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Epilepsy is one of the most common chronic disorders affecting women of childbearing age. Unfortunately, many women with epilepsy (WWE) still report not receiving key information about pregnancy. They obviously need information about epilepsy and pregnancy prior to conception with a particular emphasis on effective birth control (i.e. contraception), necessity to plan pregnancy, antiepileptic drugs optimization, and folate supplementation. The risks associated with use of antiepileptic drugs during pregnancy have to be balanced against fetal and maternal risks associated with uncontrolled seizures. This report reviews evidence-based counseling and management strategies concerning maternal and fetal risks associated with seizures, teratogenic risks associated with antiepileptic drug exposure with a special emphasis on developmental and behavioural outcomes of children exposed to intra utero antiepileptic drugs. 相似文献
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《Clinical neurophysiology》2021,132(9):2222-2231
ObjectiveChildhood absence epilepsy (CAE) is a disease with distinct seizure semiology and electroencephalographic (EEG) features. Differentiating ictal and subclinical generalized spikes and waves discharges (GSWDs) in the EEG is challenging, since they appear to be identical upon visual inspection. Here, spectral and functional connectivity (FC) analyses were applied to routine EEG data of CAE patients, to differentiate ictal and subclinical GSWDs.MethodsTwelve CAE patients with both ictal and subclinical GSWDs were retrospectively selected for this study. The selected EEG epochs were subjected to frequency analysis in the range of 1–30 Hz. Further, FC analysis based on the imaginary part of coherency was used to determine sensor level networks.ResultsDelta, alpha and beta band frequencies during ictal GSWDs showed significantly higher power compared to subclinical GSWDs. FC showed significant network differences for all frequency bands, demonstrating weaker connectivity between channels during ictal GSWDs.ConclusionUsing spectral and FC analyses significant differences between ictal and subclinical GSWDs in CAE patients were detected, suggesting that these features could be used for machine learning classification purposes to improve EEG monitoring.SignificanceIdentifying differences between ictal and subclinical GSWDs using routine EEG, may improve understanding of this syndrome and the management of patients with CAE. 相似文献
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目的 利用网络药理学和分子对接技术研究石菖蒲抗癫痫的有效成分及作用机制。方法 运用中药系统药理数据库及分析平台检索石菖蒲有效成分及主要靶点,通过GeneCards数据库收集癫痫疾病的相关潜在作用靶点,运用Cytoscape.3.7.1和 String绘制石菖蒲-癫痫靶点互作关系图,运用Metascape数据库进行GO和KEGG信号通路富集分析。运用AutoDock Vina 1.1.2软件对石菖蒲主要有效成分与癫痫相关靶标进行分子对接验证;通过构建戊四唑诱导的癫痫模型初步评价石菖蒲提取物及潜在有效成分的抗癫痫作用。结果 由 TCMSP 筛选得到4个有效成分及76个主要靶点。癫痫疾病以“Score”大于1.5分进行筛选得到3685个靶标。GO富集分析得到BP条目10个,细胞CC条目9个,MF条目10个(P<0.01),主要涉及核受体活性、离子通道活性、激素结合、神经递质受体活性、蛋白激酶活性、钙调蛋白结合等。KEGG 富集得到14条通路,主要涉及c型凝集素受体信号通路、雌激素信号通路、Ca2+信号通路、逆行内源性大麻素信号通路等。分子对接结果显示,桉脂素、山奈酚和8-异戊烯基山奈酚与癫痫关键靶标GABRA2、PPARG等具有良好的结合活性。动物实验结果表明,石菖蒲水提取物及主要潜在有效成分桉脂素和山奈酚在PTZ致小鼠癫痫模型上显示出较好的抗癫痫活性。结论 本研究通过动物实验验证了石菖蒲提取物和潜在有效成分的抗癫痫活性,并且运用网络药理学和分子对接技术探讨了其抗癫痫作用机制,发现石菖蒲可通过多个成分如桉脂素、山奈酚、8-异戊烯基山奈酚,多靶点如GABAA、PPARG等,多条通路如雌激素信号通路、钙信号通路对机体产生协调效应从而抑制癫痫的发作。该研究提示石菖蒲治疗癫痫具有多成分、多靶点、多通路特点,为石菖蒲的进一步研究提供数据支撑。 相似文献
