癫痫的睡眠动态脑电图临床应用价值

目的:探讨睡眠期动态脑电图(AEEG)在癫痫诊断中的作用。方法:利用 AEEG对836例癫痫患者自然睡眠期脑电波变化进行监测、分析。结果:正常106例 (12.7％),非特异性异常61例(7.3％),痫样波发放669例(80.0％),总异常730例 (87.3％)。痫样波出现于清醒期84例(12.5％),睡眠期408例(61.0％)。睡眠期明显高 于清醒期P<0.01。而睡眠期(NREM Ⅰ-Ⅱ期)占多数473／585例(80.7％)。结论:癫 痫和睡眠密切相关,通过自然和药物诱发睡眠,有助于提高癫痫脑电图阳性率,尤其是自然 睡眠AEEG对癫痫的定位诊断和分类更具有重要意义。对临床诊断困难的非典型发作及各种 不常见类型癫痫的作用更加突出,甚至起着决定性的作用。     

Prolonged action of tuftsin on penicillin-induced epilepsy

Brain Research Institute, Russian Academy of Medical Sciences, Moscow. Institute of Biological Research, Belgrade, Yugloslavia. Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 114, No. 7, pp. 56–58, July, 1992.     

抗抑郁剂在脑卒中患者中的预防性应用

目的观察预防性应用抗抑郁剂对脑卒中后抑郁(PSD)发生率及神经功能康复的影响。方法64例脑卒中患者随机分成两组,分别接受帕罗西汀与安慰剂治疗,采用改良爱丁堡斯堪的那维亚评分量表(MESS)和日常生活能力量表(ADL)评定脑卒中患者治疗前及治疗后神经功能缺损程度及日常生活能力;治疗结束时评定患者的PSD发生率。结果与安慰剂对照组相比,在治疗结束时,帕罗西汀组患者的MESS、ADL得分分别为11.1±4.3,27.6±4.8,低于安慰剂组的13.6±3.2及32.8±4.1;帕罗西汀组患者的PSD发生率为10.7%,亦低于对照组的41.4%,差异均具有统计学意义。结论预防性应用抗抑郁剂可以降低PSD发生率,并有利于脑卒中患者的神经功能康复。     

体内和体外实验中马桑内酯对大鼠大脑皮质神经元白细胞介素-2受体表达的影响

为了探讨免疫调质与癫痫发病机制的关系，本文应用免疫细胞化学PAP法对体内和体外实验中马桑内酯（致痫剂）对大鼠大脑皮质种经元白细胞介素-2受体表达的影响进行了研究．在体内实验中，对照经大鼠大脑皮质仅见少量弱阳性白细胞介素-2受体免疫反应神经元，其免疫反应性定位于种经元膜上．大鼠一侧侧脑室注射马桑内酯诱发癫痫后，大脑皮质白细胞介素-2受体阳性神经元明显增多，免疫反应增强．在体外实验中，用马桑内酯温育培养大双皮质神经元24h，其白细胞介素2受体阳性神经元也比对照组增加了1．5倍，免疫染色加深．本实验结果提示，大脑皮质神经元上的白细胞介素-2受体可能参与癫痫的病理机制．     

Enhancement of activity of an epileptogenic focus in the frog hippocampus by kynurenins and its depression by serotonin

Experiments on frogs with an epileptogenic focus produced by injection of 1000 units penicillin (0.4 l) into the primordial hippocampus showed that preliminary injection of two kynurenins — quinolinic acid (QA, 0.1 g) and kynurenin itself (K, 1 g) — into the region of the focus or their injection into an already functioning epileptogenic focus led to an increase in the frequency of interictal epileptiform discharges and of electrographic correlates of fits on the EEG. Anthranilic acid (AA, 5 g) had no effect on activity of the focus whereas serotonin (S, 1 g) and 5-methoxytryptamine (1 g) substantially depressed it. The provoking action of the kynurenins on epileptically predisposed brain neurons, it is suggested, may play an important role in the pathogenesis of epilepsy.Department of Pharmacology, Leningrad Pediatric Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR V. V. Zakusov). Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 87, No. 2, pp. 158–160, February, 1979.     

