Clinical and electrophysiological features of patients with coexistence of epilepsy and narcolepsy / 中华神经科杂志

Objective:To describe the electroclinical features of the coexistence of epilepsy and narcolepsy.Methods:The electroencephalography database was searched using the terms “epilepsy” and “narcolepsy” over a four-year period from January 2016 to December 2019 in the Xijing Hospital. The clinical and electrophysiological characteristics of patients with coexistence of epilepsy and narcolepsy were studied.Results:Five patients with comorbidity for epilepsy and narcolepsy were found, of which three patients were female, two patients were male. The age at epilepsy onset and narcolepsy onset was 2-12 years and 8-17 years, respectively. There were two patients with juvenile myoclonic epilepsy, one with sleep-related hypermoter epilepsy, one with epilepsy with retardation of brain development, one with symptomatic epilepsy with cognitive decline. All the patients had narcolepsy with cataplexy, which followed the onset of epilepsy by three months to eight years. All the patients accepted 24 h video electroencephalography monitoring and multiple sleep latency test. Interictal epileptic discharges were found, mean sleep latency was<8 min, and two or more sleep onset rapid eye movement periods were recorded. Duloxetine hydrochloride can effectively improve the drowsiness and catalepsy symptoms of narcolepsy, and seizures did not worsen in patients using duloxetine hydrochloride.Conclusions:Both generalized and focal epilepsy can occur in narcolepsy with cataplexy. Duloxetine hydrochloride may be safe and effective in treating narcolepsy in patients with epilepsy.

Seizure clusters / 中华神经科杂志

Seizure cluster (SC) is a common clinical phenomenon in patients with epilepsy, which was reported to be associated with post-ictal psychosis, status epilepticus, and increased risk of death, with a negative impact on the quality of life of patients and caregivers, but the diagnostic criteria, management principles and pathogenesis of SC are still unclear."seizure cluster" "acute repitetive seizures" and "cluster seizures" were used to search the relevant literatures in the databases of "Pubmed" "Wanfang Medicine" and "China Knowledge Network" from 1990 to 2019. The definitions, prevalence, risk factors, consequences, possible mechanism, and current management methods of seizure clusters were summaried in this article, to help health care professionals and patients gain a clearer understanding of SC.

Research on the electro-clinical aspects of epilepsy patients with breach rhythm / 中华神经科杂志

Objective:To investigate the clinical characteristics and electroencephalogram (EEG) of epilepsy patients with breach rhythm, improve clinical understanding of breach rhythm and avoid over-interpretation.Methods:Twelve epilepsy patients with breach rhythm who visited the Department of Neurology, Xijing Hospital, the Air Force Military Medical University from January 2016 to January 2017 were collected retrospectively. The clinical data, including etiology, clinical manifestations, EEG features and prognosis were summarized, and outpatient and telephone follow-up was performed for at least three years.Results:The clinical data of 12 patients with epilepsy with breach rhythm were collected, including eight males and four females, aged 36-78 years. After analysis, it was found that brain trauma was the most common cause of breach rhythm. Among them, two cases of skull defect were not repaired, eight cases were repaired with skull titanium mesh, one case was repaired with skull polymethylmethacrylate, and one case was repaired with skull polyetheretherketone. The distribution of the breach rhythm in 12 patients was consistent with the abnormal area of the skull. The breach rhythm can be expressed as high amplitude and fast frequency, or low amplitude and slow frequency and appear individually (similar to sharp waves, spikes). On the basis of pleomorphic slow waves, 10 patients were mixed with sharp waves and spike waves, and imaging confirmed that they had brain damage in corresponding parts. All of the 12 patients had a history of seizures, with tonic-clonic seizures and (or) focal seizures being the most common. Three patients with breach rhythm had no clinical seizures for more than five years, and had been taking antiepileptic drugs for epileptic spikes on EEG, and they were given reduction and discontinuation of the drugs and were seizure-free for three years during follow up.Conclusions:Skull repair is a common cause of breach rhythm, and repair materials with different resistances cause different waveforms and frequencies. Breach rhythm, epileptiform discharge and other pathological slow-wave activities can exist at the same time. Breach rhythm is a benign variant phenomenon which needs no special treatment.

Clinical and electrophysiological study of propriospinal myoclonus / 中华神经科杂志

Objective:To discuss the clinical and electrophysiological characteristics of propriospinal myoclonus (PSM).Methods:The clinical and electrophysiological characteristics of four patients diagnosed as PSM in the Electroencephalography Monitoring Center, Department of Neurology, Xijing Hospital, the Air Force Military Medical University from April 2018 to July 2019 were studied. All patients were accorded with diagnostic criteria of PSM that international classification of sleep disorders-3 edition recommended and were followed up.Results:There were three males and one female in the four patients. The age of onset was ranged from 43 to 55 years. The course was from eight months to three years, and the follow-up time was from three months to one year. The clinical features of the four patients were characteristically paroxysmal tic or shaking of the neck, trunk or limbs, with short duration and great frequency. All patients accepted 24-hour video electroencephalography monitoring. No epileptic discharge was recorded during the monitoring. The burst activity of deltoid, quadriceps or rectus abdominis muscle was monitored by surface electromyography at the onset of myoclonus. All patients were treated with clonazepam. Three patients had an obvious curative effect and one patient had no effect.Conclusions:The clinical manifestation of PSM is similar to seizures. There is no epileptic discharge, and only the burst activity of muscles is monitored at the onset. Most patients have significant effect on clonazepam.

Recognition of the breach rhythm / 中华神经科杂志

Breach rhythm was firstly described in 1979, and is considered as a rare benign variant of electroencephalogram. The etiology, electroencephalogram features and evaluation of breach rhythm, and so on, are discussed in this article.

Analysis of electroencephalography and synchronous electrocardiography changes in non-epileptic seizures / 中华神经科杂志

Objective To investigate the clinical features, the video electroencephalography ( V-EEG) and synchronous electrocardiography ( ECG) changes in non-epileptic seizures and the significance of ECG monitoring in the diagnosis of epilepsy.Methods We collected 3 patients who came in a chief complaint of“episodes of unconsciousness with limbs twitch”, whose clinical features and EEG, ECG in longterm VEEG monitoring were analyzed.The 3 patients were followed up for at least 6 months.Results The 3 patients were all diagnosed as epilepsy in other hospital,and during the 24-hour VEEG monitoring in our hospital,2 patients showed abnormal cardiac rate and arrest during the attack and corresponding EEG changes after cerebral ischemia and hypoxia.After consultation with the department of cardiology, they were diagnosed as cardiac syncope episode and no attack showed up after the placement of pacemaker.The Q-T interval was prolonged in the other patient during the longterm ECG monitoring, after the coherence check who was diagonsed as severe hypocalcemia combined with myocardial damage due to a lower parathyroid function and had no attack after symptomatic treatment.Conclusions The synchronous ECG monitoring during the attack is of great significance in the differential diagnosis of epileptic and non-epileptic seizures. The ECG changes in patients with longterm VEEG monitoring should be focused on.It is necessary to add the early warning function to prevent the occurrence of accidents.

Progress on preparation methods of animal model of deep venous thrombosis / 中国骨伤

Deep venous thrombosis is a common and serious complication after orthopedics operation, with the characteristics of high incidence rate and death rate, its formation mechanism and the treatment is becoming more and more attention of scholars. Establishment of animal model of deep venous thrombosis can further explore the pathological process of thrombosis or dissolution, is an important means to research of thrombosis mechanism and evaluation of therapeutic method. This review discussed the basic principle of deep venous thrombosis, the selection of experimental animals and making method of animal models.