to continuously record calcium signals in CA1 and M1 during the temporal lobe epilepsy process.We found that calcium signals varied according to the grade of temporal lobe epilepsy episodes.In particular,cortical spreading depression,which has recently been frequently used to represent the continuously and substantially increased calcium signals,was found to correspond to complex and severe behavioral characteristics of temporal lobe epilepsy ranging from gradeⅡto gradeⅤ.However,vigorous calcium oscillations and highly synchronized calcium signals in CA1 and M1 were strongly related to convulsive motor seizures.Chemogenetic inhibition of pyramidal neurons in CA1 significantly attenuated the amplitudes of the calcium signals corresponding to gradeⅠepisodes.In addition,the latency of cortical spreading depression was prolonged,and the above-mentioned abnormal calcium signals in CA1 and M1 were also significantly reduced.Intriguingly,it was possible to rescue the altered intracellular calcium dynamics.Via simultaneous analysis of calcium signals and epileptic behaviors,we found that the progression of temporal lobe epilepsy was alleviated when specific calcium signals were reduced,and that the end-point behaviors of temporal lobe epilepsy were improved.Our results indicate that the calcium dynamic between CA1 and M1 may reflect specific epileptic behaviors corresponding to different grades.Furthermore,the selective regulation of abnormal calcium signals in CA1 pyramidal neurons appears to effectively alleviate temporal lobe epilepsy,thereby providing a potential molecular mechanism for a new temporal lobe epilepsy diagnosis and treatment strategy.

Characteristics of a primate model of focal motor cortical seizures suitable for preclinical testing of therapies like DBS

Background and objective: Generating and characterizing primate models of epileptic seizures are important for understanding pathophysiology of diseases and establishing preclinical efficacy of novel therapies like Deep Brain Stimulation. A focal motor epilepsy model is described here. Method: Seizures were obtained after intracortical penicillin injection into the motor strip through a cannula in two awake monkeys and electrocorticograms were recorded by epidural screws. Seizures were analyzed and compared for number, average duration of each seizure and total duration of ictal activity. Pharmaco-resistance for antiepileptic drug was tested by administration of Diazepam during seizures. Results: A motor status with seizures mimicking those seen in Kojevnikov’s syndrome was easily generated several minutes after penicillin injection and lasted 24 h on an average. The model thus characterized appears stable and consistent. There is no significant variation between experiments in individual primate as well as between two specimens. Diazepam though reduced the total duration of seizures, failed to abolish behavioural seizures. Conclusion: This model represents a good alternative model for preclinical research aiming at testing novel therapies because seizures are obtained on demand, last up to 24 h after a single penicillin injection, are stable and resistant to Diazepam.

A follow-up study on newer anti-epileptic drugs as add-on and monotherapy for partial epilepsy in China

Background Recently,new anti-epileptic drugs （AEDs） have been more frequently selected to treat epilepsy.In the present study,we evaluated the dynamic changes of efficacy and safety of three newer AEDs for treating partial epilepsy in China.Methods Patients were collected sequentially and were divided into three groups which accepted oxcarbazepine （OXC）,lamotrigine （LTG） or topiramate （TPM） therapy.Each group included monotherapy and add-on therapy subgroups.We followed all patients for one year and recorded the indexes of efficacy and safety in detail.Results A total of 909 patients finished the follow-up observation.No significant difference was found in proportion of patients with 〉 or =50% reduction,〉 or =75% reduction and 100% seizure reduction in the LTG and OXC groups between the first and the second six months.In the TPM group there was a statistical difference between the first and the second six months in proportion of patients with 〉 or =50% reduction （P=-0.002）,〉 or =75% reduction （P 〈0.0001） and 100% seizure reduction （P=0.009） in the monotherapy subgroup,and about 〉 or =75% reduction and 100% seizure reduction in the add-on therapy subgroup （P 〈0.0001）.The efficacy between the add-on and monotherapy subgroups showed a statistical difference.The safety of the three newer AEDs was good.Conclusions The three newer AEDs all showed good efficacy and tolerability for partial epilepsy.And the efficacy can be maintained for at least one year.

