癫痫患者个性研究

目的：探讨癫痫患者的个性特征。方法：采用艾森克个性问卷对114例癫痫患者进行个性测查。结果：癫痫患者有明显的个性异常,较孤僻,易攻击,报复心强,情绪控制能力差,残忍。发病年龄愈小,个性改变愈严重。结论：癫痫患者存在明显的个性异常。     

癫痫患者个性研究

目的：探讨癫痫患者的个性特征。方法：采用艾森克个性问卷对１１４例癫痫患者进行个性测查。结果：癫痫患者有明显的个性异常,较孤僻,易攻击,报复心强,情绪控制能力差,残忍。发病年龄愈小,个性改变愈严重。结论：癫痫患者存在明显的个性异常。     

无法解释的癫痫患者猝死

无法解释的癫痫患者猝死（ＳＵＤＥＰ）是慢性癫痫患者猝死的常见类型。ＳＵＤＥＰ的危险因素有强直－阵挛发作、发作频繁、多种抗癫痫药物治疗、低智商、低年龄等。采用较少的抗癫痫药物完全控制强直－阵挛发作的发生是减少ＳＵＤＥＰ的关键。     

适形放射治疗原发性颞叶癫痫疗效初探

目的观察原发性颞叶癫痫经定向适形放射治疗后的近期疗效和长期随访结果,探讨适形放射治疗是否适用于原发性颞叶癫痫。方法自2003年4月～2004年12月间收治了11例原发性颞叶癫痫病人,以64-V-EEG的检查确定癫痫灶区域;同时经过MRI、脑磁图(MEG)、PET-CT等调整癫痫灶靶区的范围,用Win-MRT-TPS优化治疗方案,以85%～90%等剂量计算,立体定向适形放疗隔日治疗1次,每次600cGY,共2次,总量1200 cGY。病人随访3～5年,每次检查MRI、64-V-EEG,部分病人加查脑磁图(MEG)和PET-CT以评定疗效。结果治疗后患者症状逐渐缓解,6个月缓解5例,6～12个月缓解4例,2例未见效果。治疗后1年效果满意、显著改善、良好者9例,总有效率81.8%(9/11),3年77.8%(7/9),5年83.3%(5/6)。治疗后5例病人出现脑水肿,2例病人轻微头疼、恶心。7例病人局灶性脱发。结论适形放射治疗原发性颞叶癫痫患者后部分疗效良好,随访期内未发现明显不良反应,提示该方法是一种微创、有效的治疗方法。     

低剂量放疗治疗原发性癫痫初探

目的 初步探讨低剂量立体定向放射治疗原发性癫痫的方法,并评价其疗效.方法 放射治疗组均为长期低频率大发作,又不愿长期、坚持服用抗癫痫药物的原发性癫痫患者.经视频脑电图对癫痫灶定位后,以12Gy总剂量,利用立体定向适形光子刀系统对癫痫灶进行照射.每位治疗组患者选2名一般条件基本相同的门诊患者为对照,对照组与治疗组以2∶1配对.结果 患者经放射治疗后随访12～37个月,以Engel分级评价疗效,EngelⅠ级1例(9.1%),Ⅱ级2例(18.2%),Ⅲ级6例(54.5%),Ⅳ级2例(18.2%).在随访期内均未出现放疗反应和其他并发症.与对照组相比,有统计学差异.结论 经过对癫痫灶非毁损性低剂量、区域照射,部分患者疗效良好,随访期内未发现明显不良反应.提示该法是一种微创、有效的治疗方法.     

癫痫患者心理状态调查

本文报道100例癫痫患者心理状态的调查报告,其中91例患者有心理障碍;作者分析了造成或影响心理障碍的原因,并且针对这些因素提出了一些矫正措施。     

癫痫患者妊娠期癫痫发作的相关研究进展

癫痫是神经系统的一种慢性疾病,不仅影响患者身心健康,并且降低患者的生活质量.特别癫痫患者处于妊娠期癫痫发作时,由于其特殊的生理、心理特点,癫痫发作易危害到患者及其胎儿的健康甚至生命.如何处理癫患者的妊娠期合并癫痫并已成为临床上一项极具挑战性的工作.文中将从妊娠对癫痫的影响、癫痫及抗癫痫药物对妊娠的影响、抗癫痫药物选择等研究进展进行阐述.     

