抗发作药物处方模式用于治疗创伤后
Matthew Pease1, Arka N Mallela2, Souvik Roy2
1Department of Neurosurgery, Indiana University, Indianapolis, IN.
Neurology. Clinical practice
|July 16, 2025
概括
较新的抗发作药物 (ASM) 在创伤后 (PTE) 中是首选药物. 早期识别药物耐药性风险因素至关重要,因为它与创伤性脑损伤 (TBI) 患者的不良结果相关.
科学领域:
- 神经科学是一个神经科学.
- 临床神经学 临床神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 创伤后 (PTE) 是严重创伤性脑损伤 (TBI) 的常见并发症,影响超过三分之一的患者.
- 关于PTE抗发作药物的初始处方模式和长期疗效的数据有限.
研究的目的:
- 在创伤后 (PTE) 患者中描述抗发作药物 (ASM) 处方模式.
- 调查PTE中耐药性的长期过程.
- 确定药物耐药性的预测因素及其与患者结果的关联.
主要方法:
- 对84名患有严重TBI和PTE的患者的前性数据库的二次分析 (发作>7天后).
- ASM被分类为较旧的 (例如,芬伊托因) 或较新的 (例如, levetiracetam).
- 评估ASM处方模式,病学转诊,格拉斯哥结局量表 (GOS) 评分,以及用于药物耐药性预测的后勤回归.
主要成果:
- 与较旧的ASM相比,较新的ASM更有可能作为单疗法维持 (OR 4.6;P=0.02).
- 只有23%的PTE患者被转介到专门的治疗,尽管54%的患者尝试了多种ASM.
- 减压性脑膜切除术 (OR 6.0) 和初始ASM多疗法 (OR 7.2) 预测了2年的药物耐药性;药物耐药性与更糟糕的GOS结果有关 (P=0.04).
结论:
- 新一代ASM被推用于治疗PTE,因为单疗更好地维持单疗.
- 早期识别药物耐药性预测因子,如解压性脑膜切除术和初始多疗法,至关重要.
- 在PTE中,抗药性与较差的长期神经结果有关.
更多相关视频
09:16Use of a Wireless Video-EEG System to Monitor Epileptiform Discharges Following Lateral Fluid-Percussion Induced Traumatic Brain Injury
Published on: June 21, 2019
25.8K
07:07Inducing Post-Traumatic Epilepsy in a Mouse Model of Repetitive Diffuse Traumatic Brain Injury
Published on: February 10, 2020
10.7K
相关概念视频
01:24Epilepsy and Seizures: Overview
285
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...
285
01:08Antiepileptic Drugs: Sodium Channel Blockers
905
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...
905
01:14Antiepileptic Drugs: Glutamate Antagonists
521
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...
521
01:17Antiepileptic Drugs: Calcium Channel Blockers
639
Calcium channel blockers, a class of antiepileptic drugs, regulate the flow of calcium ions within neurons.
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
639
01:20Antiepileptic Drugs: Potassium Channel Activators
282
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...
282
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
455
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...
455