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find Author "王薇薇" 17 results
  • 强制正常化(Forced normalization)—一种特殊的发作,脑电图和精神病的相关性

    癫痫发作和精神症状之间有拮抗现象,即发作消失及脑电图明显改善后出现精神症状,1953 年 Landolt 称之为强制正常化(Forced normalization)。至今报道尚不多。机制仍待研究。可能诱因为抗癫痫药物或癫痫外科治疗,尤其是颞叶切除。应用抗精神病药物后大多数精神症状消失,如不积极治疗可能成为持续性精神症状。因此值得重视。

    Release date:2021-10-25 01:58 Export PDF Favorites Scan
  • Brain network theory, the significance and practice in clinical epileptology

    Currently, about one-third of patients with anti-epilepsy drug or resective surgery continue to have sezure, the mechanism remin unknown. Up to date, the main target for presurgical evaluation is to determene the EZ and SOZ. Since the early nineties of the last century network theory was introduct into neurology, provide new insights into understanding the onset, propagation and termination. Focal seizure can impact the function of whole brain, but the abnormal pattern is differet to generalized seizure. Brain network is a conception of mathematics. According to the epilepsy, network node and hub are related to the treatment. Graphy theory and connectivity are main algorithms. Understanding the mechanism of epilepsy deeply, since study the theory of epilepsy network, can improve the planning of surgery, resection epileptogenesis zone, seizure onset zone and abnormal node of hub simultaneously, increase the effect of resectiv surgery and predict the surgery outcome. Eventually, develop new drugs for correct the abnormal network and increase the effect. Nowadays, there are many algorithms for the brain network. Cooperative study by the clinicans and biophysicists instituted standard and extensively applied algorithms is the precondition of widely used clinically.

    Release date:2024-01-02 04:10 Export PDF Favorites Scan
  • 顶叶外侧癫痫—解剖、生理与临床

    顶叶为联合皮质与其他脑叶有广泛的联系。顶叶癫痫少见仅为全部癫痫的1.4%。因其无特殊性症状且迅速扩布至其他脑叶,所以发作症状复杂,临床诊断困难。具有躯体感觉、体象障碍、前庭感觉这三种先兆,发作源于顶叶的可能性非常大。发作性症状多类似额叶或颞叶发作。头皮脑电图定位意义不大,因此多需要颅内电极监测以及影像学[如磁共振成像(Magnetic resonance imaging, MRI),发作时单光子发射计算机断层成像术(Single-photon emission computed tomography,SPECT)]检测。顶叶癫痫几乎均为药物难治性发作,定位明确的外科治疗60%~80%预后良好。

    Release date:2023-03-13 02:15 Export PDF Favorites Scan
  • Timing and statregy of surgery intervention for drug resistant epilepsy

    Drug-resistant epilepsy (DRE) not only have disruption of the patients by seizure, but also influence the quality of life, cognitive function and social association, as well as development delay even retrogression for children. Epilepsy surgery is the only curative treatment currently available for focal lesional pharmacoresistant epilepsy, five years complete seizure freedom rates was around 60% after surgery. The criterion of surgical intervention at present is achievement for the diagnosis of DRE, thereafter consideration of early epilepsy surgery, but these maybe a long-term duration. Recent advance in examine methods and surgical techniques have improved the surgical treatment of epilepsy, to such patient with focal lesional structure abnormality, before the DRE emergence, under the discussion of the multidisciplinary team. Children under 3 years old, the brain have greater neural plasticity, early surgical treatment is expected at allow the healthy brain to recover and develop the language function and quality of life. Numerous cause may pose abstracts to the delay of surgical intervention: (1) diagnosis delay; (2) patient himself and their familiar recognize that there have same risk of surgical treatment; (3) the primary doctor firmly believe that epilepsy surgery is the ultimate methods; (4) special problems of the patient, such including: age, comorbidity, and the location of symptom, EEG as well as imaging non-conformation.

    Release date:2025-03-19 01:37 Export PDF Favorites Scan
  • 癫痫发作的报警与预警

    癫痫是一种最常见的神经系统疾病,特点为多数发作无诱因且难以预测。发作可导致合并症,包括外伤及癫痫猝死(Sudden unexpected death in epilepsy,SUDEP),并致生活质量下降。过去20年广泛研究了发作的预警和报警,开发很多方法及设备,如头皮脑电图、颅内脑电图、肌电图、皮肤电变化、心率和心率变异性(Heart rate variability,HRV)。其中HRV是最有前景的方法。发作发放通过网络导致交感神经和副交感神经间不平衡并且改变了自主神经发放合并心率异常。过去20年用计算机方法开发了HRV的谱分析。HRV的变化早于脑电图发作和临床发作的开始。HRV可能是癫痫发作的预警和报警的指标。现在虽有很多关于癫痫的HRV算法,但是缺少标准的对于癫痫患者的方案,并且没有固定的监测模式,使之难以转化为临床实用,解决这个问题是十分重要的。总结出一个HRV评估的最低方案可用于所有癫痫患者的研究十分必要,可使HRV成为预警癫痫发作的有用工具。