Long-term Effectiveness of Antiepileptic Drug Monotherapy in Partial Epileptic Patients： A 7-year Study in an Epilepsy Center in China

Background： It is important to choose an appropriate antiepileptic drug （AED） to manage partial epilepsy. Traditional AEDs, such as carbamazepine （CBZ） and valproate （VPA）, have been proven to have good therapeutic effects. However, in recent years, a variety of new AEDs have increasingly been used as first-line treatments for partial epilepsy. As the studies regarding the effectiveness of new drugs and comparisons between new AEDs and traditional AEDs are few, it is determined that these are areas in need of further research. Accordingly, this study investigated the long-term effectiveness of six AEDs used as monotherapy in patients with partial epilepsy. Methods： This is a retrospective, long-term observational study. Patients with partial epilepsy who received monotherapy with one of six AEDs, namely, CBZ, VPA, topiramate （TPM）, oxcarbazepine （OXC）, lamotrigine （LTG）, or levetiracetam （LEV）, were identified and followed up from May 2007 to October 2014, and time to first seizure after treatment, 12-month remission rate, retention rate, reasons for treatment discontinuation, and adverse effects were evaluated. Results： A total of 789 patients were enrolled. The median time of follow-up was 56.95 months. CBZ exhibited the best time to first seizure, with a median time to first seizure of 36.06 months （95% confidential interval： 30.64~4.07）. CBZ exhibited the highest 12-month remission rate （85.55%）, which was significantly higher than those of TPM （69.38%, P = 0.006）, LTG （70.79%, P= 0.001）, LEV （72.54%, P = 0.005）, and VPA （73.33%, P = 0.002）. CBZ, OXC, and LEV had the best retention rate, followed by LTG, TPM, and VPA. Overall, adverse effects occurred in 45.87% of patients, and the most common adverse effects were memory problems （8.09%）, rashes （7.76%）, abnormal hepatic function （6.24%）, and drowsiness （6.24%）. Conclusion： This study demonstrated that CBZ, OXC, and LEV are relatively effective in managing tbcal epilepsy as measured by time to first seizure, 12-month remission rate, and retention rate.

Stochastic fluctuations of permittivity coupling regulate seizure dynamics in partial epilepsy

Partial epilepsy is characterized by recurrent seizures that arise from a localized pathological brain region. During the onset of partial epilepsy, the seizure evolution commonly exhibits typical timescale separation phenomenon. This timescale separation behavior can be mimicked by a paradigmatic model termed as Epileptor, which consists of coupled fast-slow neural populations via a permittivity variable. By incorporating permittivity noise into the Epileptor model, we show here that stochastic fluctuations of permittivity coupling participate in the modulation of seizure dynamics in partial epilepsy. In particular, introducing a certain level of permittivity noise can make the model produce more comparable seizure-like events that capture the temporal variability in realistic partial seizures. Furthermore, we observe that with the help of permittivity noise our stochastic Epileptor model can trigger the seizure dynamics even when it operates in the theoretical nonepileptogenic regime. These findings establish a deep mechanistic understanding on how stochastic fluctuations of permittivity coupling shape the seizure dynamics in partial epilepsy,and provide insightful biological implications.

Neural matrix and its role in preoperative evaluation of partial epilepsy

The network characteristic of the central neural system has been widely accepted as a basic fabric form. However,the matrix characteristics of neural network are still not fully understood. If we ignore the matrix characteristics of the neural networks and just pay close attention to its connection mode,we are likely to fall into the theory of mechanical reductionism. This can lead to a problem in representing consciousness in a disadvantageous situation. It can also be a barrier to further improving the global workspace theory. Incomplete elucidation of the mechanisms of consciousness representation can also affect the assessment of the surgical outcome of partial epilepsy with conscious injury. Therefore,this paper reviews the epistemological development of neuroscience. We will initially describe the matrix characteristics of the neural system and their significance to the information processing mechanism,and further explore the role of neural matrix in identifying cases of partial epilepsy with little effect on the resection of the lesion.

