Epilepsy and Behavior Reports最新文献_第8页

Neuropsychiatric disorders in Chinese pediatric tuberous sclerosis complex patients associated with drug-resistant epilepsy: A TAND checklist-based survey 中国儿童结节性硬化症合并耐药癫痫患者的神经精神障碍：一项基于TAND检查表的调查

IF 1.8 Q3 CLINICAL NEUROLOGY

Epilepsy and Behavior Reports

Pub Date : 2025-04-03 DOI: 10.1016/j.ebr.2025.100765

Jie Fu , Qinrui Li , Genfu Zhang , Zhixian Yang , Jiong Qin

Tuberous sclerosis complex (TSC) is an autosomal-dominant genetic disorder frequently accompanied by neuropsychiatric disorders, especially in patients who have drug-resistant epilepsy (DRE). This study aimed to evaluate the distribution of neuropsychiatric disorders in Chinese children with TSC-related epilepsy using the TAND (Tuberous Sclerosis Complex Associated Neuropsychiatric Disorders) checklist, comparing those with DRE to those achieving seizure freedom. A total of 47 children, aged 6 to 18 years, diagnosed with TSC at Peking University People’s Hospital, participated in this cross-sectional study. All participants met the latest diagnostic criteria for TSC. Based on the definition of drug-resistant epilepsy, participants were categorized into DRE group and seizure-free group. Neurodevelopmental disorders were evaluated using the TAND checklist. The study found that 66 % of participants exhibited varying degrees of intellectual disability, with the DRE group demonstrating significantly poorer performance in intelligence, behavior, neuropsychological, and learning skills compared to the seizure-free group. The DRE group also had higher rates of attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), alongside greater impairments in psychosocial functioning. This study indicates that DRE is strongly associated with neuropsychiatric development in children with TSC, but also that all children with TSC are at increased risk of TAND. Our findings highlight the importance of regular assessment and intervention to support TAND and improve quality of life in this vulnerable group.

结节性硬化症（TSC）是一种常染色体显性遗传疾病，常伴有神经精神疾病，特别是在耐药癫痫（DRE）患者中。本研究旨在利用TAND（结节性硬化症相关神经精神疾病）检查表评估中国tsc相关癫痫患儿的神经精神疾病分布，并将DRE组与癫痫发作自由组进行比较。在北京大学人民医院诊断为TSC的儿童共47名，年龄6 ~ 18岁，参与了本横断面研究。所有参与者均符合最新的TSC诊断标准。根据耐药癫痫的定义，将参与者分为DRE组和无发作组。使用TAND检查表评估神经发育障碍。研究发现，66%的参与者表现出不同程度的智力残疾，与无癫痫组相比，DRE组在智力、行为、神经心理学和学习技能方面的表现明显较差。DRE组患注意力缺陷多动障碍（ADHD）和自闭症谱系障碍（ASD）的比例也更高，同时心理社会功能也有更大的障碍。本研究表明，DRE与TSC儿童的神经精神发展密切相关，但所有TSC儿童发生TAND的风险都增加。我们的研究结果强调了定期评估和干预的重要性，以支持TAND和改善这一弱势群体的生活质量。

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引用次数: 0

Tramadol use and risk of seizure: A report of two cases and a review of recent literature 曲马多的使用和癫痫发作的风险：两个病例的报告和最近的文献综述

IF 1.8 Q3 CLINICAL NEUROLOGY

Epilepsy and Behavior Reports

Pub Date : 2025-03-24 DOI: 10.1016/j.ebr.2025.100763

Emma Dolan , Norman Delanty

Tramadol is a common pain medication used in practice across numerous specialties. Increased incidence of tramadol abuse and overdose in recent decades has led to it being classified as a controlled drug in several countries. Tramadol appears to be an increasingly popular drug of abuse, possibly related to ease of access to it on prescription, and its potential euphoric effects.

We identified two cases of seizures directly related to tramadol exposure. We then reviewed recent literature on tramadol and its adverse effects, particularly looking at its effect on seizure risk and the incidence of seizures. We found that there were scarce recent studies on the relationship between tramadol and seizure risk. Of studies found, many were carried out in animal models. Tramadol-induced seizures were studied in humans more commonly in the context of overdose, and studies involving humans tended to have small patient cohorts and suggested further study in the area.

