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Tall gastrodis tuber combined with antiepileptic drugs repairs abnormal perfusion foci in focal epilepsy

Neural Regeneration Research 2013年第3期8卷 208-217页

作者： Weimin Wang Zhenyu Fan Yongqin Zhang Yuxia Yang Yaqing Liu Xiaoli Dang Wenjun Song Yinping Wu Jiang Ye Epilepsy Center Second HospitalLanzhou UniversityGansu Provincial Center for Prevention and Treatment of Epilepsy

One hundred patients with focal epilepsy were recruited for the present study and their seizures controlled with antiepileptic drugs. The patients then orally received a capsule of tall gastrodis tuber powder, a traditional Chinese drug, and underwent single photon emission computed tomography, long-term electroencephalogram, and CT/MRI. Blood drug levels were monitored throughout the study. Before treatment with tall gastrodis tuber, 35 of the 100 cases had abnormal CT/MRI scans; 79 cases had abnormal single photon emission computed tomography images; 86 cases had abnormal electroencephalogram; and a total of 146 abnormal perfusion foci were observed across the 100 subjects. After treatment, the number of patients with normal single photon emission computed tomography images increased by 12; normal electroencephalogram was observed in an additional 27 cases and the number of patients with epileptiform discharge decreased by 29 （34% of 86）; the total number of abnormal perfusion foci decreased by 52 （36%） and changes in abnormal loci were visible in 65 patients. These changes indicate that the administration of tall gastrodis tuber in combination with antiepileptic drugs repairs abnormal perfusion foci in patients with focal epilepsy Our results demonstrate that traditional Chinese drugs can repair abnormal perfusion foci and, as such, are a promising new pathway in the treatment of focal epilepsy.

关键词： neural regeneration traditional Chinese medicine neuroimaging brain injury tall gastrodis tuber antiepileptic drugs combination therapy focal epilepsy abnormal perfusion focus single photonemission computed tomography long-term vigilance-controlled electroencephalogram region ofinterest grant-supported paper photographs-containin^l paper: neuoreaeneration

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Short-term use of antiepileptic drugs is neurotoxic to the immature brain

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Neural Regeneration Research 2015年第4期10卷 599-604页

作者： Yu Liu Xue-ying Wang Dan Li Lin Yang Shao-ping Huang Department of Pediatrics the Second Affiliated Hospital of Xi’an Jiaotong University

Previous studies have shown that the long-term use of antiepileptic drugs can cause nervous system damage. However, short-term antiepileptic drug treatment is frequently given to in-fants, especially neonates, to control seizure. Whether the short-term use of antiepileptic drugs is neurotoxic remains unclear. In the present study, immature rats, 3–21 days of age, were intraperitoneally injected with phenobarbital and/or topiramate for 3 consecutive days. Hema-toxylin-eosin and immunohistochemical staining revealed that phenobarbital and topiramate, individually or in combination, were cytotoxic to hippocampal CA1 neurons and inhibited the expression of GluR1 and NR2B, excitatory glutamate receptor subunits. Furthermore, the com-bination of the two drugs caused greater damage than either drug alone. The results demonstrate that the short-term use of antiepileptic drugs damages neurons in the immature brain and that the combined use of antiepileptic drugs exacerbates damage. Our ifndings suggest that clinicians should consider the potential neurotoxic risk associated with the combined use of antiepileptic drugs in the treatment of seizure.

关键词： nerve regeneration seizure antiepileptic drugs immature brain hippocampus synaptic plasticity glutamate receptor NSFC grant neural regeneration

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Effect of Second-generation antiepileptic drugs on Diplopia:A Metaanalysis of Placebo-controlled Studies

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2012年第4期32卷 557-562页

作者：韩海燕渠文生康慧聪胡晓晴甄国华朱遂强薛峥 Department of Neurology Department of Internal Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and Technology

Different antiepileptic drugs(AEDs) may cause similar adverse effects,one of which is ***,the AEDs causing diplopia and the dose-response effect of each drug remains *** this study,we compared several second-generation AEDs to find out whether they would contribute to the risk of diplopia and their effect-causing dose.A meta-analysis was performed on 19 studies in agreement with our inclusion *** results showed that eight commonly used second-generation AEDs(gabapentin,levetiracetam,oxcarbazepine,lamotrigine,pregabalin,topiramate,vigabatrin and zonisamide) could cause *** reported odds ratios(ORs) ranged from 1.406 to *** risks from the highest to the lowest ORs of the eight AEDs of any dose resulted in the following order:use of oxcarbazepine(7.996),levetiracetam(7.472),lamotrigine(5.258),vigabatrin(3.562),pregabalin(3.048),topiramate(2.660),gabapentin(1.966),zonisamide(1.406).Taking into account the ORs above,we can conclude that second-generation AEDs of any dose may cause ***,the levetiracetam-caused diplopia needs to be further studied according to the data(OR,7.472;95% confidence interval,0.375-148.772).These findings ask for better concerns about patients’ quality of life when giving antiepileptic treatments.

