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Objective To study the role of interictal epileptiform discharge (IED) in reducing recurrent epilepsy after withdrawal of antiepileptic drugs (AED).Methods One hundred epilepsy pa tients with no seizure for ≥2 years were divided into IED group (n=51) and IED free group (n=49) according to the classification of epilepsy seizure developed by the International Association for the Prevention of Epilepsy in 1981.The patients were further divided into elderly group (n=21) and non-elderly group (n=79) and were followed up for at least 1 year by return visit or telephone.Results No significant difference was found in the incidence of IED in the 100 epilepsy patients with different types of seizure,such as myospasm,simple partial seizure and ≥2 seizures.However,the incidence of IED was significantly higher than that of myotonia,myospasm,absence and simple partial seizure (P＜0.05).Epilepsy recurred in 37 patients (72.5％) of IED group and in 16 patients (32.7％) of IED-free group.Logistic regression analysis showed that the course of epilepsy and IED were the risk factors for recurrent epilepsy after withdrawal of AED (OR=1.165,95％CI:1.022-1.329,P=0.022;OR=2.794,95％CI:1.040-7.509,P=0.042) and the course of epilepsy was longer in elderly group than in non-elderly group (10.10±7.55 years vs 5.97±4.04 years,P=0.001).Conclusion The seizure type and course of epilepsy are the relia ble predictors of recurrent epilepsy in patients with no seizure for a long time after withdrawal of AED,and are thus of clinical significance.
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Objective To examine the effectiveness and safty of intraperitoneal injection of rapamycin on epileptogenesis in a rat model of pentylenetetrazole-induced kindling epilepsy. Method The Sprague Dawley rats at 6-8 weeks old were randomly divided into group PTZ+RAPA and group PTZ+NS. The body weight, mortality and seizures were recorded at 1, 4 and 6 weeks after treatment. Mossy fiber sprouting in the hippocampal CA3 area and DG area was examined by Tim staining. Results 1.The rats mortality was 22.9% in PTZ+RAPA and 10.4% in PTZ+NS. Weight alteration was statistically significant between PTZ+RAPA and PTZ+NS at the corresponding time points (P0.05). There was no statistical significance in the seizure scores be-tween PTZ+RAPA and PTZ+NS (P> 0.05). 4.The scores of mossy fiber sprouting in hippocampal CA3 and DG areas was higher in PTZ+NS than in PTZ+RAPA (P<0.05). Conclusion Rapamycin cannot reduce or curb epileptic seizures in young rats. It can obviously reduce the weight of the young SD rats which may be associated with its side effects.
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Objective To investigate the role of the neuropsychological tests and functional imaging in differentiation between multiple system atrophy parkinsonism-predominant (MSA-P) and multiple system atrophy predominant cerebellar ataxia (MSA-C) or idiopathic Parkinson' s disease (PD).Methods We collected three groups of patients including MSA-P (n =8),MSA-C (n =13),idiopathic PD (n =13),and control group (n =13) between December 2012 and November 2013 in General Hospital of People's Liberation Army.We then compared the scores of neuropsychological assessment and parameters obtained from diffusion tensor imaging (DTI) examination among the four groups.Results (1) MSA-P group had longer time-consuming of trail-making test((103.7 ± 25.9) s) and lower graphic symbol test scores (20.9 ±6.1) than that of the MSA-P group ((80.9 ± 29.1) s ; 28.1 ± 7.4) and PD group ((72.0 ± 19.6) s ;29.0 ± 9.4 ; all P ＜ 0.05).(2) Mean diffusivity (MD) in both putamen (8.01 ± 0.76,7.91 ± 0.74) and the left substantia nigra (8.31 ± 0.43),thalamus (8.30 ± 0.69),external capsule (8.12 ± 0.32) of MSA-P group was significantly different from that of MSA-C group (7.27 ± 0.42,7.34 ± 0.3 1,7.58 ±0.81,7.81 ±0.34,7.70 ±0.44) and PD group (7.35 ±0.43,7.45 ±0.43,7.66 ±0.45,7.72 ±0.40,7.56 ± 0.37) ; Significantly higher MD in both middle cerebellar peduncle (8.54 ± 0.74,8.28 ± 0.71),medulla oblongata (8.32 ± 0.61) was demonstrated in MSA-C group than that of MSA-P group (8.54 ±0.74,8.28 ±0.71,8.32 ±0.61),PD group (7.25 ±0.70,7.30 ±0.66,7.65 ±0.50) and control group (6.94±0.39,7.08 ±0.32,7.44 ±0.41; all P＜0.01).(3) Fractional anisotropy (FA) in the left external capsule (0.45 ± 0.35) and right thalamus (0.28 ± 0.27),occipital lobe (0.47 ± 0.87) in MSA-P group was significantly different from that in MSA-C group (0.48 ± 0.36,0.23 ± 0.24,0.49 ± 0.49 ; P ＜0.05) ; FA in the left occipital lobe (0.46 ± 0.10) in PD group was significantly different from that in MSAP group (0.56 ± 0.82 ; P ＜ 0.01).Conclusion Trail-making test,graphic symbol test and DTI can be used to differentiate MSA-P type from MSA-C type or PD.