We suggest that tramadol may be useful as part of multi-modal analgesia in moderate to severe pain in specific contexts, but that greater awareness of its potential adverse effects, and particularly its potential to lower seizure threshold, is warranted. We feel that more readily available information specifically about tramadol’s effects on seizure threshold may be of interest to colleagues from any specialty prescribing opioid analgesia on a regular basis, but that colleagues treating patients with seizure disorders should be particularly aware of these potential adverse effects.

曲马多是一种常见的止痛药，在许多专业的实践中使用。近几十年来，曲马多滥用和过量使用的发生率增加，导致它在几个国家被列为管制药物。曲马多似乎是一种越来越受欢迎的滥用药物，可能与处方上容易获得曲马多及其潜在的欣快效果有关。我们确定了两例与曲马多暴露直接相关的癫痫发作。然后，我们回顾了最近关于曲马多及其副作用的文献，特别关注其对癫痫发作风险和癫痫发作发生率的影响。我们发现最近很少有关于曲马多与癫痫发作风险之间关系的研究。在发现的研究中，许多是在动物模型中进行的。曲马多诱发的人类癫痫发作的研究通常是在过量的情况下进行的，涉及人类的研究往往是小规模的患者队列，建议在该领域进行进一步的研究。我们建议曲马多在特定情况下可作为多模式镇痛的一部分，用于中度至重度疼痛，但需要对其潜在的不良反应，特别是降低癫痫发作阈值的潜力有更大的认识。我们认为更容易获得的关于曲马多对癫痫发作阈值影响的具体信息可能会引起任何专业开具阿片类镇痛药处方的同事的兴趣，但治疗癫痫发作障碍患者的同事应该特别注意这些潜在的不良反应。

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引用次数: 0

Safety and feasibility of exhaustive exercise testing for people with epilepsy 癫痫患者运动测试的安全性和可行性

IF 1.8 Q3 CLINICAL NEUROLOGY

Epilepsy and Behavior Reports

Pub Date : 2025-03-16 DOI: 10.1016/j.ebr.2025.100762

Franziska van den Bongard , Catharina Petersen , Claus Reinsberger

People with epilepsy (PWE) are encouraged to participate in exercise and be physically active, but some PWE may report exercise-associated seizures (EAS). However, there is a lack of objective tools to inform individual recommendations for physical activity and exercise participation in PWE. This study investigated the feasibility and safety of exhaustive exercise testing in PWE. 29 patients underwent an objectively and subjectively exhaustive exercise test on a bicycle ergometer and resting state EEG was obtained before and after exercise. One patient with a history of EAS experienced a seizure immediately after exercising. In patients without EAS, an asymptomatic subclinical electrographic seizure was observed in one patient, and two patients revealed interictal epileptiform discharges only after exercise. All EEG changes occurred in the setting of non-REM sleep, while the respective pre-exercise EEG recordings revealed less sleep. No seizures or significant EEG changes after exercise were observed in any other patient. EEG investigations before and after exhaustive exercise were feasible in PWE, but safety protocols need to be established, especially in patients with EAS. Investigation of a higher number of PWE with and without EAS with repeat exercise-associated EEG may provide information about the clinical utility of exercise-associated EEGs when counseling PWE.

癫痫患者（PWE）被鼓励参加运动和身体活动，但一些PWE可能会报告运动相关癫痫发作（EAS）。然而，缺乏客观的工具来为PWE的身体活动和运动参与提供个人建议。本研究探讨了在PWE中进行力竭运动试验的可行性和安全性。29例患者分别在自行车测力仪上进行客观和主观上的力竭运动试验，并在运动前后获得静息状态脑电图。一名有EAS病史的患者在运动后立即发作。在没有EAS的患者中，1例患者观察到无症状的亚临床电图癫痫发作，2例患者仅在运动后出现间歇性癫痫样放电。所有的脑电图变化都发生在非快速眼动睡眠的情况下，而相应的运动前脑电图记录显示睡眠较少。其他患者运动后未见癫痫发作或显著脑电图改变。穷竭运动前后的脑电图检查在PWE中是可行的，但需要建立安全方案，特别是在EAS患者中。通过重复运动相关脑电图对伴有和不伴有EAS的大量PWE进行调查，可以为运动相关脑电图在咨询PWE时的临床应用提供信息。