Prospective research on the efficacy and safety of oxcarbazepine as monotherapy and add-on therapy for partial epilepsy

The purpose of our research was to evaluate the efficacy,tolerance,and safety of oxcarbazepine(OXC)as monotherapy and add-on therapy for partial epilepsy.We carried out a prospective clinical follow-up trial at the Epilepsy Center of Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology.Sixty-seven patients with partial epilepsy received OXC therapy.The patients were randomly divided into a monotherapy group and an add-on therapy group.We observed the efficacy and safety in thefirst three months and the following three months respectively,and compared them with each other.There was a significant difference in the decrease of seizure frequency between the two groups(P=0.002).There was a significant difference in the percentage of seizure-free between the monotherapy and the add-on therapy groups in thefirst three months(P=0.02),and there were also statistical differences in the 50%response rate(P=0.017)and the percentage of seizure-free in the following three months(P=0.019).No difference was found in the 50%response rate,the 75%response rate,and the percentage of seizure-free between thefirst three months and the following three months in the whole group and the two subgroups(P>0.05).The incidence rate of side effects due to the therapy was 19.40%(13 of 67).The side effects were mainly found in thefirst three months.It is concluded that OXC is thefirst-line anti-epileptic drug(AED)for partial seizures,and could be used as the monotherapy and add-on therapy for newly diagnosed patients and patients that failed to tolerate or benefit from other AEDs.

Assessing structural integrity of the pyramidal tracts with difusion spectrum imaging to predict postoperative motor function in pediatric epilepsy patients with hemispherectomy

Background:Hemispherectomy is an efective treatment option for patients with drug-resistant epilepsy caused by hemispheric lesions.However,patients often have deterioration of their motor functions postoperatively.Difusion spectrum imaging(DSI)was reliable in presenting the natural shape of the white matter fbers.At the same time,the natural sprawl pyramid tract(PT)might be more intuitive for predicting postoperative motor functions.Therefore,we assessed the motor functions by the natural shape revealed by DSI tractography.Methods:Ten children with drug-resistant epilepsy who were candidates for hemispherectomy performed DSI PTs tractography and transcranial magnetic stimulation(TMS)for motor mapping.The motor function was evaluated with muscle strength and hand grasping capability.Pyramidal tract(PT)structural integrity and TMS mapping results were compared between patients who remained stable and those with deteriorated motor functions.Receiver operating characteristic(ROC)curves with PTs asymmetric ratio were analyzed to evaluate DSI tractography diagnostic value.Results:All patients underwent DSI acquisition,while four patients successfully performed TMS.One patient had no response to TMS until the maximal machine output was reached.Four patients failed to perform TMS due to lacking cooperation.One patient was contraindicated to TMS.DSI successfully reconstructed the sharp angle fan-shaped PTs within the hemisphere.The accurate fber distribution with fber termination and thickness within the lesioned hemisphere was replicated with DSI tractography.No signifcance was found in patients’age,sex,seizure frequency,or medication between patients with stable or deteriorated postoperative motor functions.DSI efectively predicted postoperative motor function as stable with damaged PTs,mild deterioration with atrophied PTs,and intact PTs with contralateral innervation confrmed by intracranial stimulation.The area under the curve(AUC)of DSI tractography was 0.84.According to ROC,the cut-of value of PTs asymmetric ratio was 11.5%with 100%sensitivity and 75%specifcity.The sensitivity and specifcity of TMS were 2/3 and 1/2,respectively.Conclusions:The anatomic integrity of PTs with DSI tractography could efectively predict postoperative motor function after hemispherectomy.This enables neurosurgeons to inform patients and relatives about postoperative motor functions with direct morphological evidence of PTs to help them with their surgical decisions.

A General Method to Compute the Electric Flux Lines between Two Magnet Wires in Close Contact and Its Application for the Evaluation of Partial Discharge Risks in the Slots of Electric Machines Embedded in Future Transportation Systems

The sizing of the Electrical Insulation System (EIS) is an important challenge in electric motors of higher specific power driven by faster inverters. That keeps increasing the electric stress which the winding is submitted in the stator slot. Consequently, Partial Discharges (PD) are more likely to occur. Nowadays, the Paschen’s criterion is widely used to evaluate the risk of partial discharge. It requires the knowledge of electric field lines. This paper presents a method to precisely compute the electric field lines in a two-dimensional (2D) electrostatic problem. The field of study is composed of two magnet wires in close contact. Such configuration is representative of the turn-to-turn interaction in an electric motor slot. The problem is solved using the scalar potential formulation only. The notion of flux tubes is used for the post process of the electric field lines in a developed numerical code on Matlab. The developed method is compared to a ballistic method already included on Matlab. The work presented here is included in an automatic tool to suppress or reduce the partial discharge risk in a stator slot of high power density motor destined for future transportation systems.