24h-AEEG在可疑癫痫司法鉴定中的应用

目的:探讨动态脑电图(AEEG)在可疑癫痫违法司法精神医学鉴定中的应用价值。方法:对举荐的46例可疑癫痫犯罪人的24小时动态脑电图进行回顾分析。结果:46例中,痫样放电13例(28.3%),非特异性异常8例(17.4%),总异常率为45.7%;痫样放电出现清醒期3例(23.1%),睡眠期出现10例(76.9%),两期有显著性差异(P<0.01);部位多见于额、颞区局限性异常。结论:AEEG因监测时间长,对司法精神医学鉴定中可疑癫痫犯罪的鉴别诊断可提供重要的依据,但不作为责任能力的判定依据。     

Changes in GABA-immunoreactive cell density during motor focal epilepsy induced by cobalt in the rat

Summary The distribution of GABA-immunoreactive cell bodies and terminals was studied using an anti-GABA serum during the development of chronic focal epilepsy induced by cobalt deposits onto the motor cortex of the rat. Cell counts of GABA-positive neurons were carried out in the epileptogenic area and correlated with the electrophysiological activity of the cobalt focus. In normal control rats, we identified GABA-immunoreactive somata and processes in the motor agranular cortex; they were multipolar or bipolar but never pyramidal and were present in all layers, especially in layer II. GABA-immunoreactive terminals were widely scattered in the neuropil and surrounded the unlabelled cell bodies. In the cobalt-treated animals, changes in the GABAergic innervation were observed during the development of the epileptic focus: decreases in the GABA-positive cell density and in the number of GABA-positive terminals were present before the onset of epileptic discharges and became more marked during the period of maximal spiking activity; a progressive return to normal values of GABA-positive cell density (except in the deep layers) as well as the reappearance of GABA positive terminals were associated with the extinction of the epileptic syndrome. Our observations suggest that the impaired inhibitory neurotransmission mediated by GABA plays a role in the development of the cobalt-induced epilepsy; moreover the recovery of GABAergic function which occurs during the extinction of the epileptic syndrome might imply a capacity for axonal regeneration of the GABAergic neurons.     

Afterpotentials following penicillin-induced paroxysmal depolarizations in rat hippocampal CA1 pyramidal cells in vitro

Epileptic discharges were induced by superfusion of rat hippocampal slices with penicillin. Under these conditions the neurons generated paroxysmal depolarization shifts (PDS) after electrical stimulation of Schaffer collaterals. The PDS were followed by large afterhyperpolarizations lasting about 2 s. The mechanisms causing these afterhyperpolarizations were studied in CA1 pyramidal cells. A late component of the after hyperpolarizations, which determined their overall duration, was blocked by intracellular application of EGTA and reduced by superfusion with 8-Br-cAMP. In the same neurons these drugs had a comparable effect on after hyperpolarizations following depolarizing current injections; it was therefore concluded that the late component of the PDS afterhyperpolarizations was caused by a slow Ca²⁺-activated K⁺ current. An initial fast component of PDS afterhyperpolarizations, which peaked about 60 ms after PDS onset, was reduced by EGTA but not affected by 8-Br-cAMP suggesting that the fast Ca²⁺-activated K⁺ current also contributed to the PDS afterhyperpolarizations. Superfusion of the slice with the -aminobutyric acid B receptor (GABA_B) antagonists phaclofen or 5-aminovalerate reduced the amplitude of the afterhyperpolarizations during the first 1000 ms but did not affect the late Ca²⁺-dependent component, indicating that a GABA_B-mediated K⁺ inhibitory postsynaptic potential (IPSP) contributed to the PDS afterhyperpolarization. Intracellular injection of Cl^– revealed that an early part of the afterhyperpolarizations lasting about 500 ms was Cl^–-dependent. This component was blocked by superfusion of the slices with bicuculline, suggesting that a GABA_A-mediated Cl^– IPSP contributed to the PDS afterhyperpolarization. The experiments show that different synaptic and intrinsic components with different time courses participate in the generation of PDS afterpotentials.     

癫痫病人不对称性δ、θ活动的地形图研究

利用BEAM分析技术,以50例正常人为对照,用Z值概率差异地形图,对83例部分性与全面性发作的癫痫病人脑电背景活动的δ与θ不对称性情况进行分析,并与其它结果比较后显示,BEAM对癫痫病人的不对称性δ、θ的检出率达72％,较EEG目测分析敏感,其显示的病变区与EEG目测分析、CT、SPECT结果大多符合,可用作痫灶的定侧定位,亦有助于全面性癫痫与部分性癫痫的鉴别。