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引用次数: 0

The role of ultra-high field MRI and image processing in the presurgical workup in MRI-negative focal epilepsy: A validated 7T MRI case study 超高场MRI和图像处理在MRI阴性局灶性癫痫术前检查中的作用：一项经过验证的7T MRI病例研究

IF 1.8 Q3 CLINICAL NEUROLOGY

Epilepsy and Behavior Reports

Pub Date : 2025-03-15 DOI: 10.1016/j.ebr.2025.100761

Daniel Uher , Gerhard S. Drenthen , Christianne M. Hoeberigs , Rick H.G.J. van Lanen , Albert J. Colon , Roy A.M. Haast , Vivianne H.J.M. van Kranen-Mastenbroek , Guido Widman , Paul A.M. Hofman , Louis G. Wagner , Jan C. Beckervordersandforth , Jacobus F.A. Jansen , Olaf E.M.G. Schijns , Walter H. Backes , on behalf of the ACE study group

This case study demonstrates the value of combined 7 T structural and functional MRI in the presurgical workup of a 24-year-old male with drug-resistant focal epilepsy who was initially considered MRI-negative on clinical 3 T MRI. The patient underwent extensive presurgical workup with 7 T MRI, magnetoencephalography, stereo-electroencephalography, and resection of the suspected right frontal epileptogenic zone. Histopathology showed focal cortical dysplasia (FCD) type IIb. The patient remained 11 months after surgery seizure-free. Retrospective analysis revealed that both structural and functional 7 T MRI showed abnormalities within the resected area. Morphometric Analysis Program (MAP18) detected abnormalities on both 3 T and 7 T images. However, abnormalities were more conspicuous on 7 T. Resting-state functional MRI metrics, particularly regional homogeneity and fractional amplitude of low-frequency fluctuations, demonstrated significantly increased values in both a MAP18-defined region of interest and the entire resected area compared to a healthy control group (p < 0.05). However, extensive unspecific abnormalities were also observed outside the resected region, highlighting the importance of a multimodal approach. This case study illustrates that advanced image processing of ultra-high field structural and resting-state functional MRI scans may enhance the detection of subtle epileptogenic lesions in presurgical evaluation, potentially improving post-operative seizure outcome and associated quality of life.

本病例研究证明了7 T结构和功能MRI联合检查在一名24岁男性耐药局灶性癫痫患者的术前检查中的价值，该患者最初在临床3 T MRI上被认为是MRI阴性。患者接受了广泛的术前检查，包括7t MRI、脑磁图、立体脑电图，并切除疑似右额叶癫痫区。组织病理学显示局灶性皮质发育不良（FCD） IIb型。患者术后11个月无癫痫发作。回顾性分析显示，结构和功能7t MRI显示切除区域内异常。形态计量学分析程序（MAP18）检测到3t和7t图像的异常。然而，在7 t上异常更为明显。静息状态功能MRI指标，特别是区域均匀性和低频波动的分数振幅，显示与健康对照组相比，map18定义的感兴趣区域和整个切除区域的值显着增加(p <；0.05)。然而，在切除区域外也观察到广泛的非特异性异常，强调了多模式方法的重要性。本案例研究表明，超高场结构和静息状态功能MRI扫描的先进图像处理可以增强术前评估中细微癫痫病变的检测，潜在地改善术后癫痫发作结果和相关的生活质量。

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引用次数: 0

Medication reference tables for neurologists: A focus on psychotropic medications in epilepsy 神经科医生用药参考表：癫痫的精神药物的焦点

