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status epilepticus as an initial manifestation of hepatic encephalopathy:A case report

World Journal of Clinical Cases 2020年第24期8卷 6480-6486页

作者： Bin Cui Lin Wei Wei Qu Zhi-Gui Zeng Ying Liu Zhi-Jun Zhu Li-Ying Sun Liver Transplantation Center National Clinical Research Center for Digestive DiseasesBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China Liver Transplantation Center National Clinical Research Center for Digestive DiseasesIntensive Care UnitBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND status epilepticus in patients with hepatic encephalopathy (HE) is a rare butserious condition that is refractory to antiepileptic drugs, and current treatmentplans are vague. Diagnosis may be difficult without a clear history of *** transplantation (LT) is effective to alleviate symptoms, however, there arefew reports about LT in the treatment of status epilepticus with HE. To ourknowledge, this is the first report of status epilepticus present as initialmanifestation of *** SUMMARY A 59-year-old woman with a 20-year history of heavy drinking was hospitalizedfor generalized tonic-clonic seizures. She reported no history of episodes of HE,stroke, spontaneous bacterial peritonitis, ascites or gastrointestinal *** examination revealed a comatose patient, without *** examination suggested liver cirrhosis. Plasma ammonia levels uponadmission were five times normal. Brain computed tomography (CT) was normal,while abdominal CT and ultrasound revealed mild ascites, liver cirrhosis andsplenomegaly. Electroencephalography (EEG)showed diffuse slow waves rhythm,consistent with HE, and sharp waves during ictal EEG corresponding to clinicalsemiology of focal tonic seizures. The symptoms were reversed by continuousantiepileptic treatment and lactulose. She was given oral levetiracetam, and focalaware seizures occasionally affected her 10 mo after *** status epilepticus could be an initial manifestation of HE. Antiepileptic drugs combined with lactulose are essential for treatment of status epilepticus with HE,and LT is effective to prevent the relapse.

关键词： status epilepticus Hepatic encephalopathy Decompensated alcoholic liver cirrhosis Antiepileptic drugs Liver transplantation Case report

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status epilepticus as a complication after COVID-19 mRNA-1273 vaccine:A case report

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World Journal of Clinical Cases 2021年第24期9卷 7218-7223页

作者： Robin Sin Denisa Struncova Department of Infectious Diseases and Travel Medicine Faculty of Medicine in PilsenCharles UniversityUniversity Hospital PilsenPilsen 30599Czech Republic Medical Department Emergency Medical Service of the Pilsen RegionPilsen 30100Czech Republic Department of Anaesthesiology and Intensive Care Medicine University Hospital PilsenPilsen 30460Czech Republic Faculty of Medicine Masaryk UniversityBrno 62500Czech Republic

BACKGROUND We present a rare case of status epilepticus in a 56-year-old man which arose as a complication after vaccination with the coronavirus disease 2019(COVID-19)mRNA-1273 *** patient's history included well-compensated secondary *** root cause of the situation was a fever which had developed as a side effect of the *** SUMMARY A 56-year-old man received the first dose of mRNA-1273 vaccine against the severe acute respiratory *** vaccine was administered intramuscularly(100 mg,0.5 mL).The next morning the man was found to be suffering from fever and headaches while at the same time experiencing general *** lost consciousness suddenly and experienced generalized clonic seizures which turned into status *** the Emergency Medical Service arrived the patient was unconscious with spontaneous breathing and generalized clonic *** was necessary to administer diazepam *** was also necessary to administer high doses of levetiracetam and temporary *** status epilepticus was brought under control approximately 90 min after the patient’s transport to the Emergency Department.A follow-up electroencephalogram no longer revealed abnormal indications of epileptic *** patient was temporarily hospitalized in the Intensive Care Unit and after seven days care was discharged without any further apparent *** There is currently no specific treatment against ***,the benefits of COVID-19 vaccine protection outweigh the risks.

