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find Author "黄露露" 2 results
  • 婴儿期癫痫性痉挛的检查诊断干预原则及预后

    癫痫为神经科常见疾病, 而婴儿期为癫痫发作的高峰年龄。婴儿期癫痫中痉挛发作最为常见, 且病因复杂多样。随着遗传学研究的深入, 很多以往未明确病因的婴儿期癫痫性痉挛可能为遗传因素所致, 且可能为皮层起源, 不同的遗传背景提示不同的治疗方案和预后。结合《2015年国际抗癫痫联盟关于婴儿期癫痫管理推荐共识——ILAE儿科委员会协作组报告》及我国的实际情况, 通过回顾文献提出婴儿期癫痫性痉挛的检查诊断、干预原则及预后, 希望对临床医生的工作提供帮助, 从而提高婴儿期癫痫的诊治水平, 更好地改善预后。促肾上腺皮质激素(Adreno cortico tropic hormone, ACTH)大剂量与小剂量应用均有比较良好的治疗效果。ACTH治疗后短时间内的发作控制对于患儿的精神运动发育有利。结节性硬化症患儿的癫痫性痉挛, 氨己烯酸表现出较好的治疗效果。托吡酯对于癫痫控制有一定的效果, 而其他抗癫痫药物、生酮饮食、手术治疗的效果仍不明确。对于代谢性病因所致的癫痫性痉挛, 明确病因非常重要; 结合具体病因采取相应治疗方案即可。不同因素所致婴儿期癫痫性痉挛提示不同的治疗方案。早期全面的筛查明确病因对于指导治疗具有非常重要的意义。在药物选择上, 临床医生一方面应考虑到病因的个体化差异; 另一方面应关注治疗的及时有效性, 从而保证患儿发作的控制及精神运动的发育

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  • Vigabatrin for seizures treatment in patients with tuberous sclerosis complex: an efficacy and safety study

    ObjectiveTo evaluate the efficacy, tolerability and safety of vigabatrin (VGB) for seizure treatment in patients with tuberous sclerosis complex (TSC). MethodsForty-one epilepsy patients with tuberous sclerosis complex, admitted from January 2015 to December 2015, were included in our study; they were treated with VGB with an initial dose of 20 mg/(kg·d), and a maintenance dose of 50~ 100 mg/(kg·d). Baseline seizure frequency were evaluated by the parents or the guardian, and investigated the efficacy, tolerability, adverse reactions and safety in 3 and 6 months after treatment, and compared with the baseline. The treatment outcomes were evaluated by seizure frequency as completely seizure free (100% seizure reduction), markedly effective (75%~99% seizure reduction), effective (50%~74% seizure reduction) and invalid ( < 50% seizure reduction). Adverse reactions were observed during treatment. ResultsThe completely seizure free rates after 3 and 6 months treatment were 51.2% and 57.9%; and the total effective rates (completely seizure free+markedly effective+effective) were 90.2% and 89.5%.During the 6 months, only one patients stopped VGB use because of the poor efficacy and the difficulties to buy this medicine. 14 patients appeared adverse reactions, including drowsiness, agitation, hyperactivity and myoclonus, which were transient and mild. No patients had clinically perceivable visual-field changes on clinical examination. ConclusionVGB is a effective treatment in TSC patients with epilepsy, and have a good security in short term.

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