IF 1.8 Q3 CLINICAL NEUROLOGY

Epilepsy and Behavior Reports

Pub Date : 2025-03-14 DOI: 10.1016/j.ebr.2025.100760

Heidi M. Munger Clary , Gaston Baslet , Gerardo Maria de Araujo Filho , David Dunn , Alexis Tarrada , Coraline Hingray , Andres M. Kanner

Many psychotropic medications are prescribed to people with epilepsy by neurologists and other non-neurology providers. This article presents summary tables with information on specific psychotropic drug classes (antidepressants, stimulant medications, and antipsychotic medications) including initiation schedules, dosing and indication. Given the overall paucity of epilepsy specific data available, the information is based primarily on regulatory approvals or other general population data, along with unique considerations for epilepsy such as interactions with antiseizure medications. While information is presented across the age span for antidepressants and stimulants, information on antipsychotic medications is focused on the most commonly prescribed medications for adults with psychotic episodes or acutely agitated states. Summary information on psychiatric and cognitive side effects of antiseizure medications and psychotropic benefits of antiseizure medications are also presented. This article is intended to provide a handy reference to neurologists involved in managing mental health in a clinical setting or caring for patients already receiving psychotropic medications for mental health comorbidities. This article provides an overview of a more comprehensive list of psychotropic medications than the case-based articles of the special issue and is intended to supplement the focused and practical information presented in the other articles.

许多精神药物是由神经科医生和其他非神经科医生开给癫痫患者的。这篇文章提供了关于特定精神药物类别（抗抑郁药、兴奋剂和抗精神病药物）的信息汇总表，包括起始时间表、剂量和适应症。鉴于现有的癫痫相关数据总体上缺乏，这些信息主要基于监管机构批准或其他一般人群数据，以及对癫痫的独特考虑，如与抗癫痫药物的相互作用。虽然抗抑郁药和兴奋剂的信息是跨年龄的，但抗精神病药物的信息主要集中在患有精神病发作或急性激动状态的成年人最常用的处方药上。本文还介绍了抗癫痫药物对精神和认知方面的副作用以及抗癫痫药物对精神方面的益处。这篇文章的目的是提供一个方便的参考神经科医生参与管理精神健康在临床设置或照顾病人已经接受精神药物治疗精神健康合并症。这篇文章提供了一个更全面的精神药物清单的概述，而不是以病例为基础的特刊文章，旨在补充其他文章中提出的重点和实用信息。

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引用次数: 0

Beamforming of ictal MEG aiding subtle focal cortical dysplasia localization 头部脑磁图的波束形成有助于轻度局灶性皮质发育不良的定位

IF 1.8 Q3 CLINICAL NEUROLOGY

Epilepsy and Behavior Reports

Pub Date : 2025-03-12 DOI: 10.1016/j.ebr.2025.100759

Natascha C. da Fonseca , Afsaneh Talai , Daniel Veltkamp , Fabricio S. Feltrin , Dallas Armstrong , Angela Price , Joseph A. Maldjian , Elizabeth M. Davenport

A case is presented of a 17-year-old right-handed male with drug-resistant epilepsy (DRE), initially presenting with non-lesional MRI findings, where ictal MEG beamforming successfully localized a subtle Focal Cortical Dysplasia (FCD). His seizure onset began at age 13, with episodes evolving into bilateral tonic-clonic seizures. Despite various medication trials and normal initial electroencephalograms, his seizures escalated in frequency and severity by age 16. Subsequent diagnostics were unable to reveal definitive lesions, including a high-resolution MRI and various functional imaging techniques. MEG was performed, capturing two electroclinical seizures but without interictal epileptiform discharges. Frequency-based beamforming analysis localized the seizure onset to the right anterior precuneus and superior parietal lobule. This result prompted a re-evaluation of the same MRI images, revealing subtle cortical abnormalities and pinpointing an FCD. Subsequent stereoelectroencephalography confirmed these findings, and the patient underwent successful Laser Interstitial Thermal Therapy, resulting in seizure freedom. This case highlights the utility of frequency-based ictal MEG beamforming in identifying epileptogenic zones and its potential as a powerful tool in the presurgical assessment of DRE patients and non-invasive identification of subtle FCD, especially when traditional methods are unable to localize.