300例癫痫及可疑癫痫患者AEEG分析

目的：对３００例癫痫及可疑癫痫患者的动态脑电图的应用价值进行了初步探讨。方法;使用北京明思公司ＳＷ－ＪＨ系列智能化脑电监护仪描记,并与常规脑电图比较。结果：３００例中ＥＥＧ异常５４例,ＡＥＥＧ异常１７８例ＡＥＥＧ痫样放电检出率明显高天ＥＥＧ。１４４例继发性癫痫患者中,ＥＥＧ异常８例,ＡＥＥＧ异常１０例,二者无显著性差异。     

300例癫痫及可疑癫痫患者AEEG分析

目的：对300例癫痫及可疑癫痫患者的24小时动态脑电图（AEEG）的应用价值进行了初步探讨。方法：使用北京明思公司SW－JH系列智能化脑电监护仪描记,并与普通脑电图（EEG）比较。结果：300例中EEG异常54例（18．OO％）,AEEG异常178例（59,33％）．AEEG病样放电检出率明显高于EEG。14例继发性癫痫患者中,EEG异常8例（57．14％）．AEEG异常10例（71．41％）,二者无显著性差异,（P＞0．05）。结论：AEEG在病样的放电检出上明显优于EEG,但有时AEEG也捕获不到门歇期的病样波;在继发性癫痫中,AEEG在病样波的检出上无明显优势,但AEEG可以记录到癫痫发作起始时的波形变化,对确定癫痫类型有重要意义。     

高中生手机成瘾的研究进展

随着智能手机的广泛普及,青少年手机成瘾已成为目前具有挑战性的公共卫生问题。本文目的是对国内外高中生手机成瘾的相关文献进行综述,主要从高中生手机成瘾的概念、测量工具、流行现状、影响因素及干预策略5个方面进行阐述,以期为高中生手机成瘾的干预提供参考,降低该群体手机成瘾发生率。     

神经外科患者癫痫反复发作处理分析

目的 探讨神经外科患者出现癫痫反复发作的临床特点、处理原则与方法.方法 回顾性分析沈阳军区总医院神经外科自2011年1月至6月收治的9例癫痫反复发作患者的临床资料,分析其加重的原因、发作特点及治疗方法和结果.结果 9例患者中3例合并胶质瘤、1例蛛网膜囊肿、1例海绵状血管瘤、1例脑软化灶;7例有癫痫病史,2例既往无癫痫病史;7例为额叶癫痫,2例颞叶癫痫.癫痫发作加重的原因:减药3例,新诊断的脑肿瘤2例,手术(颅内电极置入术)1例,原因不明3例.癫痫发作类型包括部分性发作与全面性发作,发作频率从间隔3min至间隔数小时发作一次.患者经给予多种抗癫痫药物联合用药治疗,包括口服与注射给药,癫痫得到控制,其中添加左乙拉西坦口服有较好的疗效.结论 神经外科患者出现癫痫反复发作多呈药物难治性,发作不易控制,其处理应使用对部分性癫痫发作有较好疗效的多种抗癫痫药物联合用药,剂量应高于常规初始剂量,包括静脉注射及肌注给药,以尽快控制癫痫发作.左乙拉西坦因口服吸收快、起效迅速及有较好的抗癫痫作用,对癫痫反复发作有较好的疗效.     

