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神经刺激用于治疗幼儿发育性和性脑病变
Guifu Geng1,2, Wandong Hu1, Yao Meng1,2
1Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, Shandong, China.
Frontiers in neurology
|November 6, 2023
概括
神经刺激 (VNS) 对耐药性发育性和性脑病变 (DEE) 有效. 患有发作 (ES) 的患者不太可能从VNS中受益,并且可能具有不良的长期结果.
科学领域:
- 神经学 神经学
- 发病学 (Epileptology) 是一个专业的学科.
- 儿科神经学 儿科神经学
背景情况:
- 发育性和性脑病变 (DEE) 在儿科管理中提出了重大挑战.
- 儿童抗药性往往需要探索超越标准抗药物的替代治疗策略.
- 神经刺激 (VNS) 是一种已知用于耐火性的神经调节技术.
研究的目的:
- 确定预测用VNS治疗DEE儿童的结果的临床变量.
- 为了确定与DEE的VNS治疗后长期不良结果相关的风险因素.
主要方法:
- 对32名患有耐药DEE的儿童进行了回顾性分析,这些儿童接受了VNS.
- 对临床,脑电图 (EEG) 和神经成像数据的评估.
- 包括费舍尔精确测试,克鲁斯卡尔-瓦利斯测试和卡普兰-梅尔生存分析在内的统计分析.
主要成果:
- 在15.6%的患者中,VNS疗法导致了无发作,在68.8%的患者中导致了反应 (>50%的发作减少).
- 轻度发育迟缓/智力障碍和多焦点EEG模式与更好的VNS反应有关.
- 发育性和性脑病与性 (ES) 是一个显著的预测者,长期结果不佳 (HR=5.433).
结论:
- 神经刺激 (VNS) 证明了作为儿科DEE辅助治疗的一般疗效.
- 发作 (ES) 的存在表明VNS治疗的预后较差.
- 需要进一步的研究来阐明VNS在DEE中的功效的预测因素.
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