Study of partial discharge characteristics at repetitive square voltages based on UHF method

Due to overvoltage produced by inverter output,inverter-fed motor insulation systems often experience fast electrical aging process,especially when partial discharge(PD) is incepted.Before putting into use,the PD detection should be performed on inverter-fed motors at repetitive square voltages to avoid the PD caused insulation deterioration when the motors are collected to inverters having specific characteristics.However,unlike PD tests at AC/DC voltages proposed in IEC 60270,the PD detection at repetitive square voltages is much more complex because of serious interference generated by impulse generator.To solve the problem,ultra-high frequency(UHF) method seems recommendable for its preferable signal-to-noise ratio(SNR).The chief aim of this study is to investigate PD pulse and statistical characteristics of turn-to-turn insulation for inverter-fed traction motors.A square-shaped Archimedes antenna,specially designed for the PD detection at repetitive square voltages of fast rise times,was used to perform PD tests on turn-to-turn insulation models.Time and frequency analysis results indicate that energy component of generator disturbance and PD pulses are mainly distributed in the 0-0.5 GHz and 0.6-1.5 GHz range,respectively.Based on the results,suitable filter was designed for power disturbance suppression.Additionally,resorting to the sensor unit(i.e.antenna and filter) and the PD test system,the PD statistical features at square voltages of different frequencies were obtained.Experimental results show that higher frequency will give rise,statistically,to PD of lower magnitudes distributing at smaller phases.A reasonable interpretation of this phenomenon was presented.Lastly,according to the PD statistical features,some suggestions for the PD detection system design,generator parameter optimization and the PD pulse extracting were given.The results of this work would be beneficial to the increase of the sensitivity when performing the PD detection on insulation systems for inverter-fed motors at repetitive square voltages and thus,improving the reliability of inverter-fed motors.

Effect of repetitive square voltage frequency on partial discharge features

The inverter-fed motor is a key component of environmental-friendly hybrid cars, high-speed trains, and other industrial applications. After the widespread use of inverter-fed motors, the repetitive impulse surges from inverters were found to cause new insulation problems in inverter-fed motors that were linked to premature insulation failure. The partial discharge (PD) induced by the overvoltage inner stator windings was found to be the root cause of insulation reliability problems. To mitigate this problem, PD detection and life testing at repetitive square voltages should be performed on new types of insulation models and entire motor insulation systems. The obtained partial discharge inception voltage (PDIV) and lifetime of insulation in the tests can be used to evaluate the insulation status of inverter-fed motor insulation systems and thus to improve the insulation designs. At AC voltage conditions, the voltage frequency can significantly affect PD activity. At repetitive square voltage with rapid rise time, the influence of the square voltage frequency on PD activity should be investigated (1) to suggest values for the repetitive square voltage frequency selection for the PDIV and lifetime tests, and (2) to increase the signal-to-noise ratio when extracting PD pulses from strong disturbances generated by the operating switch of impulse generators. Therefore, the main purpose of this paper was to investigate the effects of repetitive square voltage frequency on PD events. Insulation models of both Type I (low-voltage inverter-fed motor) and Type II (high-voltage inverter-fed motor) were used to obtain single-PD and multi-PD statistical features, respectively. Experimental results indicated that higher frequencies caused less PD events with lower PD magnitudes and shorter delay times in one square voltage cycle. This phenomenon was attributed to the different surface charge decay ratios and the initial electron emission probabilities resulting from different square voltage frequencies. Finally, a number of considerations for PD measurements on inverter-fed motors were provided to improve the sensitivity of the PD test system and to obtain high objective insulation lifetime test results, which are used to assess the insulation status of inverter-fed motors.