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The early characterization of the diazepam-binding sites outside the brain led to their assignment as peripheralbenzodiazepine receptors, or PBRs, to distinguish them from the central benzodiazepine receptor.Although PBR is a widely used and accepted name in the scientific community,recent data regarding the structure and molecular function of this protein increasingly support renaming it to represent more accurately its subcellular role (or roles) and putative tissue-specific function (or functions). Translocator protein (18 ku,TSPO), is proposed as a new name, regardless of the subcellular localization of the protein. This review deals with the pharmacological, structural and molecular characterization of the PBR and its role in the neuropshcopharmacology.
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@#Objective To study the effects neuromuscular electrotherapy and kinesitherapy on brachial plexus palsy. Methods 20 patients with brachial plexus palsy accepted neuromuscular electrical stimulation on involved muscles, and were followed up for 18～58 months. Other 17 patients accepted neurolysis alone were as control. Results The function of shoulder and elbow in electric stimulation group was significantly superior to that of control (P<0.01). Conclusion Neuromuscular electrotherapy combined with kinestherapy is effective on the brachial plexus palsy.
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@#Objective To investigate and compare the special psychologic characteristics of the post-traumatic epilepsy patients and their spouses.Methods The complete clinical data of 244 patients and their spouses were retrospectively and constractively analyzed. There were two distinct groups because of the etiology: group A including 122 patients of post-traumatic epilepsy and their spouses, and group B including essential epilepsy. Symptom Checklist-90 (SCL-90), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) were used to evaluate the psychologic status of objects.Results All of the single-item score of SCL-90 were significantly higher than the China norm (P<0.01) in both groups, and the score in group A was higher than that in group B. But the characteristics of the abnormal data were diffierent in patient from in spouse. The scores of the post-traumatic patients were higher than that of the spouses in 3 items, and lower in 5 items. Specially the depression and anxiety emotion of the spouses were more obvious than the patients in group A (P<0.01).Conclusion Both the patient and spouse have the conspicuous psychosomatic disorder, and the appearance is diffierent from each other. The psychosomatic disorder of post-traumatic epilepsy patient and spouse is more conspicuous than the essential epilepsy.
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@#Objective To explore the effects of rehabilitation on radial nerve injury.Methods 20 patients with radial nerve injury were included.The involved muscles were stimulated with NMR-muscular restorer for 10～15 min per muscle combined with kinesitherapy for 20～30 min.The patients were followed up for 12～30 months.Results 15 cases with no-operation recovered to 16 marks,which means excellent,3.5～18 months after rehabilitation.3 case after nerve exploration recovered to 16 marks in 1 case and 15 marks in 2 cases.1 case after neuro-anastomosis recovered to 6 marks,which means improved,6 months after rehabilitation.1 case after radial nerve graft recovered to 4 marks,which means no-improved after 12 months follow-up.Conclusion Neuromuscular electrotherapy combined with kinesitherapy is effective on radial nerve injury.
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Objective To investigate correlations between peripheral benzodiazepine receptors(PBRs) in mitochondria and synaptosomes in the brain and platelet membrane of rats during aging and to explore the significance of the relationships.Methods Sprague-Dawley rats of both sexes were divided into 3-,12-and(24-month) groups.All animals were sacrificed by decapitation and the brains were immediately removed.Mitochondrial components from dissected cerebral cortex and synaptosomal fractions from dissected hippocampus were isolated by gradient centrifugation.The membrane of platelets from venous blood was prepared by the method of hypotonic haemolysis.The specific binding assay of the radioactive PBRs antagonist PK11195 to membrane was performed.(Results A significant) difference about PK11195 binding activity of mitochondria was observed among three groups(F=194.6,P
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@#ObjectiveTo probe the clinical features,diagnosis and treatment of idiopathic generalized myokymia.MethodsSeven patients with idiopathic generalized myokymia were analysed retrospectively.ResultsAll 7 patients showed prominent myokymia characterized by undulating and vermicular movements spreading across the muscle surface. The myokymia in gastrocnemius muscles in all cases. The myokymia also appeared in both upper extremities in 5 patients,and in faces,waist,back,abdomen and all extremities in 2 patients. Muscle rippling movement was induced and increased by exercise,and persistent during sleep. The vermicular myokymia could be observed easily in the relaxation of the muscles. Electromyography tests showed myokymic discharges in 5 patients,but normal in 2 patients. 5 patients of them were cured with carbamazepine and phenytoin sodium.ConclusionThere are typical clinical features and effective treatment in the patients with idiopathic generalized myokymia.
