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Objective:To investigate the clinical and electrophysiological characteristics of tremor in patients with epilepsy, and explore the related factors affecting the occurrence of tremor.Methods:A cross-sectional survey was conducted to collect 80 patients with epilepsy in the Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2018 to September 2019. Patients were divided into tremor group and non-tremor group according to clinical evaluation. All patients with epilepsy were evaluated by the Clinical Rating Scale for Tremor and were examined by electromyography (EMG).Results:There were 22 (27.5%, 22/80) patients who were found with tremor by self-reported complaint and (or) physical examination by clinicians, mainly manifested as postural tremor in the upper limbs, and 7.5% (6/80) patients also showed resting tremor. The EMG examination revealed that 51 patients (63.8%, 51/80) had tremor in the upper limbs. The incidence was 2.3 times as much as clinical evaluation. Among them, 42 patients (82.3%, 42/51) manifested postural tremor in upper limbs, 32 patients (62.7%, 32/51) manifested resting tremor. The peak frequency of postural tremor was (7.2±4.1) Hz, and synchronous burst pattern was mainly showed. The peak frequency of resting tremor was (5.3±2.2) Hz, and alternating burst pattern was mainly showed. Multivariate analysis showed that large number of medications and long duration of taking valproate acid were significantly related to the occurrence of tremor in patients with epilepsy.Conclusions:Tremor is mainly manifested as postural tremor in the upper limbs in patients with epilepsy. The EMG is a more sensitive and objective examination, which can detect tremor that was not yet noticed. Large number of medications and long duration of taking valproate acid might be the mainly associated factors for occurrence of tremor in patients with epilepsy.
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Objective To observe the change of expression of inwardly rectifying K+(Kir)2.3 mRNA and protein of Kir in the hippocampus of rats with chronic temporal lobe epilepsy(TLE)in different time points and the effect of Tenidap a Kir2.3 channel opener on its expression,investigate the relationship between Kir2.3 and the pathogenesis of TLE and to explore the potential of Kir agonists as anti-epileptic drugs.Methods The pilocarpine TLE rat model was used.Animals were randomly assigned to the control or the status epilepticus(SE)groups,which were further divided into four time point subgroups consisting of 0.6,72 hours,and 2 weeks post-SE termination.Another subgroup was given Tenidap,a Kir2.3 channel opener,and tested 2 weeks post-SE.Hippoeampi were removed and the expression of Kir2.3 mRNA and protein at different time points was measured by reverse transcription polymerase chain reaction(RT-PCR)and western blotting.Results The ratios of Kir2.3 mRNA and β-actin in normal control and 0,6,72hours and 2 weeks after SE termination were 0.080±0.030,0.103±0.045,0.164±0.026,0.132±0.024.0.011±0.008,respectively(F=23.684,P<0.01).The ratios of Kir2.3 protein and GAPDH in propotional groups were0.305±0.030,0.263±0.028,0.767±0.167,0.498±0.077,0.176±0.026(F=44.183.P<0.05).The expression of Kir2.3 channel in the epileptic rats was bimodal,increasing immediately after SE,relative to controls,and declining in the chronically epileptic period.Tenidap administration upregulated both the mRNA(0.021±0.006)and protein expression(0.636±0.140) of Kir2.3(F=25.216 and 47.355,P<0.05 and 0.01).Condusion These findings suggest that the pathogenesis of TLE is accompanied by a decrease in Kit2.3 expression,which may be ameliorated by the administration of tenidap.
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Objective To explore the application of CT value in calculating the proton incident energy in proton treatment planning system. Methods Bethe-Block formula and the formula for calculating the proton range were analyzed to study the correlation of the range of proton beam ( 70-250 MeV ) between a variety of radiation equivalent material and water. Procedure of Monte Carlo SRIM2008 was used to verify the possibility of a constant proportional coefficient of range ( Ci ). The proportional coefficient ( Ci ) of range in radiation-equivalent material and the CT value were fitted by using Origin 8.0 software to study the functional relation of CT value and Ci. The actual range of proton was equivalent to a range of water and incident proton energy could be calculated. Results There was a constant range of Ci of proton beam (70-250 MeV) between a variety of radiation equivalent material and water. There was a functional relation between CT value and Ci ( r = 0.999). The actual range of proton in radiation equivalent material can be equivalent to a range of the water. Conclusions CT values and a range of proportional coefficient ( Ci ),and the actual required range of the tumor could be used to accurately calculate the water equivalent range,and the incident proton energy to the position of Bragg peak. A new exploration for using CT technology in proton treatment planning system could be obtained.