癫癎性精神分裂症样精神病的临床资料分析

目的探讨癫疴性精神分裂症样精神病的临床特征和预后。方法69例瘢疴性精神分裂症样精神病患者的。临床资料进行回顾性分析。结果癫疴性精神分裂症样精神病患者86．96％为缓慢起病,精神病性症状出现于癫疴发作11.9年之后,88．4％的患者在癫疴发作控制和发作减少之后出现精神病性症状,76．8％患者的异常脑电图恢复正常或得到改善。临床精神症状以思维障碍和幻听为主。33％的患者有智能低下。结论良性病程,不呈精神分裂症性衰退,愈后无精神分裂症的残留症状。     

5例癫痫性痉挛患者的临床诊治及脑电图特点分析

目的 探讨癫痫性痉挛患者的临床表现、脑电图(EEG)特点及治疗效果.方法 2009年7月～201 1年10月间,就诊于吉林大学第一医院癫痫门诊的5例诊断为痉挛性发作的癫痫患者,对其临床资料及长程录像脑电图监测结果,进行回顾性分析研究.结果 幼儿期发病的患儿3例,首先表现为部分性发作,后表现为成串样的点头,伴有双上肢抬起外展,两侧不对称,右侧肢体为著.老年期发病的癫痫性痉挛患者2例表现为一侧肢体短暂性屈曲样动作,呈串样发作,伴有肢体的僵硬,每天10余串发作,每串10余次.同步录像脑电图监测到1～2串痉挛发作,相应脑电见泛化性高波幅负相慢波,随后见低波幅快活动,相应肌电见爆发性肌电活动且电位递减,似“菱状”改变.结合其临床发作特点及相关脑电检查诊断为“癫痫症(痉挛性发作)”,给予抗癫痫药物治疗有效.结论 癫痫性痉挛并非仅见于婴儿West综合征,可由诸多严重的脑部疾病引起,常合并其他部分性或全面性发作,相对广谱AED仍为本病首选治疗方法.     

Infantile epileptic encephalopathy with late‐onset spasms: Report of 19 patients

Purpose: Late‐onset spasms (LOS) are epileptic spasms starting after the first year of life. Our aim was to assess the electroclinical features and the follow‐up of the patients with this particular type of epileptic seizure. Methods: We retrospectively included all patients with LOS confirmed by electroencephalography between 1989 and 2008. Clinical and electroencephalographic findings at diagnosis and during follow‐up were collected. The Vineland scale was used to evaluate the neuropsychological outcome. Results: We report 19 patients with LOS of 240 patients with recorded epileptic spasms. Eighteen patients had an epileptic encephalopathy with late‐onset spasms. The ictal electroencephalography (EEG) showed a focal or generalized discharge of triphasic slow‐waves, slow‐spikes, or slow spikes‐waves with fast activities. The interictal EEG usually showed focal or generalized slow‐waves or slow spikes‐waves without hypsarhythmia. LOS were controlled in only six patients. Three developed typical Lennox‐Gastaut syndrome and 10 had a severe epileptic encephalopathy. Neuropsychological outcome was evaluated in 15 patients with the Vineland scale. Cognitive functions were normal in only one patient, whereas severe cognitive delay was observed in 12 of 15. Conclusion: Epileptic spasms may appear after the age of one. They are more frequently observed in patients with epileptic encephalopathy. In few patients this type of seizure was observed before the patients fulfill Lennox‐Gastaut syndrome criteria. In one patient, we diagnosed a focal epilepsy with seizures occurring in cluster. When LOS are related to an epileptic encephalopathy, this epileptic syndrome seems to be linked to refractory epilepsy and severe cognitive outcome unrelated to the etiology.     

难治性癫痫患者致痫灶细胞凋亡现象的研究

目的观察难治性癫痫患者手术切除癫痫灶中细胞凋亡现象,探讨神经元凋亡在癫痫发病机制中的意义,为临床治疗提供新的理论依据.方法收集16例经手术治疗的难治性癫痫患者致痫灶标本,在对临床资料全面分析的基础上,应用光镜、电镜及凋亡细胞DNA原位末端标记法（TUNEL）观察标本中存在的细胞凋亡现象.结果致痫灶周围神经元普遍固缩、减少,反应性胶质细胞增生.TUNEL阳性细胞数量较对照组显著增高（P＜0.01）,且绝大部分为神经元.结论难治性癫痫患者致痫灶周围存在细胞凋亡现象,神经元凋亡可能参与癫痫的发病过程.     

