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find Author "胡越" 4 results
  • 脑炎后癫痫诊断与治疗进展

    脑炎后癫痫(Postencephalitic epilepsy,PEE)是指脑炎急性期后出现癫痫发作,是急性脑炎常见的后遗症,部分可发展为难治性癫痫。病毒感染引起的 PEE 是最常见类型。文章总结了 PEE 的病因、流行病学、发病机制,PEE 发生相关的危险因素以及用药指征,以期为该疾病的诊断、治疗及预后评估提供临床参考。

    Release date:2020-09-04 03:02 Export PDF Favorites Scan
  • 迷走神经刺激术治疗儿童难治性癫痫的研究进展

    癫痫是一种严重威胁人类身心健康的慢性功能性神经疾病,是几个世纪以来困扰医学界的难题之一。药物难治性癫痫以反复癫痫发作为主要特征,通常规范使用 2 种及以上抗癫痫药物(AEDs)症状难以控制,伴有认知功能损害的疾病。迷走神经刺激术(Vagus nerve stimulation,VNS)是一种无需开颅、通过神经调控治疗难治性癫痫的方法,在不损害重要神经功能的前提下,通过手术的方式阻断癫痫发作时电流传导通路,从而减少或者控制癫痫发作,可以降低因痫性放电继发脑损害,进而减少抗癫痫药物使用产生的副作用。自 1997 年美国食品药品监督局批准 VNS 上市应用于治疗癫痫以来,其适应证已经从成人逐步扩展到了儿童。儿童作为癫痫患者的特殊群体,处于生长发育关键期,有效、及时的调控干预可以为患儿中枢神经系统发育创造时机,为难治性癫痫患者治疗提供新思路。文章探讨了 VNS 的年龄适应证以及在不同年龄段儿童中的应用,并对 VNS 在改善儿童认知行为,儿童遗传性癫痫、发育性和癫痫性脑病、儿童结构性病因相关性癫痫治疗的有效性,VNS 使用的安全性和不良反应等方面作一综述。

    Release date:2021-02-27 02:57 Export PDF Favorites Scan
  • A QUIPS analysis of related factors of poor outcome in children with convulsive status epilepticus

    ObjectiveUsing Quality in prognosis studies (QUIPS) analysis, this paper systematically reviewed the factors influencing the poor outcome of children with convulsive status epilepticus (CSE).MethodsTo longitudinal cohort studies on the prognostic evaluation of CSE mortality and mobidity in children.The retrieval time was from January 2008 to November 2019, and three system reviewers PUBMED, EMBASE, COCHRANE and other databases were used to search for literatures related carried out literature extraction and quality evaluation. According to the QUIPS analysis method, the included literatures were scored, the quality grade was divided, and the analysis variables of medium/high quality literatures with statistical significance were selected to draw a conclusion.ResultsQUIPS analysis was used to assess the literature quality, 17 medium/high quality literatures were included, and the factors with statistical significance (P<0.05) mentioned at least twice or more in≥2 medium/high quality literatures were selected, which were considered as important risk factors affecting prognosis.These factors include: etiology, age, duration of convulsion, refractory CSE, neuroimaging abnormalities.ConclusionFive risk factors indicating poor outcome of CSE in children were summarized. Due to the heterogeneity of various literature studies, Meta-analysis has not been completed, so it has certain limitations.

    Release date:2021-04-25 09:50 Export PDF Favorites Scan
  • A Meta-analysis of effectiveness and safety of steroids combined with antiepileptic drugs in the treatment of children with epileptic electrical status during sleep

    ObjectiveTo systematically evaluate the efficacy of steroids combined with antiepileptic drugs compared with alone antiepileptic drugs in the treatment of children with epileptic electrical status during sleep to provide evidence-based medical basis for its treatment.MethodsElectronic searches were maded in PubMed, Embase database, Cochrane Library, CNKI, Wanfang and the Chinese biomedical literature database for the literature about steroids combined with antiepileptic drugs compared with alone antiepileptic drugs in the treatment, and retrieval time is from January 1990 to October 2020. Two evaluators independently screened literature, extracted data, evaluated literature quality and risk of bias and checked each other. Meta analysis was performed by stata16.0 software.ResultsA total of 679 children with ESES were included in 10 studies, including 9 randomized controlled trials and 1 retrospective cohort study. Meta analysis results showed that there were statistically significant differences in clinical improvement rate [RR=1.31, 95%CI (1.21, 1.42), P<0.01], electroencephalogram discharge improvement rate [RR=1.35, 95%CI (1.25, 1.46), P<0.01] and cognitive intelligence score [SMD=1.19, 95%CI (0.80, 1.57), P<0.01] between steroids combined with antiepileptic drugs group and alone antiepileptic drugs group after 6 months follow-up. The incidence of adverse reactions in steroids combined with antiepileptic drugs group was higher than that in alone antiepileptic drugs group, and the difference was statistically significant [RR=4.13, 95%CI (1.06, 16.13), P<0.01]. All adverse reactions improved or disappeared after drug withdrawal.ConclusionCompared with alone antiepileptic drugs, steroids combined with antiepileptic drugs group has advantages in controlling epileptic seizures, improving electroencephalogram abnormalities and improving cognitive ability, and it is relatively safe.

    Release date:2021-06-24 01:24 Export PDF Favorites Scan
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