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Objective:To investigate the effects of monotherapy of SSRI and SSRI with psychotherapy on patients of somatoform disorders.Methods:96 patients who met the criteria of CCMD-3 for somatoform disorders were divided into three groups:group one taking Fluoxetine only;group two taking Fluoxetine and a small dose of Olanzapine;group three combining the above two medicines with Gestalt psychotherapy.Before treatment and after three months' treatment,the effects of each group were evaluated by scores of HAMD.Results:According to the effective rate within each group(53.1%、61.8% and 96.7%),there was significantly differences in three groups after three months treatment(?2=15.5,P
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Objective To analyze the clinical features and risk factors for epilepsy during the acute phase of aseptic meningitis. Methods 138 cases of aseptic meningitis with complete clinical data were retrospectively reviewed. Among them 21 had seizures, and 117 had not. All of them were inpatients in the same period after meningitis. Based on a standardized questionnaire, a database was established with Microsoft Access 2002 including 51 indexes and some subindexes. Univariate analysis and nonconditional multivariate stepwise logistic regression were carried out based on the summarization of the characters of clinical seizure. Results Fourteen cases (66.7%) manifested generalized seizures in those patients with epilepsy. Seventeen patients (80.1%) experienced epilepsy within 2 weeks after meningitis. The independent risk factors for seizures during the acute phase of aseptic meningitis were the increased contents of cerebrospinal fluid protein (OR=19.40), raised intracranial pressure (OR=8.848), and low-voltage activity in electroencephalogram (OR=5.039). Conclusions Generalized seizure is the major type of epilepsy induced by acute aseptic meningitis. Epilepsy occurred within 2 weeks in most patients with meningitis and seizures. High level of cerebrospinal fluid protein, raised intracranial pressure and low-voltage activity in electroencephalogram were the main predictive risk factors for epilepsy during the acute phase of aseptic meningitis.
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Objective To analyse the role of AEEG and MRI in diagnosis of epilepsy on its primary epileptic focus and pathologic lesions. Methods We reviewed the results of sixty epileptic patients on routine EEG, twenty-four hour active EEG(AEEG),CT scanning and MRI examinations. The relationship between epileptic discharges of AEEG and lesions of MRI was analyzed by using ? 2 test. Results AEEG showed a higher sensitivity in finding epileptic focus in 80% patients, as compared with the rate of 32% in routine EEG. The sensitivity on finding the cerebral lesion related to the epileptic focus by using MRI was 60%, as compared with the rate of 33% in CT scanning. There was a correlative relationship between the AEEG discharge foci and the lesions found by MRI( P
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Objective To observe the therapeutic the effect and safety of high dose intravenous gamma globulin (GG) treating Guillain Barre syndrome (GBS) and multiple sclerosis (MS).Methods 17 patients with GBS and 12 patients with MS were treated with IVIG in a dose of 0.2 g/kg/d for 4 consecutive days (in a dose of 0.4g/kg for the first day), and 25 patients with GBS and 41 patients with MS were treated with steroid. Their therapeutic effectiveness was compared. Results In GBS and MS group, clinical grading scale and time of appearing effect of IVIG treated groups were superior to that of steroid treated groups ( P
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Objective To assess the diagnosis value of diffusion- weighted imaging (DWI) in Creutzfeldt-Jakob disease (CJD).Methods 8 cases of sporadic CJD who underwent MRI were reported. 4 cases were definite,3 cases were probable and 1 case was possible. The sensitivity of DWI and conventional MRI were compared. Results T_1WI and T_2WI revealed no abnormal signals except nonspecific diffuse brain atrophy in 4 cases, whereas DWI detected hyperintense abnormalities in all cases. 2 cases showed linear lesions only in the cerebral cortex, and 6 cases showed lesions in both the cerebral cortex and the striatum. The lesions were symmetric in 5 cases, but were asymmetric in the other 3 cases. Although fluid-attenuated inversion recovery (FLAIR) imaging also showed cortical hyperintensity in 1 case, the high signal changes were more evident and extensive on DWI. Conclusions The hyperintense changes in the cerebral cortices and/or striata on DWI are considered characteristic of CJD. DWI is more sensitive than conventional MRI in depicting lesions of CJD and may be an essential tool for the early diagnosis of this disease.
