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癫痫是由多种病因引起的慢性脑部疾病,以脑部神经元异常过度放电所致的突然反复和短暂的中枢神经系统功能失常为特征[1]。而癫痫患者的死亡率是健康人群的2~5倍。癫痫 相似文献
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<正>癫痫猝死是癫痫患者突然发生的意外死亡,通过尸检排除中毒及结构性异常的死因,死亡前可有癫痫发作但要排除癫痫发作相关的其他死亡原因(溺水、摔死、意外事故、癫痫持续状态等)~[1]。癫痫患者死亡率约为普通人群2~4倍~[2]。癫痫猝死占癫痫死亡原因2%~18%~[3-4]。癫痫猝死每年发生率为0.1%,虽然发病率低于神经系统其他疾病,但它是继脑卒中之后造成潜在寿命损失的第2大原因~[5]。 相似文献
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脑卒中与癫痫 总被引:3,自引:0,他引:3
孙红斌 《实用医院临床杂志》2008,5(2)
脑卒中是癫痫最为常见的病因之一,尤其是65岁以上的老年患者,同时癫痫发作也可诱发脑卒中。本文重点介绍脑卒中后癫痫发病机制、脑卒中后癫痫的定义与分类及脑卒中后癫痫与卒中类型、病灶部位、大小的关系,对脑血管疾病积极的一级、二级预防以降低脑卒中的发病率,降低脑卒中后癫痫的患病率。 相似文献
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刘娟 《实用诊断与治疗杂志》2008,(1):45-48
癫痫是儿童时期的常见病,多发病,约30%的癫痫患儿同时伴有认知功能障碍,主要表现为注意力、记忆力、推理判断及学习能力的下降。其原因是多方面的,包括致痫灶部位、不同发作类型、发病年龄、病程、发作频率、抗癫痫药物及家庭社会因素均影响患儿认知。应用神经心理学评定量表、事件相关电位及功能影像学检查可以测量认知功能损伤程度。通过综合治疗可提高癫痫患儿的认知功能。 相似文献
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在过去的十年里,抗癫痫药物虽有所发展,但还有三分之一的癫痫患者对药物治疗发生耐药。而对于那些药物治疗有效的患者,现有的AEDs似乎不能影响癫痫的自然病程。目前没有药物可以阻碍癫痫的发展。因此,以后的研究必须更深入地了解癫痫产生的基本机制和癫痫耐药的生物学机制,发展新的药物来逆转或预防耐药。为达到这些目标,研究癫痫的动物模型就成为最重要的前提。以下对几种常用的模型在耐药方面的研究作一简要综述。 相似文献
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Velagapudi P Turagam M Laurence T Kocheril A 《Pacing and clinical electrophysiology : PACE》2012,35(3):363-370
Sudden unexpected death in epilepsy (SUDEP) is a major clinical problem in epilepsy patients in the United States, especially those with chronic, uncontrolled epilepsy. Several pathophysiological events contributing to SUDEP include cardiac arrhythmias, respiratory dysfunction, and dysregulation of systemic or cerebral circulation. There is a significant body of literature suggesting the prominent role of cardiac arrhythmias in the pathogenesis of SUDEP. There is evidence to say that long-standing epilepsy can cause physiological and anatomical autonomic instability resulting in life-threatening arrhythmias. Tachyarrhythmias, bradyarrhythmias, and asystole are commonly seen during ictal, interictal, and postictal phase in epilepsy patients. It is unclear if these rhythm disturbances need attention as some of them may be just benign findings. Evidence regarding prolonged cardiovascular monitoring or the benefit of pacemaker/defibrillator implantation for primary or secondary prevention in epilepsy patients is limited. Awareness regarding pathophysiology, cardiac effects, and management options of SUDEP will become useful in guiding more individualized treatment in the near future. (PACE 2011; 1-8). 相似文献
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Patients with refractory epilepsy face an elevated risk of sudden death, with rates as high as 1% per year. This phenomenon, known as sudden unexpected death in epilepsy (SUDEP), is believed to be a seizure-related occurrence, but the exact underlying mechanisms are uncertain. Both pulmonary and cardiac pathophysiologies have been proposed. The cardiac mechanism of greatest interest is the precipitation of arrhythmias by seizure discharges via the autonomic nervous system. SUDEP prevention has centered on effective seizure control, and epilepsy surgery has reduced SUDEP incidence in a number of studies. Additional prophylaxis methods are needed, however, for the large number of patients with treatment-refractory epilepsy. Future research should aim to clarify whether the association between seizures and autonomic dysfunction and cardiac arrhythmias extends to a demonstrable cardiac mechanism for SUDEP. 相似文献
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SAPHIR O 《Postgraduate medicine》1955,18(2):A-38-44
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Lahiff M 《Professional nurse (London, England)》2000,15(10):620-621
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The initial challenge in primary prevention of sudden cardiac death (SCD) lies in identifying those at greatest risk, before the index event. Ventricular fibrillation is the leading cause of SCD; however, many clinical conditions predispose fatal ventricular dysrhythmias. In patients with structural heart disease, left ventricular dysfunction is the strongest predictor of SCD. Noninvasive markers such as nonsustained ventricular tachycardia, delayed potentials, decreased heart rate variability and baroreflex sensitivity, and repolarization alternans are further observed to assess risk in ischemic cardiomyopathy; however, most of these markers have poor positive predictive value and lack specificity. The electrophysiologic study has strong positive predictive value, but remains a costly and invasive method for risk stratification. In patients with normal hearts, genetic predisposition may identify patients at risk but clinical markers are not readily recognized. The implantable loop recorder is a useful tool in detecting dysrhythmic causes of syncope and identifying patients at risk for SCD. 相似文献
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When people die suddenly and unexpectedly ethical issues often come to the fore. The aim of the study was to describe experiences of members of stroke teams in stroke units of ethical problems and how the teams manage the situation when caring for patients faced with sudden and unexpected death from stroke. Data were collected through four focus group interviews with 19 team members in stroke-unit teams, and analysed using interpretive content analysis. Three themes emerged from the analysis characterized by information, decisions about care and support for the next-of-kin in the changing and uncertain situation, with mutual trust as the core. Mutual trust, both within the stroke team and with next-of-kin was seen by the stroke-team members as a way of handling ethical problems by administering care with the patient's best interest at heart. 相似文献