癫痫患儿家长抑郁水平及相关因素的调查分析

目的了解癫痫患儿家长抑郁水平以及相关的影响因素,为其有效的减轻心理负担提供依据.方法对48例确诊癫痫的患儿家长进行问卷调查,问卷包括自设相关因素调查问卷和流调中心用抑郁量表两部分.结果癫痫患儿家长抑郁量表得分为(29.37±9.04),超过16分的67.2%,抑郁程度与父母的文化程度及癫痫知识掌握程度成负相关,与患儿癫痫的类型和发作频率等无关.结论癫痫患儿家长的抑郁水平较高,心理负担较重,对癫痫知识掌握不足,急需得到更多的疾病知识和心理支持.     

癫痫患儿家长抑郁水平及相关因素的调查分析

目的　了解癫痫患儿家长抑郁水平以及相关的影响因素 ,为其有效的减轻心理负担提供依据。方法　对 4 8例确诊癫痫的患儿家长进行问卷调查 ,问卷包括自设相关因素调查问卷和流调中心用抑郁量表两部分。结果　癫痫患儿家长抑郁量表得分为 (2 9.37± 9.0 4 ) ,超过 16分的 6 7.2 % ,抑郁程度与父母的文化程度及癫痫知识掌握程度成负相关 ,与患儿癫痫的类型和发作频率等无关。结论　癫痫患儿家长的抑郁水平较高 ,心理负担较重 ,对癫痫知识掌握不足 ,急需得到更多的疾病知识和心理支持     

癫痫患者对痫性发作的自我知晓研究

目的:研究痫性发作后患者对癫痫事件发生的自我知晓程度。方法:癫痫患者39例痫性发作后1 h,在视频脑电监测下询问患者是否出现痫性发作,并通过视频脑电图确认痫性发作的种类、发作时间等,进行统计学分析。结果:接受视频脑电监测的39例癫痫患者共有69次痫性发作,痫性发作不知晓37次(53.6%)。痫性发作不知晓率在复杂部分性发作为89.3%,全身强直-阵挛发作为58.8%,单纯部分性发作为8.3%,三者差异有统计学意义(P<0.05);脑电图初始改变出现在左侧大脑半球的痫性发作不知晓率为75.8%,右侧大脑半球为33.3%,差异有统计学意义(P<0.05)。结论:癫痫患者的痫性发作不知晓率>50%。痫性发作所致的意识受损程度及痫性发作的起源部位可能是影响患者对痫性发作自我知晓的原因。     

安定颈动脉内注射对癫痫灶定侧的价值

目的：探讨安定颈动脉内注射试验对癫痫灶定侧的价值。方法：对8例两侧同步性和/或2例游走性痫性放电癫痫患者进行安定颈动脉内注射试验，观察注射后痫样波受抑制情况来确定痫灶侧。结果：安定颈动脉内注射干痫灶侧，两侧痫样波同时消失；注射于痫灶对侧，则注射侧痫样波消失，而病灶侧痫样波仍存在。结论：安定颈动脉内注射对癫痫灶定侧有重要价值，可替代传统的颈动脉内阿米妥钠注射试验。本试验还具有用药量小，不良反应少，效果好等优点，值得临床推广应用。     

Recent Advances in Treating Epileptic Children

Epilepsy remains a tough therapeutic problem. Although no dramatic breakthrough has occurred, therapy has improved significantly, partly because physicians more sharply delineate seizure types. New drugs have helped, too. Ethosuximide has replaced trimethadione in treating petit mal epilepsy, and quinacrine, sulthiame, carbamazepine and diazepam show promise for treating various types of seizures.     

2000例癫痫病例的发作分类研究

目的：对2000例癫痫病例进行发作分类研究，规范我国的发作分类诊断，以利于癫痫病人的诊治。方法：按中华医学会第一届全国癫痫学术会议拟订的发作分类统计。结果：依据临床 脑电图可分类达到97．35％；全面性发作占78．95％；其中强直-阵挛性发作占68．85％；肌阵挛性发作占2．8％；强直性发作占0．5％；失神性发作占6．8％；部分性发作占18．4％；其中单纯部分性发作占2．15％；复杂部分性发作占4．75％；单纯部分性继发全面性发作占1%；复杂部分性继发全面性发作占10．5％；不能分类达2．65％。结论：判断癫痫发作分类须详细分析综合各项资料。中华医学会1985年第一届全国癫痫学术会议拟订的发作分类，与1981年国际防治癫痫联盟建议的发作分类基本相似。稍简化后，符合我国国情，用于我国癫痫分类，可起到规范作用，利于癫痫病人的治疗。     

86例癫痫性脑病患儿的遗传特征研究

目的：探讨癫痫性脑病（EE）患儿的遗传特征,明确分子水平病因。方法：以86例不明原因EE患儿为 研究对象,对其进行家系全外显子组测序（WES）及基因组拷贝数变异（CNV）分析。结果：86例EE患儿中, 具有明确致病意义的遗传变异51例（59.30%）,包括基因突变46例（53.49%）,CNV 5例（5.81%）;其中新生 突变44例,占总致病变异的86.27%。86例EE患儿中,新生儿期发病11例,婴儿期发病52例,幼儿期发病 18例,学龄前期发病5例。结论：儿童EE基因突变率高,以新生突变为主,发病年龄以婴幼儿期为主。     

The Relationship Between Headaches with Epileptic and Non-epileptic Seizures: a Narrative Review

Purpose of Review

The purpose of this review is to examine the relationship between headaches and epilepsy as well as headaches and psychogenic non-epileptic seizures (PNES). Emphasis was placed on clinical characteristics, pathophysiology, and treatment.

Recent Findings

Epilepsy and headaches are common disorders that co-occur more often than would be expected by chance. There are some overlapping clinical features between migraine and epilepsy as well as evidence for shared underlying mechanisms. Proposed theories for a shared etiology include ion channel dysfunction, glutamatergic mechanisms, and mitochondrial dysfunction. Some, but not all, recent diagnostic classification systems have recognized the relationship between headaches and epilepsy. Ictal headaches are rare and should raise suspicion for PNES. Headaches in patients with epilepsy are undertreated despite evidence for efficacy of abortive headache medications.

Summary

Comorbid headaches and epilepsy are relatively common in the population presenting to a neurologist. Patients who have headaches and epilepsy and/or PNES should receive appropriate treatment that often includes mutually beneficial preventative therapy and includes abortive headache treatment.

     

Epileptic seizures and epilepsy in the elderly

Contrary to former views the incidence rate of epilepsies after age 65 are higher than in childhood and adolescence and epileptic seizures are one of the most common neurological problems in the elderly. The most common seizure types are primary focal with possible secondary generalization in about two thirds of the patients, the most common etiology are cerebrovascular disturbances, brain tumors, head injuries and degenerative diseases. Todd's pareses or other postictal disturbances are quite common. This article covers diagnostic and therapeutic aspects with special consideration of the influence of accompanying diseases (especially of the liver and kidneys) on the pharmacotherapy.