耐药性:一种多中心的类固醇治疗案例系列
Raffaele Falsaperla1, Ausilia Desiree Collotta2, Simona D Marino3
1Paediatric and Paediatric Emergency Department, University Hospital "Policlinico-San Marco", Catania, Italy; Unit of Intensive Care and Neonatology, University Hospital "Policlinico-San Marco", Catania, Italy.
Seizure
|February 23, 2024
概括
皮质类固醇显著减少了三分之二的耐药性患者的发作频率. 这项研究表明,当常规抗发作药物失败时,类固醇是治疗的可行选择.
科学领域:
- 神经学 神经学
- 发病学 (Epileptology) 是一个专业的学科.
- 药理学 药理学是指药理学的学科.
背景情况:
- 耐药性 (DREs) 在患者管理中带来了重大挑战.
- 除了常规抗发作药物 (ASM),确定有效的治疗选择至关重要.
研究的目的:
- 评估皮质类固醇在控制DREs患者发作的疗效.
- 根据病病因,脑电图 (EEG) 图案和描述来评估类固醇反应.
- 为了比较不同的皮质类固醇治疗方案的有效性.
主要方法:
- 这是一项追溯的多中心队列研究,遵循STROBE指南.
- 数据收集包括病病因,间歇性脑电图模式,发作类型和使用的类固醇治疗方案.
- 在分析中包括30名被诊断患有DRE的患者.
主要成果:
- 62.7%的患者在6个月的皮质类固醇治疗后至少减少了50%的发作频率.
- 良好的反应与结构/损伤或免疫/感染病因以及焦点间脉脑电图异常有关.
- 甲基普雷尼索隆 (30毫克/公斤/天3天) 显示出最高的疗效,在85.7%的患者中降低了>50%的发作.
结论:
- 皮质类固醇提供了显著的治疗益处,大约三分之二的DRE患者经历了大量的发作减少.
- 类固醇应该被认为是对标准ASM耐药的儿科病例的有价值的治疗选择.
- 特定的类固醇治疗方案,如甲基prednisolone,在管理中显示出有希望的结果.
相关概念视频
01:14Antiepileptic Drugs: Glutamate Antagonists
355
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
355
01:24Arteries of the Lower Limbs
189
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
189
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
301
Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
301
01:08Antiepileptic Drugs: Sodium Channel Blockers
559
Antiepileptic drugs are specialized medications that prevent seizures in individuals diagnosed with epilepsy. These drugs primarily function by blocking the movement of sodium ions through channels in the neuronal membrane, inhibiting the repetitive firing of action potentials often associated with seizures.
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
559
01:20Antiepileptic Drugs: Potassium Channel Activators
183
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
183
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
399
γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
399