关键词： SARS-CoV-2 COVID-19 mRNA vaccine Complication of vaccination status epilepticus Case report

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status epilepticus in patients with genetic generalized epilepsy:a case series study

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Acta Epileptologica 2023年第4期6卷 231-237页

作者： Gengyao Hu Bi Wang Beibei Chen Zezhi Wang Ze Chen Yonghong Liu Department of Neurology Xijing hospitalFourth Military Medical University(Air Force Medical University)Xi’an710032PR China

Background Genetic generalized epilepsy(GGE)accounts for nearly one-third of all *** feature of status epilepticus(SE)in patients with GGE has been rarely *** aimed to determine the electroclinical characteristics of SEin patients with *** In this retrospective study,nine patients with GGE were enrolled at Xijing Hospital,Xi'an,China from May 2014 to May *** was confrmed by 24-h video-EEG *** demography,clinical manifestation,brain MRI and *** Of the nine patients in the study,seven were *** mean age of the patients at the time of inclusion was 16.8 years(range 7-31 years),and the mean age at the onset of epilepsy was 10.9 years(range 6-17 years).The follow-up time ranged from 3 months to 6 *** absence status was identified in four patients showing eyelid myoclonia with absence and one patient showing perioral myoclonia with *** SE was identi-fied in three patients showing juvenile myoclonic *** SE was found in one patient with eyelid myo-clonia with *** was terminated by oral midazolam in four *** the other five patients,SE terminated *** The seizure type of SE in patients with GGE is often consistent with their major *** mida-zolam may be an option to terminate SE in patients with GGE.

关键词： Genetic generalized epilepsy status epilepticus Electroencephalography

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Characterization of the Expression of the ATP-Gated P2X7 Receptor Following status epilepticus and during Epilepsy Using a P2X7-EGFP Reporter Mouse

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Neuroscience Bulletin 2020年第11期36卷 1242-1258页

作者： James Morgan Mariana Alves Giorgia Conte Aida Menendez-Mendez Laura de Diego-Garcia Gioacchino de Leo Edward Beamer Jonathon Smith Annette Nicke Tobias Engel Department of Physiology and Medical Physics Royal College of Surgeons in IrelandDublin D02 YN77Ireland FutureNeuro Science Foundation Ireland Research Centre for Chronic and Rare Neurological DiseasesRoyal College of Surgeons in IrelandDublin D02 YN77Ireland Walther Straub Institute of Pharmacology and Toxicology Faculty of MedicineLudwig-Maximilians-Universitat Miinchen80336 MunichGermany

Mounting evidence suggests that the ATP-gated P2X7 receptor contributes to increased hyperexcitability in the *** increased expression of P2X7 in the hippocampus and cortex following status epilepticus and during epilepsy has been repeatedly demonstrated,the cell type-specific expression of P2X7 and its expression in extra-hippocampal brain structures remains incompletely *** this study,P2X7 expression was visualized by using a transgenic mouse model overexpressing P2X7 fused to the fluorescent protein *** results showed increased P2X7-EGFP expression after status epilepticus induced by intra-amygdala kainic acid and during epilepsy in different brain regions including the hippocampus,cortex,striatum,thalamus and cerebellum,and this was most evident in microglia and *** of P2X7-EGFP with cell type-specific markers was not detected in neurons or *** data suggest that P2X7 activation is a common pathological hallmark across different brain structures,possibly contributing to brain inflammation and neurodegeneration following acute seizures and during epilepsy.

关键词： Purinergic signaling P2X7 Green fluorescence protein status epilepticus Epilepsy Cell typespecific expression

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Activation of metabotropic glutamate receptor 1 regulates hippocampal CA1 region excitability in rats with status epilepticus by suppressing the HCN1 channel

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Neural Regeneration Research 2023年第3期18卷 594-602页

作者： Xiao-Dan Luo Tao Xiang Si-Jun Li Mei-Gang Ma Mei-Ling Chen Yuan Wu Department of Neurology First Affiliated Hospital of Guangxi Medical UniversityNanningGuangxi Zhuang Autonomous RegionChina Department of Neurology First Affiliated Hospital of University of South ChinaHengyangHunan ProvinceChina Department of Neurology Affiliated Hospital of Guilin Medical UniversityGuilinGuangxi Zhuang Autonomous RegionChina