本文报告一例17岁右撇子男性耐药癫痫（DRE）患者，最初表现为非病变性MRI发现，颅磁图波束形成成功定位了轻微的局灶性皮质发育不良（FCD）。他的癫痫发作开始于13岁，发作演变为双侧强直阵挛发作。尽管各种药物试验和正常的初始脑电图，他的癫痫发作的频率和严重程度在16岁时升级。随后的诊断无法显示明确的病变，包括高分辨率MRI和各种功能成像技术。进行脑磁图，捕捉到两次电临床发作，但没有发作间性癫痫样放电。基于频率的波束形成分析将癫痫发作定位于右侧楔前叶和顶叶上小叶。这一结果促使对相同的MRI图像进行重新评估，揭示了细微的皮质异常并确定了FCD。随后的立体脑电图证实了这些发现，患者接受了成功的激光间质热治疗，导致癫痫发作自由。本病例强调了基于频率的颅磁图波束形成在识别癫痫区方面的应用，以及它作为术前评估DRE患者和非侵入性识别细微FCD的有力工具的潜力，特别是当传统方法无法定位时。

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引用次数: 0

Genetic insights into progressive myoclonic epilepsies: A case study of KCTD7 mutation in an Iranian-Azeri-Turkish family 进行性肌阵挛性癫痫的遗传洞察：伊朗-阿塞拜疆-土耳其家族KCTD7突变的案例研究

IF 1.8 Q3 CLINICAL NEUROLOGY

Epilepsy and Behavior Reports

Pub Date : 2025-02-27 DOI: 10.1016/j.ebr.2025.100757

Haneieh Honarmand , Mortaza Bonyadi , Mohammad Barzegar

Progressive Myoclonic Epilepsies (PMEs) are a rare and heterogeneous group of epileptic disorders often with progressive neurologic deterioration. The intensity of the clinical features varies depending on the underlying genetic etiology. This study aims to identify the genetic mutation associated with PME in a family belonging to the Iranian-Azeri-Turkish ethnic population. A 5-year-old boy and his 8-year-old sister, presenting with PME-related electroclinical features such as myoclonic seizures and progressive cognitive and motor decline, underwent comprehensive clinical evaluations, including pedigree analysis, laboratory tests, and EEG assessments, followed by Whole-Exome Sequencing (WES) to identify potential disease-causing mutations. We identified a novel homozygous mutation (c.14C > T) in the KCTD7 gene in both siblings, confirmed through Sanger sequencing. This mutation was not observed in a cohort of 430 healthy individuals from the same Iranian-Azeri-Turkish ethnic background, providing strong evidence for its pathogenic role. This finding advances our understanding of the genetic basis and phenotypic diversity of PMEs, but further research is needed to elucidate how KCTD7 mutations contribute to epilepsy and neurodegeneration.

进行性肌阵挛性癫痫（PMEs）是一种罕见且异质性的癫痫性疾病，常伴有进行性神经系统恶化。临床特征的强度取决于潜在的遗传病因。本研究旨在确定一个属于伊朗-阿塞拜疆-土耳其民族人口的家庭中与PME相关的基因突变。一个5岁的男孩和他8岁的妹妹，表现出与pme相关的电临床特征，如肌阵挛性发作和进行性认知和运动能力下降，进行了全面的临床评估，包括谱系分析、实验室检查和脑电图评估，随后进行了全外显子组测序（WES）以确定潜在的致病突变。我们发现了一个新的纯合突变(c.14C >；通过Sanger测序证实，KCTD7基因在兄弟姐妹中均存在。在同一伊朗-阿塞拜疆-土耳其种族背景的430名健康个体队列中未观察到这种突变，为其致病作用提供了强有力的证据。这一发现促进了我们对PMEs的遗传基础和表型多样性的理解，但需要进一步的研究来阐明KCTD7突变如何导致癫痫和神经变性。

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引用次数: 0

Major depression, anxiety disorder and suicidality in epilepsy: What should neurologists do? 癫痫患者的重度抑郁、焦虑障碍和自杀倾向：神经科医生应该怎么做？