青年脑梗死误诊为单纯部分性发作癫痫临床分析

目的探讨青年脑梗死诊治要点及误诊为单纯部分性发作癫痫的原因、防范措施。方法对2021年2月—2022年10月收治的曾误诊为单纯部分性发作癫痫的青年脑梗死7例的临床资料进行回顾性分析。结果本组7例年龄23~38岁,主要表现为多次发作一过性或短暂性右肢乏力,伴右面部发麻;右肢肌力均减低,右鼻唇沟变浅和腱反射减弱各3例,舌右伸偏斜、共济失调和Babinski征阳性各2例。7例均于外院综合门诊误诊为单纯部分性发作癫痫,误诊时间2~3 d。入我院后均经头颅MRI及磁共振血管造影(MRA)检查确诊脑梗死,予相应治疗后病情好转出院。出院后随访6个月,7例均未复发,2例遗留轻微肢体功能障碍。结论青年脑梗死早期症状不典型,易误诊。基层医院临床医生应提高对该病警惕性,加强对其认识,对有脑部体征且伴有脑梗死易患因素青年患者,不要因年龄小而轻易否定脑梗死诊断,必要时及时转诊并行MRI、MRA等影像学检查,以及早确诊并治疗。

脑瘫共患癫痫患儿的临床特点分析

目的 分析脑性瘫痪(简称脑瘫)共患癫痫患儿的临床特点。方法 回顾性分析2019年1月-2022年12月郑州大学第三附属医院收治的155例脑瘫共患癫痫患儿的临床资料,按照脑瘫分型将患儿分为4组:痉挛型双瘫组(n=29)、痉挛型偏瘫组(n=33)、痉挛型四肢瘫组(n=73)及非痉挛型组(n=20)。比较各组患儿性别、出生季节、出生体重、胎龄以及胎龄与体重关系的差异,分析围产期危险因素、头颅MRI分类系统(MRICS)、粗大运动功能分级(GMFCS)、癫痫首次发病年龄等临床资料与脑瘫分型的关系。结果 155例脑瘫共患癫痫患儿中,男101例,女54例。在胎龄28~31+6周的患儿中,痉挛型偏瘫的比例低于痉挛型双瘫及痉挛型四肢瘫(P=0.009)。痉挛型偏瘫组患儿的窒息史比例明显低于其他3组,缺血缺氧性脑病(HIE)比例明显低于痉挛型四肢瘫组及非痉挛型组(P<0.05)。痉挛型四肢瘫组患儿癫痫首次发作年龄<1岁的比例明显高于痉挛型双瘫组(P=0.041);痉挛型双瘫组患儿白质损伤的比例高于其他3组,而灰质损伤的比例低于痉挛型偏瘫组及非痉挛型组(P=0.001);痉挛型四肢瘫组患儿GMFCS分级Ⅳ-Ⅴ级的比例高于其他3组(P<0.001);痉挛型偏瘫组患儿Ⅰ-Ⅲ级比例明显高于痉挛型四肢瘫组及非痉挛型组(P<0.001)。结论 在脑瘫共患癫痫患儿中,脑瘫分型的患儿在胎龄、窒息史、HIE史、癫痫首次发作年龄、MRICS分类及GMFCS分级方面存在差异。

用于变频电机绝缘测试的高频高压脉冲发生器设计

高频高压脉冲是变频电机绝缘评估的关键技术之一,其产生、控制、保护与传统高压直流、正弦条件下的相应技术具有较大差异,已成为高频高压脉冲技术的关键难题。为此,采用时钟可达纳秒级的现场可编程逻辑门阵列,研制了一套边沿时间40~500 ns可调的高频高压脉冲发生器。基于半桥结构的脉冲发生器,提出测试容量达1600 pF、电压峰峰值可达24 kV的全桥拓扑结构。通过设计多级电压突降保护算法、电流脉宽实时检测、纳秒级脉冲控制技术以及多种抗干扰措施,保障了脉冲发生器在高频电磁干扰环境下安全稳定运行。实验结果表明,该脉冲发生器产生电压的脉宽和死区时间最小1μs,最大重复频率100 kHz,为变频电机全参数绝缘测试提供了新平台。