Concentration of metabolites of valproic acid in plasma of epileptic patients

With the help of synthetic reference substances, five metabolites of valproic acid (VPA) could be quantitated by gas chromatography in the plasma of 26 epileptic patients undergoing chronic therapy with sodium valproate. The products of beta-oxidation, i.e., 2-en-VPA, 3-hydroxy-VPA, and 3-keto-VPA were found to be the major metabolites of VPA in plasma, whereas the intermediates of omega-oxidation, 4-hydroxy-VPA and 5-hydroxy-VPA, were present only in markedly lower concentrations. It was thus confirmed that in addition to the excretion of VPA as the glucuronide, beta-oxidation is the preferred metabolic pathway of VPA in man. However, taking the anticonvulsant activity of the metabolites as derived from animal experiments into consideration, none of the metabolites found in human plasma seems to contribute markedly to the therapeutic effect of VPA. Thus, in most patients, VPA seems responsible for more than 90% of the antiepileptic activity during continued medication in man.     

Monitoring of phenytoin in epileptic children: value of the single morning sample

Summary The intra-individual variation in plasma concentration of phenytoin was studied in ten clinically well controlled children on monotherapy. The drug concentration was determined in routine pre-dose samples taken on three to five different mornings. On two of these occasions, plasma phenytoin was also determined at 0.5, 1, 2, 3, 5 and 7 h after the dose. The difference between the highest and lowest morning concentrations in a patient varied between 7.5 and 40 mol/l (mean 20.1 mol/l). Half of all morning concentration values were lower than 40 mol/l. This often-recommended lower limit for good seizure control should therefore be reconsidered. The two concentration versus time curves in each patient during 7 h after administration differed considerably in shape, and the first curve could not be used for prediction of the second curve. The ratio between unbound and total drug was very stable and amounted to 9.4, SD 0.94% (n = 168). It is concluded that the conventional single morning sample is satisfactory for routine monitoring in well-controlled children on monotherapy with phenytoin. In problem patients, and during combination therapy, however, more extensive investigation will be necessary, including repeated morning samples as well as determination of dose-interval curves and protein binding.     

Phantom vibration and phantom ringing among mobile phone users: A systematic review of literature

The last decade has witnessed considerable interest in pathological conditions stemming from misuse or overuse of technology, a condition commonly referred to as technopathology. Of the several complaints reported, phantom vibration or phantom ringing is one that has not yet been widely explored. The objective of conducting a systematic review is to provide an understanding of the phenomena and summarize the research conducted so far. Major databases were searched and articles that matched the inclusion criteria were selected for final analysis. According to findings obtained, phantom vibration or phantom ringing was commonly experienced by mobile phone users; however, few found it bothersome and hence took no steps to eliminate it. As of now, literature in the area is limited and many aspects of the phenomena such as its prevalence across populations, causal factors, consequences, and treatment plans are yet to be studied. Also, a clinical criterion for identification of the condition needs to be formulated. With increase in the number of individuals reporting mobile phone‐related problem behavior, phantom vibration, or phantom ringing may be expected to become a cause of concern for mental health professionals within some years. Finally, the need for further research is emphasized while presenting directions for future investigations.     

文拉法辛与舍曲林治疗癫痫性抑郁障碍的对照研究

目的探讨文拉法辛和舍曲林治疗癫痫性抑郁障碍的疗效和安全性。方法将64例符合CCMD-3癫痫性抑郁障碍患者随机分为两组,在维持原抗癫痫药物的治疗基础上,分别给予文拉法辛和舍曲林治疗,疗程6周。采用汉密尔顿抑郁量表（HAMD）。汉密尔顿焦虑量表（HAMA）和副反应量表（TESS）评定疗效和不良反应。结果文拉法辛组显效率为83.3%,舍曲林组的显效率为76.7%。两者疗效相当。舍曲林组有2例引起癫痫发作次数增加,而文拉法辛对癫痫无明显影响。结论文拉法辛治疗癫痫性抑郁障碍疗效肯定,不良反应小,临床上可作为首选药物。