Dysregulation of hyperpolarization-activated cyclic nucleotide-gated cation(HCN)channels alters neuronal ***,the role of HCN channels in status epilepticus is not fully *** this study,we established rat models of pentylenetetrazole-induced status *** performed western blot assays and immunofluorescence *** results showed that HCN1 channel protein expression,particularly HCN1 surface protein,was significantly decreased in the hippocampal CA1 region,whereas the expression of HCN2 channel protein was ***,metabolic glutamate receptor 1(mGluR1)protein expression was increased after status *** mGluR1 agonist(RS)-3,5-dihydroxyphenylglycine injected intracerebroventricularly increased the sensitivity and severity of pentylenetetrazole-induced status epilepticus,whereas application of the mGluR1 antagonist(+)-2-methyl-4-carboxyphenylglycine(LY367385)alleviated the severity of pentylenetetrazole-induced status *** results from double immunofluorescence labeling revealed that mGluR1 and HCN1 were co-localized in the CA1 ***,a protein kinase A inhibitor(H89)administered intraperitoneally successfully reversed HCN1 channel inhibition,thereby suppressing the severity and prolonging the latency of pentylenetetrazole-induced status ***,H89 reduced the level of mGluR1,downregulated cyclic adenosine monophosphate(cAMP)/protein kinase A expression,significantly increased tetratricopeptide repeat-containing Rab8b-interacting protein(TRIP8b)(1a-4)expression,and restored TRIP8b(1b-2)***8b(1a-4)and TRIP8b(1b-2)are subunits of Rab8b interacting protein that regulate HCN1 surface protein.

关键词： (RS)-3,5-dihydroxyphenylglycine CA1 region excitability H89 HCN1 channel LY367385 mGluR1 pentylenetetrazole status epilepticus

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Ocimum sanctum extract preserves neuronal echotexture and controls seizure in lithium-pilocarpine induced status epilepticus rats

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Asian Pacific Journal of Tropical Biomedicine 2023年第11期13卷 479-487,I0009页

作者： Soumya Sucharita Pattnaik Sudhir Chandra Sarangi Deeksha Sharma Surabhi Sinha Tapas C Nag Aruna Nambirajan Manjari Tripathi Department of Pharmacology All India Institute of Medical SciencesNew DelhiIndia Department of Anatomy All India Institute of Medical SciencesNew DelhiIndia Department of Pathology All India Institute of Medical SciencesNew DelhiIndia Department of Neurology All India Institute of Medical SciencesNew DelhiIndia

Objective:To investigate the effect of Ocimum sanctum hydroalcoholic extract(OSHE)on seizure control and neuronal injury in rats with lithium-pilocarpine-induced status epilepticus(SE).Methods:SE was induced by administering lithium chloride followed by pilocarpine 24 h *** was administered either alone or in combination with valproate(VPA)3 days before SE induction until 14 days post-SE *** parameters were recorded on day 1(0-3 h),day 1-3 and day 4-14 *** day 14 post-SE,neurobehavioural tests(elevated plus maze and passive avoidance)were done followed by total antioxidant capacity,neuron-specific enolase,immunohistochemistry,and electron microscopic assessment in the hippocampus and cortex ***:OSHE+VPA provided more significant seizure protection(75%)than VPA(62.5%),OSHE(62.5%),or SE control(12.5%)(overall P=0.003).The latency to stage-3/4 seizures was increased and the number of stage-3/4 seizures was reduced in all treatment groups compared to the SE control group(P=0.002 and<0.001,respectively).The OSHE+VPA group also had better memory retention than other treatment groups(P<0.001)in the passive avoidance *** antioxidant capacity level was significantly higher and neuron-specific enolase was lower in the OSHE and OSHE+VPA groups compared to the SE control *** microscopic study showed significant myelin sheath damage(67.5%,P<0.05)and axonal degeneration(51.8%,P<0.001)in the hippocampus of the SE control group,which were alleviated by OSHE or OSHE+VPA *** immunohistochemical analysis,the OSHE,OSHE+VPA,and VPA groups had a significantly higher number of viable neurons and less neuronal loss compared to the SE control in the hippocampus(P<0.001).Conclusions:OSHE either alone or in combination with VPA shows better seizure control by preservation of neuronal echotexture and reducing oxidative stress in the hippocampus.