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0.05), whereas definite etiology, partial or generalized seizure, generalized tonic-clonic seizure, epileptic syndrome, nervous system signs, EEG slow wave, EEG epileptiform discharges, imaging abnormalities and therapy after first onset had statistic difference in intermittent time between first seizure and recurrence (all P
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Objective To investigate the clinical, pathological and imaging features of sporadic Creutzfeldt-Jakob disease (CJD). Methods The clinical, pathological, electroencephalogram (EEG) and imaging data of 12 cases of CJD were analyzed retrospectively.Results (1) 7 cases of the enrolled patients were male and 5 were female. The average onset age of them was 49 years old. 3 cases were acute onset by visual loss and 9 cases were subacute onset by hypophrenia, mental and behavior disorder or cerebellar ataxia. All the cases showed dementia, myoclonus and extrapyramidal sign. (2) 9 cases showed typical triphasic wave on EEG and 1 case presented atypical triphasic wave. (3) 5 cases showed abnormal hyperintense lesions in basal ganglia on T 2-weighted images (T 2WI). 8 cases in occipital and/or frontal cortex showed the abnormal hyperintense lesions on diffusion-weighted images (DWI), and 5 of them accompanied symmetric diffuse hyperintense lesions in basal ganglia. (4) 1 case with postmortem and 6 cases with biopsy of brain showed classic pathological features of CJD.Conclusion On the base of typical clinic manifestations, EEG and DWI examinations are useful in early diagnosis of sporadic CJD.
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Objective: To examine the temperament of childhood epilepsy. Methods:Subjects were 84 children with epilepsy diagnosed by criteria of ILAE (international league of anti-epilepsy) 1981 and 168 normal children. Their temperament was assessed with Carey's temperament questionnaires (for parents).Results:Children with epilepsy had higher scores on activity level (3.4?0.6/3.1?0.7,t=5.38,P
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Objective To explore the feature of epileptiform discharges during day and night in patients with sleep epilepsy and its diagnosis value. Methods Ambulatory EEG (AEEG) was performed continuously for 24 hours in 91 patients with sleep epilepsy. The frequency of epileptiform discharges in wake phase and sleep phase were analyzed. Results Epileptiform discharges were observed in 71 patients. 4 patients showed epileptiform discharges only in wakefulness, 41 only in sleep and 26 both in wakefulness and sleep. 34 patients showed epileptiform discharges only in stage 1 and 2 of NREM sleep, and 33 patients displayed epileptiform discharges in whole cycle of sleep. Seizure frequency in the patients with epileptiform discharges in wakefulness was higher than those without epileptiform discharges or with epileptiform discharges in sleep (both P
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Objective To explore the pathogenic course,clinical features and prognosis on hallervorden spatz disease(HSD).Methods To review and sum up clinical data of three patients of 1985 with HSD in one family,and followed up survey in 2001.Results The same parents had three(2 males,1 female) of six children who were suffered from HSD.Clinical features include bilateral pigmentary degeneration of the retina,optic atrophy and progressive dementia,and lay in bed after several years with convulsive seizure,opisthotonus,limb rigidity,hyperreflexia, pyramidal sign positive;they were suited therapy to the illness.2 cases for death,another case for progressive deterioration,the patient lost labour ability and couldn't take care of himself.Conclusion HSD is kindred hereditary disorder,major cases occur the symptoms before 20 years old (progressive deterioration).After attacking about 20 years the patients died.The HSD gene located on chromosome 20p12.3 p13.
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300mmH2O), non-purulent CSF with pleocytosis up to 2700?106/L, increased polykaryocytes in the early stage, normal or obviously high total protein level, normal glucose and chloride level, and negative laboratory examinations (such as culture-and smear-examination of Mycobacterium tuberculosis, adenosine deaminase, anti-TB antibody, immuno-dot-blot assay MycoDot and PPD assay). In this series of 167 patients, 7 of them died (3.7%). Conclusions The findings in CSF examination in most patients with tuberculous meningitis may show atypical findings, therefore it should be emphasized to repeat the analysis of CSF in order to obtain an accurate diagnosis of tuberculous meningitis.