    Release date:2022-09-06 03:50 Export PDF Favorites Scan
  • 轻度皮质发育畸形伴少突胶质细胞增生及癫痫(MOGHE)—一个新的临床组织病理学实体

    2002年Burger等首先报道癫痫患者的大脑标本中有少突胶质细胞增生。2013年Coras等认为是一个新的临床病理学实体称之增殖性少突胶质细胞伴癫痫(Proliferative oligodendroglial hyperlasia in epilepsy,POGHE)。2017年Schurr等详细研究其病理学后确认为轻度皮质发育畸形伴少突胶质细胞增生及癫痫(Mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy,MOGHE)。迄今国外文献报道92例,国内尚无报道及介绍,本文对92例进行分析并复习文献。均为儿童药物难治性部分发作,发作年龄≤15岁者96.4%,≤10岁者83.1%。临床表现多种多样。电临床多定位于额叶(81.5%),少数在颞顶或颞枕区。磁共振成像异常类似于局灶性皮质发育不良(Focal cortical dysplasia,FCD),尤其是FCDⅡa。均为药物难治性癫痫,并做外科切除性治疗。组织病理学均有不同于FCD的特点,即灰白质交界处有簇状或层状少突胶质细胞增生及异位神经元。但皮质分层无异常。

    Release date:2022-04-28 09:14 Export PDF Favorites Scan
  • 癫痫的抑郁共患病

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  • 眶额区癫痫--有待深入研究的癫痫类型

    眶额区位于双侧额叶下方前颅凹中, 嗅束将直回与其他脑回分开。眶额区本身在各脑回间, 以及与额叶凸面及内侧面, 颞叶有广泛的联系。眶额区起源的癫痫少见。发作开始均先出现动作停止、无反应及茫然, 而后根据扩布的不同出现:嗅觉异常、过度运动、头眼偏向同侧或对侧、重复动作等运动症状、自主神经症状, 还可以有难以确定的感觉异常、发笑、似曾相识、视幻觉、自动症。根据临床症状可以分为额叶型、颞叶型及额颞叶型。头皮脑电图很难提供有定位价值的异常, 常为额颞叶甚至双侧额颞叶异常。深部电极尤其是立体脑电图有定侧定位价值。眶额区癫痫几乎均为药物难治性癫痫, 应以外科治疗为主。

    Release date:2017-01-22 09:09 Export PDF Favorites Scan
  • 双侧颞叶癫痫

    颞叶癫痫(Temporal lobe epilepsy,TLE)是最常见的限局性癫痫,药物治疗效果差,因此是癫痫外科治疗的主要类型。但标准前颞切除后 1~2 年无发作率仅为 65%,其原因之一是双侧颞叶癫痫(Bilateral temporal lobe epilepsy,BTLE)。BTLE 的定义尚无统一标准,在临床及头皮脑电图可发现有 BTLE 的可能,颅内电极尤其是立体定向脑电图在确定 BTLE 方面起决定性作用。BTLE 的确切发生率尚不了解,在 TLE 大约 30%~40% 为 BTLE。双侧颞叶间有功能性相互密切联系,一侧颞叶病变或功能异常很容易影响对侧颞叶,逐渐形成 BTLE。BTLE 几乎均为药物难治的,在精准定位定侧的情况下,如能证实发作的 50%~80% 以上起于一侧,神经心理检查对侧颞叶功能适当,无颞外症状,行一侧颞叶切除 30% 预后好。对 BTLE 尚有很多需深入研究的问题,尤其是外科治疗的适应证及预后。今后应深入开展多中心大样本前瞻性研究。

    Release date:2020-05-19 01:07 Export PDF Favorites Scan
  • The role of magnetoencephalography in presurgical focus localization in epilepsy

    Intracranial electrographic recording, especially stereoencephalography (SEEG), remains the gold standard for preoperative localization in epilepsy patients. However, this method is invasive and has low spatial resolution. In 1982, magnetoencephalography (MEG) began to be used in epilepsy clinics. MEG is not affected by the skull and scalp, can provide signals with high temporal and spatial resolution, and can be used to determine the epiletogensis zone (EZ) and the seizure onset zone (SOZ). Magnetic source imaging (MSI) is a method that superimposes the MEG data on a magnetic resonance image (MRI) and has become a major tool for presurgical localization. The applicability of MEG data has been largely improved by the development of many post-MRI processing methods in the last 20 years. In terms of the sensitivity of localization, MEG is superior to VEEG, MRI, PET and SPECT, despite inferiority to SEEG. MEG can also assist in the intracranial placement of electrodes and improve preoperative planning. Limitations of MEG include high cost, insensitivity to radiation source, and difficulty in locating deep EZ in the medial regions of the brain. These limitations could be overcome by new generations of equipment and improvement of algorithmics.

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