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Prognostic value of dynamic electroencephalogram in comatose patients with different diseased regions

Neural Regeneration Research 2007年第7期2卷 421-424页

作者： huapin huang chunhui che an zheng xiaoyun zhuang fang jiang nan liu Department of Neurology Union Hospital of Fujian Medical University Fuzhou 350001 Fujian Province China

BACKGROUND： It has proved that dynamic electroencephalogram （EEG） is definite in judging the outcome of ischemic hypoxic comatose patients, EEG is more sensitive to the cortical affection, but not sensitive to the subcortical and brainstem affections, thus it is necessary to clarify the indications of this technique in the clinical application.OBJECTIVE： To observe and compare the prognostic value of dynamic EEG and Glasgow coma score in comatose patients with different diseased region.DESIGN： A clinical case-controlled observation.SETTING： Union Hospital of Fujian Medical University.PARTICIPANTS： Sixty-eight comatose patients were selected from the Union Hospital affiliated to Fujian Medical University from June 1998 to January 2005. The diseased regions were identified using cranial CT （n =43） or MR （n =25）. According to different primarily diseased regions, the comatose patients were divided into two groups： ① brainstem affection group （n =23）： 13 males and 10 females, 14 - 62 years of age; ②diffuse cortical affection group （n =45）： 28 males and 17 females, 23 - 75 years of age.METHODS： The dynamic EEG and Glasgow coma score were examined in the 45 comatose patients with primarily cortical affection and 22 comatose patients with primarily brainstem affection at acute phase. The patients were followed-up for 3 months to observe the outcome, The termination of outcome judgment was 3 months after attack or the death. The clinical outcome was classified as complete rehabilitation, survived with disability, death or vegetative state. Correlations of dynamic EEG and Glasgow coma score with the outcome of patients were analyzed. The correlations of dynamic EEG grades and Glasgow coma scores with the outcome were analyzed, and the prognostic value of dynamic EEG grades was compared between the two groups.MAIN OUTCOME MEASURES： ① Correlations of dynamic EEG and Glasgow coma score with the outcome of patients; ② Comparison of the prognostic value of dynamic EEG

关键词： dynamic electroencephalogram brainstem infarction coma outcome cerebral cortex

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Chaotic electrical stimulation of the subthalamic nucleus-mossy fiber sprouting, epileptic seizures, and brain electrical activity in pentylenetetrazol-kindled rats

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Neural Regeneration Research 2008年第6期3卷 593-597页

作者： Shenggen chen chunhui che huapin huang Changyun liu xiaoyun zhuang fang jiang Department of Neurology Union Hospital Affiliated to Fujian Medical University Fuzhou 350001 Fujian Province China

BACKGROUND： Previous studies have demonstrated that appropriate interventions can alter brain electrical activity of epileptic patients prior to and during a seizure, leading to maintenance of a highly chaotic state, thereby inhibiting abnormal epileptic discharges, and eventually controlling epileptic seizure. OBJECTIVE： This study was designed to observe the effects of chaotic electrical stimulation to the subthalamic nucleus on mossy fiber sprouting, epileptic seizures, and electrical discharges, and to summarize the most suitable intervention. DESIGN, TIME AND SETTING： This randomized grouping, neuroelectrophysiological study was performed at the Laboratory of Neurology, Union Hospital Affiliated to Fujian Medical University in September 2007. MATERIALS： Fifty-five healthy, male, Sprague Dawley rats were subjected to an epileptic model by an intraperitoneal injection of pentylenetetrazol. The YC-2 programmed electrical stimulator was provided by chengdu Instrument Factory, China; the video electroencephalographic system （KT-88-2400） and 24-hour active electroencephalographic system were products of Contec Medical System Co., Ltd., China; pentylenetetrazol was purchased from Sigma, USA. METHODS： The present interventional method consisted of electrical stimulation to the subthalamic nucleus with an intensity of 500 μA, pulse width 0.05 ms, frequency 30 Hz, and a duration of 20 minutes for 14 successive days. Fifty-five rats were divided into 6 groups：（1） pre-stimulation （n = 10）, pentylenetetrazol was administered and 30 minutes later, chaotic electrical stimulation was performed; （2） synchronous stimulation （n = 10）, rats received pentylenetetrazol and chaotic electrical stimulation concurrently; （3） post-administration stimulation （n = 10）, after pentylenetetrazol administration, chaotic electrical stimulation was performed immediately after cessation of a seizure; （4） sham-stimulation （n = 10）, following pentylenetetrazol administration, an electrode was conn

关键词： chaotic deep brain stimulation epilepsy mossy fiber subthalamic nucleus Timm staining

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