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AIM: To compare the early response to the new and traditional antiepileptic drugs (AEDs) in the treatment of partial epilepsy. METHODS: Patients from neurology Department of Huzhou Central Hospital between January 2013 and June 2018 were included; outcomes included time to first seizure, time to treatment failure and 6-month, 1- and 2-year seizure-free rates were compared. RESULTS: A total of 250 patients with partial epilepsy were divided into carbamazepine (CBZ) group (n =62), levetiracetam (LEV) group (n = 67), oxcarbazepine (OXC) group (n = 63), and lamotrigine (LTG) group (n = 58). In terms of time to first seizure after monotherapy, CBZ and OXC were equivalent (P = 0.635), while CBZ was superi- or to LTG (P LTG > OXC > LEV, and CBZ was superior to OXC and LEV (all P 0.05). A total of 25 patients had adverse reactions; with CBZ (19.3%) more often than LTG (8.6%), OXC (7.9%), or LEV (4.5%). CONCLUSION: Treatment response to CBZ is superior compared to that of OXC and LEV, especially in the early stages of treatment, and equivalent to that of LTG, but the incidence of side effects is higher as well.
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Objective To investigate the effect of pramipexole in the treatment of Parkinson after stroke .Methods 94 cases with Parkinson after stroke in our hospital from June 2013 to November 2015 were randomly selected and divided into two groups,47 cases respectively.Control group received routine etiological and symptomatic treatment, the study group received conventional therapy and symptomatic treatment and pramipexole treatment,two groups were treated for eight weeks.Parkinson’s disease scores,inflammatory cytokines and oxidative stress index,and the clinical effect and complications of contrast were compared after the treatment.Results Compared with before treatment,scores of daily activities of emotion integral integral,the motor function in two groups decreased,levels of serum IL-1β,IL-6,TNF-αand Hs-CRP decreased,levels of CAT,T-SOD,T-GSH in plasma increased (P<0.05),and compared with the control group,scores of daily activities of emotion integral integral,the motor function in the study group were lower,levels of serum IL-1β,IL-6,TNF-αand Hs-CRP were lower,levels of CAT,T-SOD,T-GSH in plasma were higher (P<0.05),and the total effective rate in the study group 91.49% was higher than the control group 74.47% (P<0.05).Conclusion Pramipexole in the treatment of Parkinson after stroke was effective with high safety,and it can reduce Inflammatory factors and increase oxidative stress.
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To retrospectively analyze the clinical data of 176 patients of recurrent cerebral infarction at our hospital.Based upon the treatment of acute stroke trial (TOAST) classification,the types of recurrent ischemic stroke with initial brainstem infarction were classified.And univariate and multivariate logistic analyses of risk factors were performed.The major types in a decreasing order were atherosclerotic cerebral infarction (AT,n =24,70.6％),small arterial occlusive stroke (SA,n =8,23.5％) and cardiogenic cerebral embolism (CE,n =2,5.9％).Brainstem infarction was more likely to be affected by poor life habits and a history of diabetes mellitus (DM).And atrial fibrillation was a major independent risk factor for non-brainstem infarction.Multivariate logistic analysis showed that poor living habits (P =0.03),a history of DM (P =0.004),vulnerable plaque (P =0.01) and poor compliance of secondary prevention medication (P =0.02) were independent risk factors for recurrent ischemic stroke with initial brainstem infarction.Health education should be strengthened for preventing recurrent ischemic stroke with brainstem infarction.
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Objective To explore the influence of different treatment time on the relapse and prognosis of patients with newly diagnosed epilepsy. Methods To prospectively studied the clinical characteristics of 155 patients with newly diagnosed epilepsy. Patients were separated into immediate ( n =84, seizures ≤3 times) or deferred (n =71, seizures ＞ 3 times) treatment groups according to number of seizures before treatment with appropriate antiepileptic drugs (AEDs). The patients were followed up for at least one year (median, 29 months). Kaplan-Meier survival statistics was used to analyze time to first seizure or time to treatment failure (inadequate seizure control and (or) intolerable side-effects ). The proportions of patients with treatment failure and seizure free during follow up were also compared. Results There was no significant difference in time to first seizure or time to treatment failure between immediate ( 1484 days and 2992 days) and deferred treatment ( 1104 days and 1964 days; Log-Rank test x2 =0. 571 and 0. 018 respectively, P = 0. 450 and 0. 893 ). Subgroup analyses according to etiology ( primary and cryptogenic/symptomatic epilepsy) and age (children ≤ 16 years; adult ＞ 16 years) did not reveal any difference between immediate and deferred treatment. During follow up, there were 20 treatment failure patients ( 23. 8% ) in immediate treatment group and 16 ( 22.5% ) in deferred treatment group ( no statistical difference, x2 =0. 035 ,P =0. 852). There were 40 seizure free patients (47. 6% ) in immediate treatment group and 30 (42. 3% ) in deferred treatment group ( no statistical difference, x2 = 0. 447, P =0. 504 ). Conclusions For newly diagnosed epilepsy patients with a few seizures ( seizures ≤ 3 ), immediate AEDs treatment does not affect the relapse and prognosis.