IF 1.8 Q3 CLINICAL NEUROLOGY

Epilepsy and Behavior Reports

Pub Date : 2025-02-27 DOI: 10.1016/j.ebr.2025.100758

Andres M. Kanner

Four to five patients with epilepsy (PWE) can suffer from Major Depressive episodes (MDE). Comorbid anxiety disorders (AD) frequently occur together with MDE. Failure to treat MDE can negatively affect several aspects of their life as well as the management of the epilepsy. Often, suicidal ideation is among its symptoms, which need to be addressed without delay to prevent suicidal attempts or a completed suicide. Unfortunately, access to health care professionals is very limited and, in many communities, non-existent. Accordingly, it falls upon the treating neurologist to begin a pharmacologic trial with psychotropic drugs. The purpose of this manuscript is to provide neurologists with very useful strategies on how to screen and identify MDEs with and without AD in the outpatient clinic and how to select the appropiate psychotropic drugs. Using an illustrative case, we discuss its differential diagnosis, particularly the recognition of iatrogenic episodes, and demonstrate the selection and mode of use of commonly used antidepressant in PWE. Finally, we provide a guide on how the neurologist can assess the suicidal risk of a patient that endorses suicidal ideation and the steps that need to be taken to minimize the risk of suicidal behavior.

四到五名癫痫（PWE）患者可能会出现重度抑郁发作（MDE）。合并焦虑症（AD）经常与重度抑郁发作同时发生。如果不治疗重度抑郁发作，会对患者生活的多个方面以及癫痫的治疗产生负面影响。通常，自杀意念也是其症状之一，需要毫不拖延地加以解决，以防止自杀未遂或自杀身亡。遗憾的是，获得医疗保健专业人员服务的途径非常有限，在许多社区甚至根本不存在。因此，治疗患者的神经科医生不得不开始使用精神药物进行药物治疗。本手稿旨在为神经科医生提供非常有用的策略，帮助他们在门诊中筛查和识别伴有或不伴有注意力缺失症的 MDE，以及如何选择合适的精神药物。通过一个示例病例，我们讨论了其鉴别诊断，尤其是对先天性发作的识别，并演示了在 PWE 中常用抗抑郁药物的选择和使用方式。最后，我们将指导神经科医生如何评估有自杀倾向的患者的自杀风险，以及需要采取哪些措施将自杀行为的风险降至最低。

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引用次数: 0

Enhancing seizure control in ultra-refractory postencephalitic epilepsies using multinodal network neuromodulation 多节神经网络调节增强超难治性脑后癫痫发作控制

IF 1.8 Q3 CLINICAL NEUROLOGY

Epilepsy and Behavior Reports

Pub Date : 2025-02-17 DOI: 10.1016/j.ebr.2025.100755

Subhiksha Srinivasan , Surya Suresh , Ganne Chaitanya , Manoj Saranathan , Nitin Tandon , Sandipan Pati

This case series reports the formidable challenge posed by postencephalitic epilepsies, characterized by frequent drug-resistant seizures and neuropsychiatric and cognitive comorbidities. Polypharmacy is frequently required, and surgical resection may not be feasible due to multifocality. Neuromodulation therapies, including Deep Brain Stimulation (DBS) and Responsive Neurostimulation (RNS), offer a potential lifeline. In this case series, we shed light on the intricate landscape of seizure management and neuropsychiatric comorbidities in five individuals with frequent seizures (often weekly) and ultra-refractory epilepsy (defined as resistance to more than six different antiseizure medications, including failed epilepsy surgery) following catastrophic encephalitis. Four out of five patients achieved at least 50% reduction in seizure frequency following multimodal neuromodulation interventions. Moreover, we underscore the pivotal role of RNS electrocorticography (ECoG) in monitoring the epileptiform burden to guide therapy. Postencephalitic patients often present with a complex interplay of epileptic and nonepileptic (including neuropsychiatric) events, necessitating distinct therapeutic approaches. RNS ECoG emerges as a critical tool for differentiation and tailored therapy. While our findings highlight the potential effectiveness of neuromodulation in managing postencephalitic epilepsy, further research is needed to identify predictors of treatment response and explore the application of these therapies in chronic epilepsy caused by encephalitis. Overall, neuromodulation offers hope for improving these patients’ quality of life.