KCNMA1基因变异相关儿童神经系统疾病表型谱研究

目的总结KCNMA1基因变异患儿的临床表型和基因变异特点。方法回顾性分析2013年3月—2023年5月在北京大学第一医院儿童医学中心就诊的10例KCNMA1基因杂合变异患儿的临床资料,总结并分析其临床表现及颅脑影像学、脑电图特点。结果10例KCNMA1变异患儿中,男8例,女2例。共发现9个不同的KCNMA1变异位点,其中错义变异5个,移码变异3个,剪切位点变异1个。7个变异位点为新发变异,2个变异位点为遗传性变异。10例KCNMA1变异患儿中,6例仅表现为癫痫发作,3例表现为癫痫发作合并阵发性运动障碍,1例仅表现为阵发性运动障碍。9例有癫痫发作的患儿起病年龄为3日龄~1岁8月龄(中位起病年龄为8月龄),癫痫发作类型包括局灶性发作6例,癫痫性痉挛4例,肌阵挛发作2例,不典型失神发作2例,全面强直阵挛发作2例,肌阵挛失张力发作1例,失张力发作1例,5例患儿有多种发作类型。符合癫痫综合征诊断的患儿中诊断为婴儿癫痫性痉挛综合征1例,肌阵挛失张力癫痫1例。4例运动障碍患儿起病年龄为15日龄~1岁6月龄,运动障碍主要表现为阵发性非运动诱发的肌张力障碍,其中1例阵发性运动障碍合并眼球运动异常。10例KCNMA1变异患儿中,4例有颅脑MRI异常,其中脑室增宽3例,蛛网膜下腔增宽2例,胼胝体发育不良2例,脑白质髓鞘化落后1例。脑电图背景活动减慢5例;10例发作间期均监测到癫痫样放电,表现为局灶性放电、多灶性放电或广泛性放电,其中4例可见高峰失律,1例存在睡眠中癫痫性电持续状态;4例监测到癫痫发作,其中癫痫性痉挛3例,不典型失神发作1例。10例患儿均有发育落后。结论KCNMA1基因变异相关神经系统表型主要包括癫痫、阵发性非运动诱发的运动障碍和发育落后。癫痫多在2岁以内起病,具有多种发作类型,以局灶性发作常见。阵发性运动障碍主要表现为阵发性肌张力障碍。

卡马西平治疗新诊断部分性癫痫的临床效果及对认知功能的影响

目的 探讨新诊断部分性癫痫患者采用卡马西平(CBZ)治疗的临床效果及对认知功能的影响。方法 选取2020年3月至2022年9月于鹿邑县人民医院接受治疗的新诊断部分性癫痫患者共计136例,以随机数字表法分为研究组(n=68)与对照组(n=68),对照组给予托吡酯片治疗,研究组给予CBZ联合托吡酯片治疗,对两组临床疗效、认知功能、生存质量、血清指标、不良反应进行比较。结果 研究组治疗有效率(95.59%)较对照组(80.88%)更高,差异具有统计学意义(P <0.05);两组治疗3个月后蒙特利尔认知评估量表(MoCA)评分提高,且研究组较对照组更高,差异均有统计学意义(P <0.05);两组治疗后癫痫患者生活质量评定量表-31(QOLIE-31)提高,且研究组较对照组更高,差异均有统计学意义(P <0.05);两组治疗后血清神经肽Y(NPY)、胶质纤维酸性蛋白(GFAP)水平降低,且研究组较对照组更低,差异均有统计学意义(P <0.05);研究组不良反应发生率(4.41%)较对照组(20.59%)更低,差异具有统计学意义(P <0.05)。结论 新诊断部分性癫痫给予CBZ治疗能够提升临床疗效,增强认知功能,提高生活质量,改善血清指标,减少不良反应发生。

减重结合功能性电刺激对脑卒中患者下肢运动功能的疗效

目的观察减重结合功能性电刺激对脑卒中患者下肢运动功能的疗效。方法2023年1月至2024年2月,选择佛山市禅城区人民医院康复医院住院脑卒中患者60例,随机分为对照组(n=30)和观察组(n=30)。对照组接受常规康复,观察组增加天轨系统减重结合功能性电刺激,共3周。治疗前后采用平衡评定与训练仪、Berg平衡量表(BBS)、FMA评定量表下肢部分(FMA-LE)、Holden步行功能分级(FAC)进行评定。结果治疗后,两组X轴轨迹长、动摇平均速度、动摇总轨迹长、Y轴轨迹长、单位面积轨迹长、BBS评分、FMA-LE评分、FAC评分均较治疗前显著改善(|t|>4.809,P<0.001)。除X轴轨迹长和动摇平均速度外,其他指标观察组均优于对照组(|t|>2.268,P<0.05)。结论增加减重结合功能性电刺激能更有效改善脑卒中患者的下肢运动功能、平衡功能和步行功能。