与手术评估前更多药物试验和儿科耐药术术后结果相关的因素
Debopam Samanta1, Grace Newell2, Avery Robert Caraway3
1University of Arkansas for Medical Sciences, Little Rock.
Neurology
|October 7, 2025
概括
经过两种以上的抗发作药物 (ASM) 失败后评估进行手术的耐药性儿童的抗发作自由结果更差. 及时的外科评估对于在儿科中更好地控制发作至关重要.
科学领域:
- 儿科神经学 儿科神经学
- 手术 手术 手术
- 临床结果 临床结果
背景情况:
- 许多患有耐药的儿童在手术评估中面临延迟,接受多种抗发作药物 (ASM) 试验.
- 指南建议在两个ASM失败后进行外科评估,但在两个以上的ASM后进行评估是常见的临床情景.
研究的目的:
- 在患有的儿童中,确定与延迟外科评估相关的因素 (在超过2次ASM失败后).
- 评估延迟外科评估对自由率的影响.
主要方法:
- 在美国24个中心 (2018-2023) 进行手术评估的1,767名儿童的回顾性分析.
- 在初始评估之前,评估时间分类为 ≤2 vs >2 ASM 失败.
- 多变量后勤回归用于识别延迟评估的预测因素及其与自由的关联.
主要成果:
- 超过一半 (54.6%) 的儿童在超过2次ASM失败后开始评估.
- 预测延迟评估的因素包括遗传病因,一般性发作,每日发作,多次发作类型,正常的MRI和异常的神经学检查.
- 在≤2个ASM失败后启动评估与明显更高的自由率 (60.8%与39.3%) 有关.
结论:
- 儿科的手术评估延迟 (>2个ASM失败) 与更复杂的类型和减少发作自由度有关.
- 尽管有延迟,但绝大多数 (80%) 患者的发作减少了50%以上,这突显了手术的好处,无论时间如何.
更多相关视频
07:01Electrophoretic Delivery of γ-aminobutyric Acid GABA into Epileptic Focus Prevents Seizures in Mice
Published on: May 16, 2019
9.4K
10:02Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD
Published on: March 12, 2020
16.6K
相关概念视频
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
212
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
212
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
192
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
192
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
242
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
242
01:21Factors Affecting Drug Response: Overview
3.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
3.0K
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
252
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
252
01:24Epilepsy and Seizures: Overview
1.2K
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...
1.2K