关键词： status epilepticus Ocimum sanctum Seizure protection Neuronal injury Electron microscopy

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status epilepticus increases mature granule cells in the molecular layer of the dentate gyrus in rats

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Neural Regeneration Research 2013年第7期8卷 609-615页

作者： Zhaoliang Liang Fei Gao Fajun Wang Xiaochen Wang Xinyu Song Kejing Liu Ren-Zhi Zhan Institute of Physiology Shandong University School of Medicine

Enhanced neurogenesis in the dentate gyrus of the hippocampus following seizure activity, especially status epilepticus, is associated with ectopic residence and aberrant integration of newborn granule cells. Hilar ectopic granule cells may be detrimental to the stability of dentate circuitry by means of their electrophysiological properties and synaptic connectivity. We hypothesized that status epilepticus also increases ectopic granule cells in the molecular layer. status epilepticus was induced in male Sprague-Dawley rats by intraperitoneal injection of pilocarpine. Immunostaining showed that many doublecortin-positive cells were present in the molecular layer and the hilus 7 days after the induction of status epilepticus. At least 10 weeks after status epilepticus, the estimated number of cells positive for both prospero homeobox protein 1 and neuron-specific nuclear protein in the hilus was significantly increased. A similar trend was also found in the molecular layer. These findings indicate that status epilepticus can increase the numbers of mature and ectopic newborn granule cells in the molecular layer.

关键词： neural regeneration basic research status epilepticus hippocampus dentate gyrus granule cells molecular layer prospero homeobox protein 1 neuron-specific nuclear protein doublecortin grants-supported paper photographs-containing paper neuroregeneration

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Hippocampus protection from apoptosis by Baicalin in a LiClpilocarpine-induced rat status epilepticus model through autophagy activation

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World Journal of Psychiatry 2023年第9期13卷 620-629页

作者： Bin Yang Han-Yu Wen Ri-Sheng Liang Ting-Ming Lu Zheng-Yan Zhu Chun-Hua Wang Department of Neurosurgery Affiliated Union Hospital of Fujian Medical UniversityFuzhou 350001Fujian ProvinceChina Department of Neurosurgery Affiliated Union Hospital of Fujian Medical UniversityNeurosurgery Research Institute of Fujian ProvinceFuzhou 350001Fujian ProvinceChina

BACKGROUND Autophagy is associated with hippocampal injury following status epilepticus(SE)and is considered a potential therapeutic ***,an emerging multitherapeutic drug,has shown neuroprotective effects in patients with nervous system diseases due to its antioxidant *** To investigate the potential role of autophagy in LiCl-pilocarpine-induced *** The drugs were administered 30 min before *** staining showed that Baicalin attenuated hippocampal injury and reduced neuronal death in the *** blotting and terminal deoxynucleotidyl transferase dUTP nick end labeling assay confirmed that Baicalin reversed the expression intensity of cleaved caspase-3 and apoptosis in hippocampal CA1 following ***,western blotting and immunofluorescence staining were used to measure the expression of autophagy markers(p62/SQSTM1,Beclin 1,and LC3)and apoptotic pathway markers(cleaved caspase-3 and Bcl-2).RESULTS Baicalin significantly upregulated autophagic activity and downregulated mitochondrial apoptotic pathway ***,3-methyladenine,a commonly used autophagy inhibitor,was simultaneously administered to inhibit the Baicalin-induced autophagy,abrogating the protective effect of Baicalin on the mitochondrial apoptotic *** We illustrated that Baicalin-induced activation of autophagy alleviates apoptotic death and protects the hippocampus of SE rats.