本病例系列报告了脑后癫痫带来的巨大挑战，其特征是频繁的耐药癫痫发作和神经精神和认知合并症。经常需要多药治疗，由于多灶性，手术切除可能不可行。神经调节疗法，包括深部脑刺激（DBS）和反应性神经刺激（RNS），提供了潜在的生命线。在本病例系列中，我们阐明了5例灾难性脑炎后频繁发作（通常每周一次）和超难治性癫痫（定义为对6种以上不同的抗癫痫药物有耐药性，包括失败的癫痫手术）的患者的癫痫发作管理和神经精神合并症的复杂情况。在多模态神经调节干预后，五分之四的患者癫痫发作频率至少降低了50%。此外，我们强调RNS皮质电图（ECoG）在监测癫痫样负担以指导治疗方面的关键作用。脑后患者通常表现为癫痫和非癫痫（包括神经精神）事件的复杂相互作用，需要不同的治疗方法。RNS ECoG成为分化和定制治疗的关键工具。虽然我们的研究结果强调了神经调节在治疗脑炎后癫痫中的潜在有效性，但需要进一步的研究来确定治疗反应的预测因素，并探索这些疗法在脑炎引起的慢性癫痫中的应用。总的来说，神经调节为改善这些患者的生活质量提供了希望。

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引用次数: 0

Examining the role of physical activity in older adults with epilepsy 检查身体活动在老年癫痫患者中的作用

IF 1.8 Q3 CLINICAL NEUROLOGY

Epilepsy and Behavior Reports

Pub Date : 2025-02-17 DOI: 10.1016/j.ebr.2025.100756

Stephen P. Klaus , Serdar Akkol , Smitha K. Achuthan , Annie He , Cynthia Zheng , Ed Faught , Halley B. Alexander

Epilepsy disproportionately affects older adults due to acquired conditions including stroke, neurodegeneration and head trauma secondary to falls. Current literature lacks adequate representation of specific therapies and considerations for this cohort. Furthermore, older adults are more susceptible to the adverse effects of anti-seizure medications necessitating increased caution when treating. Non-pharmacological interventions, including physical activity (PA), are underrecognized, particularly in older adults where they may be of greatest benefit. The following narrative review describes how older adults are uniquely impacted by epilepsy and associated comorbidities. It examines the current literature with respect to PA in epilepsy and, where available, evidence for PA in older adults. This includes how PA can affect pathogenesis and reduce the incidence of epilepsy onset through the reduction of neuroinflammation. PA may also be utilized by older adults with epilepsy to improve cardiovascular function, seizure control, prevent falls and secondary head injury, as an adjunct treatment for mood disorders and cognitive decline, and to promote general well-being. PA has a large and underappreciated role to play in older adults with epilepsy and is increasingly being recognized by healthcare providers and incorporated into practice guidelines.

由于获得性疾病，包括中风、神经变性和跌倒后继发的头部创伤，癫痫对老年人的影响尤为严重。目前的文献缺乏对该队列的特定治疗和考虑的充分代表。此外，老年人更容易受到抗癫痫药物的不良影响，因此在治疗时要更加谨慎。包括身体活动在内的非药物干预措施尚未得到充分认识，特别是在老年人中，这可能是最大的益处。以下叙述性回顾描述了老年人如何受到癫痫和相关合并症的独特影响。它检查了目前关于癫痫中PA的文献，以及老年人中PA的证据。这包括PA如何通过减少神经炎症影响发病机制和减少癫痫发作的发生率。老年癫痫患者也可使用PA来改善心血管功能，控制癫痫发作，预防跌倒和继发性头部损伤，作为情绪障碍和认知能力下降的辅助治疗，并促进总体健康。PA在老年癫痫患者中发挥着巨大而未被充分认识的作用，并且越来越多地被卫生保健提供者认识到并纳入实践指南。

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引用次数: 0