上皮质激素与维加巴林结合作为西综合征的二线治疗
Luciana de Paula Souza1, Danielle Caldas Bufara2, Tallulah Spina Tensini3
1Secretaria de Estado da Saúde, Departamento de Saúde do Paraná, Curitiba PR, Brazil.
Arquivos de neuro-psiquiatria
|August 20, 2025
概括
对韦斯特综合征的初始缓解率很高,但具有显著的长期复发风险. 对于初始治疗没有反应的患者来说,这种治疗是一种可行的选择.
科学领域:
- 神经学
- 儿童神经学
- 病学
背景情况:
- 韦斯特综合征是一种严重的性脑病.
- 目前对韦斯特综合征的治疗选择有限,特别是在耐火病例中.
- 用上皮质激素和vigabatrin进行联合治疗是一种潜在的治疗策略.
研究的目的:
- 在韦斯特综合征患者中评估连续使用vigabatrin和 adrenocorticotropic激素治疗的疗效和耐受性.
- 确定临床和脑电图缓解率,不良反应和复发率.
- 评估长期结果,包括其他类型的进展.
主要方法:
- 这项前性研究涉及来自两个专科中心的39名韦斯特综合症患者 (2-120个月).
- 患者接受了肌肉内添加维加巴特林的四氧化.
- 进行了至少1年的随访,记录了缓解率,不良事件和复发率.
主要成果:
- 观察到高初始临床和脑电学缓解率:7天后为46. 1%,30天后为94. 8%,一年后为74. 1%.
- 在1年的随访中,86. 0%的患者报告了不良反应.
- 发作复发率为21. 6%,而73. 6%的患者在21个月内发展出其他类型的.
结论:
- 在韦斯特综合征中,联合维加巴林和上腺皮质激素治疗有效地实现了短期的临床和脑电学缓解.
- 这种治疗与相当大的副作用和显著的中期复发率有关.
- 这种连续治疗是对抗初始治疗的韦斯特综合征患者的可行选择.
相关概念视频
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
446
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...
446
01:28Drug Therapy
97
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
97
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
640
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...
640
01:14Antiepileptic Drugs: Glutamate Antagonists
512
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...
512
01:20Antiepileptic Drugs: Potassium Channel Activators
274
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...
274
01:24Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
847
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
847