关键词： partial seizure add-on therapy antiepileptic drugs diplopia meta-analysis

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Models for predicting treatment efficacy of antiepileptic drugs and prognosis of treatment withdrawal in epilepsy patients

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Acta Epileptologica 2021年第1期3卷 1-6页

作者： Shijun Yang Bin Wang Xiong Han Department of Neurology People’s Hospital of Zhengzhou UniversityHenan Provincial People’s HospitalZhengzhou 450003China

Although anteplleptlc drugs(AEDs)are the most effective treatment for epllepsy,30-40%of patlents with epllepsy would develop drug-efacory *** accurate,prellminary predlctlon of the efflcacy of AEDs has great clinical signflcance for patent treatment and *** studles have developed statstical models and machine-learning algorithms(MLAS)to predlct the fficacy of AEDs treatment and the progression of disease ater treatment withdrawal,In order to provlde asstance for makng cInlcal decslons In the alm of precse,personalzed treatment The fleld of predcton models with statstical models and MLAs's atracting growing Interest and's developing ***'s more,more and more studles focus on the external valldation of the exlsting model In this revlew,we will glve a brlef overvlew of recent developments In this discipline.

关键词： Prediction model Machine learning antiepileptic drugs Drug response Withdrawal reaction

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Traditional Chinese medicine in combination with antiepileptic drugs in repair of abnormal perfusion foci in patients with epilepsy

Traditional Chinese medicine in combination with antiepilept...

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2012第二届国际神经再生高峰论坛

作者： Weimin Wang Tiancheng Wang Jiang Ye Yaqing Liu Xiaoli Dang Wenjun Song Yinping Wu Zhenyu Fan Epilepsy Centre Second Hospital Lanzhou University

Interictal hypoperfusion and ictal hyperperfusion appear in patients with epilepsy. antiepileptic drugs can control seizures, but do not repair the abnormal perfusion foci. Recent studies have investigated new principles for treatment of epilepsy, including repair of the initial insult, neuroprotection, antagonism of epileptogenesis and disease modification. It was found that the epileptic focus is chronic, localized, irregular, single or multiple, sensitive, and dynamic. Four types of abnormal perfusion foci and 20 subtypes have been observed in epilepsy patients. Abnormal perfusion foci were reversible and irreversible. Patients can "survive with abnormal perfusion foci", and abnormal perfusion focus can be repaired. Dynamic observation of abnormal perfusion foci can be used as an indicator for prognosis of epilepsy, withdrawal and relapse. Temporal lobe has a significantly high incidence of abnormal perfusion focus, but the lowest repair rate. The total number of abnormal perfusion foci was reduced by 1/3-2/3 after repair. However, repair of hypoperfusion is the main target. The incidence of hyperperfusion foci in infant children was significantly higher than in adolescents or adults. Electroencephalogram analysis was inconsistent with abnormal perfusion foci. Carbamazepine and valproic acid significantly reduced the number of abnormal perfusion foci. antiepileptic drugs combined with traditional Chinese medicine can reduce brain damage and improve the control and cure rates of epilepsy, and have potential for the repair of abnormal perfusion foci in patients with epilepsy.

关键词： Chinese medicine antiepileptic drugs repair abnormal perfusion foci epilepsy

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The utilization of antiepileptic drugs on monotherapy and polytherapy for children at Shanghai in China

The utilization of antiepileptic drugs on monotherapy and po...

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第十三届江浙沪儿科学术会议暨2016年浙江省医学会儿科...

