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Microglial contributions to aberrant neurogenesis and pathophysiology of epilepsy

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Neuroimmunology and Neuroinflammation 2020年第3期7卷 234-247页

作者： Tanya R.Victor Stella E.Tsirka Department of Pharmacological Sciences Stony Brook UniversityStony BrookNY 11794USA

Microglia are dynamic cells that constitute the brain's innate immune system.Recently,research has demonstrated microglial roles beyond immunity,which include homeostatic roles in the central nervous system.The function of microglia is an active area of study,with insights into changes in neurogenesis and synaptic pruning being discovered in both health and disease.In epilepsy,activated microglia contribute to several changes that occur during epileptogenesis.In this review,we focus on the effects of microglia on neurogenesis and synaptic pruning,and discuss the current state of anti-seizure drugs and how they affect microglia during these processes.Our understanding of the role of microglia post-seizure is still limited and may be pivotal in recognizing new therapeutic targets for seizure intervention.

关键词： Microglia epilepsy neurogenesis neuroinflammation seizures

GABA receptor γ2 subunit mutation P282S causes spontaneous seizures in transgenic zebrafish model

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解剖学杂志 2021年第S1期44卷 214-214页

作者： Zhang Qi Shen Mi Shen Yuntian Zhou Jing Wang Jie Liang Wenpeng Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education Nantong 226001

A de novo γ-aminobutyric acid type A(GABA_(A))receptor γ2 subunit P282S mutation was recently found in a patient with epileptic encephalopathy(EE).The patient's seizures remained intractable,although a slight improvement was observed with Lamotrigine(LTG)treatment.To explore the pathological mechanism of GABRG2(P282S)mutation in epilepsy and to screen some effective anti-epileptic drugs in vivo,we established a transgenic zebrafish model with human GABRG2(P282S)mutation.The transgenic zebrafish was generated by overexpressing mutant human GABRG2(P282S)subunits in neurons.

关键词： seizures epilepsy drugs

Eslicarbazepine acetate:A therapeutic agent of paramount importance in acute anticonvulsant therapy

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Journal of Acute Disease 2017年第6期6卷 245-254,253页

作者： Farah Iram Shah Alam Khan Aftab Ahmad Anees A.Siddiqui Asif Husain Department of Pharmaceutical Chemistry School of Pharmaceutical Education and ResearchJamia Hamdard(Hamdard University)New Delhi-110062India Department of Pharmacy Oman Medical CollegeMuscatSultanate of Oman Health Information Technology Department Jeddah Community CollegeKing Abdulaziz UniversityP.O.Box-80283Jeddah-21589Kingdom of Saudi Arabia

Eslicarbazepine acetate (ESL) is a new, once daily, orally administered, third generation antiepileptic drug which is indicated in the treatment of partial-onset seizures. ESL is known to exert it's anticonvulsant effect by blocking the voltage-gated sodium channels. Several clinical trials and pharmacological studies have revealed that seizure control was better with ESL monotherapy (1 200 or 1 600 mg once daily) following a switch from other antiepileptic drugs in comparison with pseudo-placebo patients. The studies have indicated the ESL to be well tolerated and produced only mild to moderate emergent adverse events with the therapy. Being a dibenzazepine family member, structure and chemistry of ESL resembles more or less to carbamazepine and oxcarbazepine. ESL differs structurally from carbamazepine and oxcarbazepine at the 10, 11 position of dibenazepine nucleus. This molecular variation results in differences in metabolism and thus helps to prevent the formation of toxic epoxide metabolites. ESL following oral administration is rapidly metabolised to active metabolite namely S-licarbazepine which is responsible for its pharmacological activity. ESL exhibits acceptable pharmacokinetic profile and shows insignificant drug-drug interactions. In phase III clinical program, ESL was found to be efficacious and well tolerated in adult patients with partial onset seizures previously not controlled with treatment with one or two other antiepileptic drugs.

