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Epilepsy is one of the most common neurological diseases, affecting about 70 million people worldwide, more than half of whom are children.Even though seizure-free is largely achieved by anti-seizure medications, there are still one-third of patients with epilepsy who continue to experience seizure attacks and develop into refractory epilepsy(RE). RE can seriously impair the life-quality of children and their families, and impose a substantial burden on society.Therefore, it is of great significance to explore and discover novel therapeutic methods and strategies for RE in children.This review is aimed to introduce several current and emerging therapeutic approaches for RE, including some new anti-seizure medications, ketogenic diet, neurosurgery, neurostimulation and emerging precision medicine, and provide new treatment strategy to children with RE.
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Objective To observe the effect of complement 5a receptor(C5aR)antagonist(PMX53)and palmitic acid(PA)on the inflammatory reaction of microglia,and to investigate the roles and mechanisms of com-plement C5a-C5aR in PA induced microglia inflammation.Methods Microglia from one day old mice was collect-ed,purified and identified by primary culture and immunohistochemical staining,and then was randomly divided into three groups including PA group,PA+PMX53 group and control group.The expressions of tumor necrosis factor-α(TNF-α),Iba-1 and ERK1/2 were determined by ELISA,Western blot and QT-PCR.Results In PA group, the levels of Iba-1 and TNF-α were higher significantly than the control group(P<0.001).Similarly,the levels of ERK1/2 mRNA(P = 0.005 6)and p-ERK1/2 protein(P < 0.001)in the PA group were higher significantly than that in control group in spite of no difference in ERK1/2 protein in all groups. However,the levels of Iba-1,p-ERK1/2 protein,ERK1/2 mRNA and TNF-α in the PA+PMX53 group were significantly lower than that in the PA group(P<0.001),although there was no difference in ERK1/2 protein in all groups.Conclusions C5a receptor antagonist suppresses inflammatory reaction of microglia induced byPA,suggesting that C5a-C5aR-ERK may par-ticipate in the inflammation of microglia induced byPA. Therefore,C5a receptor antagonist may protect the brain tissues from inflammation-induced damage.
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Syncope is a common pediatric emergency event,which can be caused by various metabolic disorders different from other illness. The major metabolic anomalies include hypoglycemia, hyperventilation,electrolytes imbalance,hypoxemia and others, in which hypoglycemia is caused by hyperinsulinemia,pituitary and adrenal disease, diabetes, ketotic hypoglycemia, inherited metabolic disorders of sugar, organic acids and amino-acids,etc. This article introduced the common metabolic anomalies and their causes,diagnosis and therapy.
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The neonatal burst suppression is a severe EEG pattern and always demonstrates serious damage of nerve system. But the outcome of these patients depends on the different etiology. A total of 256 cases of video EEG recordings were analyzed in order to summarize the etiology and outcome of burst suppression. The results showed that some patients in all 17 cases of burst suppression showed EEG improvement. The etiology was the dominant factor in long term outcome. It was suggested that effective video EEG monitoring is helpful for etiologic study and prognosis evaluation.
Assuntos
Eletroencefalografia/métodos , Hipóxia-Isquemia Encefálica/diagnóstico , Monitorização Fisiológica/métodos , Neonatologia/métodos , Gravação em VídeoRESUMO
The neonatal burst suppression is a severe EEG pattern and always demonstrates serious damage of nerve system. But the outcome of these patients depends on the different etiology. A total of 256 cases of video EEG recordings were analyzed in order to summarize the etiology and outcome of burst suppression. The results showed that some patients in all 17 cases of burst suppression showed EEG improvement. The etiology was the dominant factor in long term outcome. It was sug-gested that effective video EEG monitoring is helpful for etiologic study and prognosis evaluation.