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目的 运用科学知识图谱的手段,分析中医药治疗癫痫的研究进程并提炼重点。方法 设置检索时间为1990年至2020年,检索对象为中国知网(CNKI)该领域的相关文献,运用CiteSpace软件科学、准确地分析这些文献的作者信息、研究(发文)机构、关键词情况。结果 共计纳入文献793篇,马融-张喜莲、刘金民、谢炜、王洪图-张丽萍等领导核心作者团队,北京、广州以及广西中医药大学、天津中医药大学第一附属医院、南方医科大学等单位为主要进行相关研究的机构,高频关键词包括大鼠、难治性癫痫、小儿癫痫、海马、脑电图等,作用机制、网络药理学、肠道菌群、氧化应激、分子生物学等为近年来的热点与前沿。结论 通过借用知识图谱的分析能帮助提炼国内中医药治疗癫痫研究领域的重点,全面分析并科学判断近年来该领域的热点及前沿,为未来的研究夯实基础并把握方向。 相似文献
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R. López Ruiz S. Quintas P. Largo M. de Toledo M.T. Carreras A. Gago-Veiga R. Manzanares J. Vivancos 《Neurología (Barcelona, Spain)》2019,34(2):73-79
Objective
Thirty percent of the patients for whom code stroke is activated have stroke mimics, the most common being epilepsy. Our purpose was to evaluate the usefulness of multiparametric CT for differentiating between seizure-related symptoms and vascular events.Material and methods
We conducted a retrospective observational study; data were gathered prospectively during one year. We studied multiparametric CT images of patients admitted following code stroke activation and finally diagnosed with epilepsy.Results
The study included a total of 11 patients; 36% were men and mean age was 74.5 years. Three patients had right hemisphere syndrome, 4 displayed left hemisphere syndrome, and the remaining 4 had isolated aphasia. Maximum time from symptom onset to multiparametric CT study was 8.16 hours. Perfusion CT results were normal in 2 patients. Nine patients showed longer or shorter times to peak (Tmax); cerebral blood volume (CBV) and cerebral blood flow (CBF) maps varied. EEG was performed a maximum of 47.6 hours after symptom onset. Four patients showed findings compatible with status epilepticus, 2 displayed focal epileptiform activity, and 5 showed post-ictal slowing ipsilateral to perfusion CT abnormalities.Conclusion
The most sensitive parameter for differentiating between stroke and epilepsy in our series was increased time to peak in multilobar cortical locations in the absence of large-vessel occlusion and basal ganglia involvement. Multiparametric CT is a fast, readily available, and useful tool for the differential diagnosis of acute-onset neurological signs of epileptic origin in patients initially attended after code stroke activation. 相似文献8.
《Clinical neurophysiology》2019,130(1):128-137
ObjectiveHigh frequency oscillations (HFO) between 80–500 Hz are markers of epileptic areas in intracranial and maybe also scalp EEG. We investigate simultaneous recordings of scalp and intracranial EEG and hypothesize that scalp HFOs provide important additional clinical information in the presurgical setting.MethodsSpikes and HFOs were visually identified in all intracranial scalp EEG channels. Analysis of correlation of event location between intracranial and scalp EEG as well as relationship between events and the SOZ and zone of surgical removal was performed.Results24 patients could be included, 23 showed spikes and 19 HFOs on scalp recordings. In 15/19 patients highest scalp HFO rate was located over the implantation side, with 13 patients having the highest scalp and intracranial HFO rate over the same region. 17 patients underwent surgery, 7 became seizure free. Patients with poor post-operative outcome showed significantly more regions with HFO than those with seizure free outcome.ConclusionsScalp HFOs are mostly located over the SOZ. Widespread scalp HFOs are indicative of a larger epileptic network and associated with poor postsurgical outcome.SignificanceAnalysis of scalp HFO add clinically important information about the extent of epileptic areas during presurgical simultaneous scalp and intracranial EEG recordings. 相似文献
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