关键词： Eslicarbazepine acetate Partial-onset seizures Epilepsy Antiepileptic drugs Drug interactions

Neurologic complications after liver transplantation

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World Journal of Hepatology 2013年第8期5卷 409-416页

作者： Saa A Zivkovi Neurology Service - MSL Department of Veterans Affairs Medical Center Department of Neurology University of Pittsburgh School of Medicine

Neurologic complications are relatively common after solid organ transplantation and affect 15%-30%of liver transplant recipients.Etiology is often related to immunosuppressant neurotoxicity and opportunistic infections.Most common complications include seizures and encephalopathy,and occurrence of central pontine myelinolysis is relatively specific for liver transplant recipients.Delayed allograft function may precipitate hepatic encephalopathy and neurotoxicity of calcineurin inhibitors typically manifests with tremor,headaches and encephalopathy.Reduction of neurotoxic immunosuppressants or conversion to an alternative medication usually result in clinical improvement.Standard preventive and diagnostic protocols have helped to reduce the prevalence of opportunistic central nervous system(CNS)infections,but viral and fungal CNS infections still affect 1%of liver transplant recipients,and the morbidity and mortality in the affected patients remain fairly high.Critical illness myopathy may also affect up to 7%of liver transplant recipients.Liver insufficiency is also associated with various neurologic disorders which may improve or resolve after successful liver transplantation.Accurate diagnosis and timely intervention are essential to improve outcomes,while advances in clinical management and extended post-transplant survival are increasingly shifting the focus to chronic post-transplant complications which are often encountered in a community hospital and an outpatient setting.

关键词： Liver transplantation Neurologic complications Meningoencephalitis seizures Stroke Critical illness myopathy

Use of antiepileptic drugs in children with brain tumors: A review for acute management

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Journal of Acute Disease 2018年第5期7卷 181-185页

作者： Jennifer Herrera-Bejarano Amit Agrawal Claudia Marcela Navas Valbuena Guru Dutta Satyarthee Chandramouli Balasubramanian Andrei F.Joaquim George Chater Cure Luis Rafael Moscote-Salazar Physician Universidad del RosarioBogotaColombia Professor of Neurosurgery MM Institute of Medical Sciences&ResearchMaharishi Markandesh(w)ar UniversityMullana-Ambala133-207.HaryanaIndia Physician Universidad Industrial de SantanderUISBucaramangaColombia Assistant Professor of Neurosurgery All India Institute of Medical SciencesNew DelhiIndia Department of Neurosurgery Birmingham Children's HospitalBirminghamUK Department of Neurology Neurosurgery DivisionUniversity of Campinas(UNICAMP)Campinas-SPBrazil Neurosurgeon Clinica General del NorteBarranquillaColombia Neurosurgeon-Critical Care University of CartagenaCartagena de IndiasColombia

Patients with primary or secondary tumors in the central nervous system may have seizures resulting from direct tissue damage,metabolic abnormalities,infection,or toxic side effects of medications.In pediatric patients,it is more frequent to use drugs to control secondary epilepsy.In this article,we discuss the main nuances of antiepileptic drugs for the proper management of children with central nervous system tumors.

关键词： Antiepileptic drugs Brain tumors Neuro oncology seizures

Emergency treatment of proximal femural fracture within 48h: The Umbria Region experience

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Journal of Acute Disease 2017年第5期6卷 210-213页

作者： Pellegrino Ferrara Luca Khalil El Jaouni Giuseppe Rocco Talesa Serena Parmeggiani University of Perugia PerugiaItaly

Objective: To study the main aspects of osteoporotic emergency fracture of the hip in the Umbria Region in the years 2006-2011. Methods: The study was conducted from January 1 of 2006 to December 31 of 2011, and included only patients over 49 years of age. Patients who did not habitually reside in the region were excluded. They were collected in each based on the following data: age, sex, place of residence (urban or rural), time of the year, fractured side, type of trauma, history of fracture contralateral and perioperative mortality. Results: From 2006 to 2011, a progressive increase in the number of femoral fracture admissions in regional hospitals was observed, equal to 4.73% per annum. The incidence went from 6.8 to 8.1 for 1.000 ultra-65th residents. The most affected age groups are those between 75-84 years and 85-94 years. Conclusions: The epidemiology of osteoporotic hip fracture in the Umbria Region follows a pattern similar to that of other Italian regions. The in-hospital mortality of these patients is partly determined by age and number of complications they suffer during admission. The impact of economic resources on patients who break the osteoporotic hip justifies the implementation of programs for the prevention of osteoporosis and fractures.