作者： Yan Wang Zhiping Li Department of Pharmacy Children’s Hospital of Fudan University

Objective:It was well known that the utilizations of antiepileptic drugs had been showed in many countries,such as Italy,Netherlands,Dutch,and so ***,those in China were rarely *** this article,the AEDs using pattern in clinic for children at Shanghai of China were ***,the application of monotherapy and polytherapy of AEDs was analyzed to assess whether drug mono-and polytherapy are rational or ***:In this research,8160 prescriptions of total 1,483,061 children aged 0-18 years in the Children’s hospital of Fudan university on the diagnosis of epilepsy were retrieved from July 2014 to October *** pattern of AEDs and the individual AED applied to monotherapy and polytherapy on using rate and dosage were ***,the utilization of valproic acid(VPA),levetiracetam(LEV) and topiramate(TPM) prescribed to different ages of children was ***:Children aged from 2 years to 11 years were the most frequency in the prescriptions with 74.07%.VPA solution,LEV tablet,Oxcarbazepine(OX) tablet and TPM were in the highest frequency used both in monotherapy and ***,proportion of older AED and newer AED on polytherapy arrived at 59.83%and 53.84%,which was higher than those of monotherapy with 18.67%and 39.63%.Furthermore,the dosage was increased from 9.50 ± 0.17 ml to 11.49 ± 0.34 ml in VPA group,from 4.79 ± 0.1 1 ml to 5.61 ± 0.19 ml in LEV group and from 59.45 ± 2.46 mg to 77.34 ± 3.06 mg in TPM with the number of medication added on polytherapy,which were significantly higher than ***:The usage of newer AED in children was all-too-frequency at Shanghai of China,while polytherapy was most commonly used in Chinese children,and certain different dose between monotherapy and polytherapy was found in VPA,LEV,and TPM.

关键词： monotherapy polytherapy antiepileptic drugs children

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Metabotropic glutamate receptors(mGluRs)in epileptogenesis:an update on abnormal mGluRs signaling and its therapeutic implications

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Neural Regeneration Research 2024年第2期19卷 360-368页

作者： Leyi Huang Wenjie Xiao Yan Wang Juan Li Jiaoe Gong Ewen Tu Lili Long Bo Xiao Xiaoxin Yan Lily Wan Department of Anatomy and Neurobiology Central South University Xiangya Medical SchoolChangshaHunan ProvinceChina Department of Neurology Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina Department of Neurology Hunan Children’s HospitalChangshaHunan ProvinceChina Department of Neurology Brain Hospital of Hunan ProvinceChangshaHunan ProvinceChina

Epilepsy is a neurological disorder characterized by high morbidity,high recurrence,and drug *** signaling through the excitatory neurotransmitter glutamate is intricately associated with *** glutamate receptors(mGluRs)are G protein-coupled receptors activated by glutamate and are key regulators of neuronal and synaptic *** mGluR signaling has been associated with various neurological disorders,and numerous studies have shown a close relationship between mGluRs expression/activity and the development of *** this review,we first introduce the three groups of mGluRs and their associated signaling ***,we detail how these receptors influence epilepsy by describing the signaling cascades triggered by their activation and their neuroprotective or detrimental roles in *** addition,strategies for pharmacological manipulation of these receptors during the treatment of epilepsy in experimental studies is also *** hope that this review will provide a foundation for future studies on the development of mGluR-targeted antiepileptic drugs.

关键词： antiepileptic drugs epileptogenesis metabotropic glutamate receptors(mGluRs) signal pathways therapeutic potentials

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Spontaneous bilateral femur neck fracture secondary to grand mal seizure:A case report

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World Journal of Clinical Cases 2022年第30期10卷 11111-11115页

作者： Eyup Senocak Department of Orthopedics and Traumatology Erzurum City HospitalErzurum 25144Turkey

BACKGROUND Spontaneous bilateral femur neck fracture is a rare entity in the general *** SUMMARY A 17-year-old immobile,developmentally delayed male with the sequelae of cerebral palsy fractured both femoral necks during a grand mal epileptic *** had been treated with valproic acid as an antiseizure medication for about 10years;otherwise,he had no history of drug *** laboratory analysis was normal except a marked vitamin D *** reduction and osteosynthesis with percutaneous cannulated screws were *** union was observed at 6 mo,and rapid postoperative rehabilitation was *** A femoral neck fracture may occur in a person with epilepsy presenting with hip pain in the emergency department.