关键词： Baicalin status epilepticus Autophagy Mitochondrial apoptosis

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Mitochondrial transplantation ameliorates hippocampal damage following status epilepticus

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Animal Models and Experimental Medicine 2023年第1期6卷 41-50页

作者： Xiaoxia Jia Qinghua Wang Jianlun Ji Wenchun Lu Zhidong Liu Hao Tian Lin Guo Yun Wang Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy Xuzhou Medical UniversityXuzhouChina Psychology Laboratory School of ManagementXuzhou Medical UniversityXuzhouChina Department of Pharmacy The Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina Agro-Products Processing Research Institute Yunnan Academy of Agricultural SciencesKunmingChina

Background:Hippocampal damage caused by status epilepticus(SE)can bring about cognitive decline and emotional disorders,which are common clinical comorbidities in patients with *** is therefore imperative to develop a novel therapeutic strat-egy for protecting hippocampal damage after *** dysfunction is one of contributing factors in *** the therapeutic benefits of mitochondrial replenishment by exogenous mitochondria,we hypothesized that transplantation of mitochondria would be capable of ameliorating hippocampal damage following ***:Pilocarpine was used to induced SE in ***-generated cognitive de-cline and emotional disorders were determined using novel object recognition,the tail suspension test,and the open field ***-induced hippocampal pathology was assessed by quantifying loss of neurons and activation of microglia and *** metabolites underlying mitochondrial transplantation were determined using ***:The results showed that peripheral administration of isolated mitochon-dria could improve cognitive deficits and depressive and anxiety-like *** mitochondria blunted the production of reactive oxygen species,pro-liferation of microglia and astrocytes,and loss of neurons in the *** metabonomic profiles showed that mitochondrial transplantation altered multiple metabolic pathways such as sphingolipid signaling pathway and carbon *** potential affected metabolites,mitochondrial transplantation decreased levels of sphingolipid(d18:1/18:0)and methylmalonic acid,and elevated levels of D-fructose-1,***:To the best of our knowledge,these findings provide the first direct ex-perimental evidence that artificial mitochondrial transplantation is capable of amelio-rating hippocampal damage following *** new findings support mitochondrial transplantation as a promising therapeutic strategy for epilepsy-associated psychiat-ric and cogniti

关键词： cognitive deficit emotional disorders hippocampal damage mitochondrial transplantation status epilepticus

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Long non-coding RNA Tug 1 regulates inflammation in microglia and in status epilepticus rats through the NF-κB signaling pathway

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Acta Epileptologica 2022年第2期5卷 88-96页

作者： Ming Wang Yangmei Xie Yiye Shao Yinghui Chen Department of Neurology Huashan HospitalFudan UniversityShang-hai 200040China Department of Neurology Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai 200080China.

Background:Inflammation plays an important role in the pathogenesis of status epilepticus(SE).The long non-cod-ing RNA(lncRNA)taurine up-regulated gene1(Tug1)plays a well-defned role in inflammatory ***,the molecular mechanism of Tug1 in SE progression remains *** present study,we investigated whether Tug1 is involved in microglial inflammation in SE ***:The SE rat model was established via intraperitoneal injection of lithium chloride ***-binding protein immunoprecipitation(RIP)and RIP sequencing were carried out in rat microglia(RM).Tug1 cloned into the adenovirus was overexpressed in the *** of Tug1 was performed via siRNA *** level of Tug1 and inflammatory factors IL-1βand TNF-αwas examined by real-time polymerase chain reaction(RT-PCR)and western *** levels of p65,P-p65,p-IKBa and IkBa were assessed by western ***:The RIP-seq result showed 14 lncRNAs that bound to the NF-κB p65 protein in *** lncRNA Tug1 directly interacted with *** level of declined Tug1 was decreased in the hippocampus of SE *** ofTug1 reduced the LPS-induced inflammation and M1/M2 polarization of microglia,while knockdown of Tug1 aggravated the inflammatory response in ***,the protein levels of p-p65/p65 and p-IkBa/IkBa were reduced in the Tug1-overexpression microglia and elevated in the Tug1-knockdown ***:These findings indicate that Tug1 modulates the inflammation in microglia through the NF-κB signal pathway,and the Tug1/P65 axis are like to play a signifcant role in the inflammatory processes,providing a valid target for the therapy of SE.

关键词： Inflammation Microglia status epilepticus lncRNA NF-κB signaling pathway Tug1

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