关键词： Eslicarbazepine acetate Partial-onset seizures Epilepsy Antiepileptic drugs Drug interactions

Febrile Convulsions in Infants at the Pediatrics University Hospital Center Charles de Gaulle of Ouagadougou (Burkina Faso)

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Open Journal of Pediatrics 2018年第2期8卷 199-206页

作者： A. Kaboré A. Diallo H. Savadogo S. A. P. Ouédraogo K. Nagalo S. Yougbaré D. Yé Service of Médical Pediatrics Charles De Gaulle Pediatric University Teaching Hospital Ouagadougou Burkina Faso

Context: seizures rank high among the commonest emergencies encountered in Pediatrics. As far as the etiologies are concerned, the most frequently confronted cause is infectious diseases. Therefore, particularly in the present work context, febrile seizures have been inadequately investigated. The study aimed at assessing the prevalence of febrile convulsions in our pediatrics department. Materials and Methods: This retrospective study was performed in the Pediatrics Medical Service Department of the Pediatrics University Hospital Charles de Gaulle of Ouagadougou in Burkina Faso (West Africa). Infants from one and thirty months of age, hospitalized between January 1, 2011 and December 31, 2012, were included in this study. seizures are defined as those who accompany fevers above or equal to 38°C. However, the exclusions from the study included those infants recognized as epileptics;those with abnormal psychomotor development;those afflicted with encephalitis and meningitis;and children with hypoglycemia or dehydration with ionic disorders, as well as those infants who lacked lumbar puncture results. Data were analyzed using the Epi Info software version 3.5.1. Results: While the average age of the patients was 13 months, the average incidence of the febrile seizures was 2.5%. The seizures occurred all through the year, peaking in October (14.1%). The peak frequency (38.7%) was recorded in children from 12 to 24 months. About one-half of the patients (46.2%) registered a temperature from 38.5°C to 39.4°C. In 68.9% of the cases, the tonic convulsions were of the common type of convulsions. The number of convulsions was in the range of >2 episodes/24 h in 83.3% of the children. The pathologies commonly associated with tonic convulsions included acute gastroenteritis (29.4%), malaria (25.8%) and bronchopneumopathies (23.3%). The evolution was favorable in 95.3% of the cases. Conclusion: While this study confirms the benign character of the febrile convulsions, their recurrent quality necessitates the codification of

关键词： Febrile seizures Infants Associated Pathologies

Neurocysticercosis (NCC) vs Central Nervous System (CNS) Tuberculoma in Children—Dilemma over Clinico-Radiological Diagnosis?

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Open Journal of Pediatrics 2016年第3期6卷 245-251页

作者： Bharat-Bhushan Sharma Shashi Sharma Department of Radio-Diagnosis SGT Medical College Gurgaon India Department of Pediatrics SGT Medical College Gurgaon India

Background: Neurocysticercosis (NCC) and central nervous system (CNS) tuberculomas often overlap in clinical presentation and imaging. Though the aetio-pathology entirely differs in both the scenarios but there is great confusion in their clinico-radiological evaluation as the findings and appearances are similar in many ways. The stress should be laid out over the salient features of each entity in the background of their presentation. The study was conducted to highlight the differentiation of the clinico-radiological findings in both the entities. Material and Methods: Ten patients between 5 - 15 years (mean age 10.4 years) with complaints of headache and with or without seizures had undergone MRI alone or with CT examinations. Basic sequences of T1W, T2W, T2W FLAIR and T1W contrast studies were carried out in all the cases. CT was carried out in only three cases and contrast was given in two cases. Results: Eight patients were having ring enhancing lesions in post contrast studies in MRI and two had only cystic lesions ranging from 1 - 3 cm in diameter. Conclusion: Seven cases having tuberculomas were confirmed by both the modalities with one case inconclusive. Two cases were diagnosed as neurocysticercosis as per the results. The reasonable achievable target was the goal to differentiate between NCC and tuberculomas in the brain and it was achieved. Contrast MRI and spectroscopy brought out many findings for the distinct features in many cases.

关键词： Neurocysticercosis Tuberculomas seizures CT MRI

Neurological Disorders

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China Medical Abstracts(Internal Medicine) 2011年第1期28卷 59-64页

14.1 Neuroanatomy, neuropathology 2011120 Meta analysis on the association betweenparental 5, 10-methylenetrahydrofolate reeducatesC677T polymorphism and the neural tube defects oftheir offspring. LIU

关键词： seizures epilepsy cortical impairment brainstem offspring rehabilitation substantia Epilepsy Neurol