关键词： Grand mal seizure Bilateral femur neck fracture antiepileptic drugs Immobile patient Valproic acid use Spontan fracture Case report

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Epileptic Seizures in Neonates Treated with Hypothermia for Hypoxo-Ischemic Encephalopathy in Brazzaville, Congo: Types and Evolution

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Neuroscience & Medicine 2023年第4期14卷 63-75页

作者： Josué Euberma Diatewa Dinah Happhia Boubayi Motoula-Latou Benoîte Gracia Diatewa Gabrielle Ontsira Grâce Kadidja Cléona Nkounkou-Milandou Eliot Prince Galiéni Sounga-Banzouzi Ghislain Armel Mpandzou Jean Robert Mabiala-Babela Paul Macaire Ossou-Nguiet Neurology Department University Hospital of Brazzaville Brazzaville Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of Congo Neonatology Department Blanche Gomez Mother and Child Hospital Brazzaville Republic of Congo Neonatology Department University Hospital of Brazzaville Brazzaville Republic of Congo Neurology Department Loandjili General Hospital Pointe Noire Republic of Congo

Background: Moderate to severe hypoxic-ischemic encephalopathy (HIE) in neonates is often treated with hypothermia. However, some neonates may experience epileptic seizures during therapeutic hypothermia (TH). Data on the electrophysiologic and evolutionary aspects of these seizures are scarce in African countries. Objectives: To determine the types of epileptic seizures caused by HIE in neonates in Brazzaville;to describe the evolution of background EEG activities during TH and rewarming;to report the evolution of epileptic seizures. Methods: This was a cross-sectional, descriptive study conducted from January 2020 to July 2022. It took place in Brazzaville in the Neonatology Department of the Blanche Gomez Mother and Child Hospital. It focused on term neonates suffering from moderate or severe HIE. They were treated with hypothermia combined with phenobarbital for 72 hours. Results: Among 36 neonates meeting inclusion criteria, there were 18 boys and 18 girls. Thirty-one (86.1%) neonates had grade 2 and 5 (13.9%) grade 3 HIE. In our neonates, HIE had induced isolated electrographic seizures (n = 11;30.6%), electroclinical seizures (n = 25;69.4%), and 6 types of background EEG activity. During TH and rewarming, there were 52.8% of patients with improved background EEG activity, 41.7% of patients with unchanged background EEG activity, and 5.5% of patients with worsened background EEG activity. At the end of rewarming, only 9 (25%) patients still had seizures. Conclusion: Isolated electrographic and electroclinical seizures are the only pathological entities found in our studied population. In neonates with moderate HIE, the applied therapeutic strategy positively influences the evolution of both seizures and background EEG activity. On the other hand, in neonates with severe HIE, the same therapeutic strategy is ineffective. .

关键词： Epileptic Seizures Neonate Hypoxo-Ischemic Encephalopathy Therapeutic Hypothermia antiepileptic drugs Brazzaville

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Hepatitis C virus treatment with glecaprevir and pibrentasvir in patients co-prescribed carbamazepine:Three case reports

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2023年第4期14卷 33-38页

作者： Michael Braude Dilip T Ratnam Louise Marsh Joshua H Abasszade Anouk T Dev Department of Gastroenterology and Hepatology Monash HealthClayton 3168VICAustralia General Practice Margaret River Medical CentreMargaret River 6285Australia

BACKGROUND Highly effective and well-tolerated direct-acting antiviral(DAA)therapies have revolutionised the management of hepatitis C virus(HCV);however,niche populations face treatment *** co-prescribed with several firstgeneration anti-epileptic drugs(AEDs)are contraindicated due to drug-drug interactions.A common example is carbamazepine whereby steady-state carbamazepine reduces the maximum concentration and area under the curve of velpatasvir,glecaprevir and pibrentasvir due to potent cytochrome P450(CYP)3A4 *** also induces P-glycoprotein which reduces glecaprevir and pibrentasvir’s area under curve to infinite *** and glecaprevir-pibrentasvir are contraindicated in patients who are co-prescribed carbamazepine due to the risk of reduced DAA therapeutic effect and consequently,virological treatment *** presents a challenge for patients in whom carbamazepine substitution is medically unfeasible,impractical or ***,the properties of current generation DAA therapies,including high-potency non-structural protein 5A inhibitory effect,may be sufficient to overcome reduced bioavailability arising from carbamazepine related CYP 3A4 and P-glycoprotein *** SUMMARY We present a case series of three patients with non-cirrhotic,treatment-naïve,genotype 1a,1b,and 3a HCV who were treated with a 12 wk course of glecaprevir-pibrentasvir,while co-prescribed carbamazepine for seizure ***-pibrentasvir combination therapy was chosen due to its potent in vitro activity and low barrier to pan-genotypic resistance associated *** therapy was dose-separated from carbamazepine to maximise time to peak concentration,and taken with meals to improve *** virological response at 12 wk was achieved in each patient with no adverse *** DAA therapies,including glecaprevir-pibrentasvir,warrant consideration as a therapeutic agent in people with HCV w

关键词： antiepileptic drugs Drug interactions Hepatitis C virus Sustained virological response Health care access Case repor

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