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find Author "雒晨宇" 4 results
  • 癫痫与睡眠障碍相关机制研究进展

    睡眠在癫痫疾病管理中具有非常重要的作用,睡眠的昼夜节律可以影响癫痫的发作频率及发作时间。睡眠质量下降是癫痫发作的常见诱因,提高睡眠效率和控制癫痫发作对所有癫痫患者的生活质量都有显著积极影响。癫痫发作过程机制复杂,目前研究表明癫痫发作时细胞兴奋性及一系列的神经递质、激素、离子通道发生变化,这些变化可能会作用于睡眠-觉醒周期,引发睡眠结构及昼夜节律发生变化。而这些关联可能为针对癫痫控制及癫痫患者睡眠障碍和昼夜节律紊乱提供新的治疗途径,从而达到既能良好的控制癫痫发作,又能改善患者的睡眠,从而改善患者生活质量。

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  • Clinical efficacy and safety study of agomelatine combined with eszopiclone in the treatment of epilepsy complicated by insomnia

    Objective To investigate the clinical effect and safety study of agomelatine combined with eszopiclone in the treatment of epilepsy complicated by insomnia. Methods 69 epilepsy complicated by insomnia patients were collected in the outpatient of the Department of Neurology, the First Affiliated Hospital of Shanxi Medical University from December 2021 to October 2022. Patients were randomly divided into control group (34 cases) and observation group (35 cases) Patients in control group were given eszopiclone, 1.5 ~ 3 mg (3 ~ 5 times/week). Patients in observation group were given agomelatine 25 mg (1 time/day) and eszopiclone 1.5 ~ 3 mg (3 ~ 5 times/week). Patients in both groups maintained their original anti-seizure medications treatment regimen for 12 weeks during the study. Pittsburgh sleep quality index (PSQI), Insomnia severity scale (ISI), Patient health questionnaire-9 (PHQ-9) and Generalized anxiety disorder-7 (GAD-7) were used to compare differences in subjective sleep quality, insomnia severity, depression and anxiety symptoms before treatment and at the end of 4 and 12 weeks of treatment. The change of seizure frequency before and after treatment was statistically evaluated to assess epilepsy control. The adverse effects after medication were recorded in both groups. Results After 4 weeks and 12 weeks of treatment, the scores of PSQI, ISI, PHQ-9 and GAD-7 of both groups were significantly lower than those before treatment, and the scores of PSQI, ISI, PHQ-9 and GAD-7 in the combined group at the 4th week and 12 weeks after treatment were significantly lower than those in the single-drug group (P<0.05). The incidence of adverse reactions was 13.33% in the single-agent group and 15.63% in the combined group. Conclusions Agomelatine combined with eszopiclone improve subjective sleep quality, insomnia severity, depression and anxiety symptoms of patients more significantly.

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  • Advances in medium-chain triglyceride ketogenic diet for refractory epilepsy

    Ketogenic diet (KD) is one of the effective treatments for refractory epilepsy (RE) and is recommended when anti-seizure medications (ASMs) are ineffective or less effective, inoperable or ineffective. The efficacy of the medium-chain triglyceride (MCT) ketogenic diet is as good as the classical KD (CKD), which has been demonstrated in several retrospective, prospective, and randomized studies, and MCT is more ketogenic than long-chain triglycerides, so MCTD allows more carbohydrate and protein foods, which makes MCTD more palatable than CKD more palatable. Research advances in the mechanisms and clinical efficacy associated with MCTD in the treatment of refractory epilepsy are reviewed.

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  • Effect of pregabalin monotherapy on sleep structure and quality of patients with focal epilepsy

    Objective To investigate the effect of anti-seizure medications (ASMs) pregabalin (PGB) monotherapy on sleep structure and quality of patients with focal epilepsy. MethodsAdult patients whom newly diagnosed focal epilepsy were collected and treated with PGB monotherapy. The main outcome measures were the changes of polysomnography and video-electroencephalography (PSG-VEEG), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) in epilepsy patients with PGB and baseline. Results PGB improved significantly sleep structural parameters, including increased total sleep time (P<0.001), decreased sleep latency (P<0.001), improved sleep efficiency (P<0.001), reduced wake time after sleep onset (P<0.001), increased sleep maintenance efficiency (P<0.001) and proportion of N3 sleep stage (P<0.001). In the group with poor sleep efficiency, 86.7% of patients achieved sleep efficiency>85% after PGB treatment. The difference was statistically significant (P<0.01). PGB reduced significantly PSQI score (P<0.001) and ISI score (P<0.001). No significant change in ESS score was observed (P>0.05). ConclusionsPGB could enhance slow-wave sleep (SWS), increase sleep quality and improve insomnia in patients with epilepsy without causing daytime sleepiness.

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