Amiodarone hydrochloride is a potent anti-arrhythmic agent, known as a multiple ion-channel blocker in the heart. Although it has been detected in the rat brain, there are no data related to its central nervous system...Amiodarone hydrochloride is a potent anti-arrhythmic agent, known as a multiple ion-channel blocker in the heart. Although it has been detected in the rat brain, there are no data related to its central nervous system （CNS） effects. In this study, we evaluated anticonvulsant and hypnotic effects of amiodarone. Convulsions were induced by phentylenetetrazole （PTZ） （100 mg/kg） or caffeine （300 mg/kg） in mice. In both models, amiodarone prolonged both latency period and time to death, and acted as an anticonvulsant drug. It was found to be more effective in the PTZ model than in the caffeine model; none of the animals treated with 150 mg/kg dose amiodarone had died in the PTZ model. For hypnotic effect, sleeping was induced with pentobarbital （35 mg/kg） in rats. Amiodarone dose-dependently increased the sleeping time （677.7%-725.9%）. In the sleeping test, all rats in 200 mg/kg amiodarone group died. In conclusion, anticonvulsant and hypnotic effects of amiodarone have shown the depressant effects on CNS. These effects may be dependent on its pharmacological properties.展开更多
Objective: To evaluate the anticonvulsant effect of the essential oil of Myrothamnus moschatus(M. moschatus) in convulsion induced by pentylenetetrazole and picrotoxin in rodent models.Methods: The essential oil of th...Objective: To evaluate the anticonvulsant effect of the essential oil of Myrothamnus moschatus(M. moschatus) in convulsion induced by pentylenetetrazole and picrotoxin in rodent models.Methods: The essential oil of the aerial parts of M. moschatus was extracted by steam distillation. Thereafter, it was injected subcutaneously to rats and mice at escalating doses(0.1–0.8 m L/kg). Ten minutes after drug injection, pentylenetetrazole was injected intraperitoneally to rats and picrotoxin was administered to mice by the same route.Diazepam served as the positive control. Every single animal was placed into transparent cage and observed for convulsive behavior for 30 min by using ordinary security cameras connected to a video recorder. Death occurring for a period of 24 h was also recorded.Results: The essential oil at 0.8 m L/kg completely arrested the pentylenetetrazole-induced convulsion without any sedative effect and delayed its appearance at lower doses, but showed moderate activities on picrotoxin-induced convulsion. For the rats treated with pentylenetetrazole alone, the mortality was 100% within 1 h, but for the rats pre-treated with the essential oil, the mortality was 0%. For the mice treated with picrotoxin, the mortality rate was also 100%, while 20%–100% died in those that had been pre-treated with the oil.Conclusions: The results confirmed at least partly the traditional uses of the smoke of M. moschatus for the management of convulsion, and implied that the essential oil may inhibit the convulsion by GABAergic neuromodulation.展开更多
Objective:To assess the anticonvulsant potentials of ethanolic extract of Eleusine indica.Methods:Albino Wistar mice were separated into five groups with six animals in each group and thereafter pretreated with distil...Objective:To assess the anticonvulsant potentials of ethanolic extract of Eleusine indica.Methods:Albino Wistar mice were separated into five groups with six animals in each group and thereafter pretreated with distilled water,various doses of the extract(200-600 mg/kg)and standard drug diazepam(0.5 mg/kg).Thirty minutes later,pentylenetetrazole(70 mg/kg),aminophylline(280 mg/kg)and isoniazid(250 mg/kg)were used to induce convulsions by intraperitoneal administration.These mice were then placed in plexiglas cages and monitored for the occurrence of seizures over a thirty-minute time period.The latency of convulsions,duration of tonic convulsions and mortality protection were recorded.Data obtained were analyzed using GraphPad InStat 3.10.Results:The results showed that the extract exhibited a dose-dependent increase in the latency of clonic convulsions and decrease in duration of tonic convulsions as compared to the control and these effects were statistically significant(P<0.001).The extract also provided protection against the mortality which was similar to that produced by the standard drug diazepam.Conclusions:The significant increase in the latency of clonic convulsions and decrease in duration of tonic convulsions caused by the extract show anticonvulsant activity and corroborate with the claims of the traditional use of the plant as an anticonvulsant remedy.展开更多
Human herpesvirus 6(HHV-6)is a common childhood infection but rarely causes severe complications.In immunocompetent children,conditions such as febrile convulsions and roseola infantum are typical,with occasional seve...Human herpesvirus 6(HHV-6)is a common childhood infection but rarely causes severe complications.In immunocompetent children,conditions such as febrile convulsions and roseola infantum are typical,with occasional severe manifestations like meningoencephalitis and myocarditis.展开更多
This paper introduces one case of a child with hyperpyretic convulsion treated successfully by acupuncture. It is considered that acupuncture therapy have synergistic effect with western medicine treatment during the ...This paper introduces one case of a child with hyperpyretic convulsion treated successfully by acupuncture. It is considered that acupuncture therapy have synergistic effect with western medicine treatment during the treatment of children with continuous convulsion.展开更多
BACKGROUND： Physiological convulsive thresholds degrade when the brain is in some pathologic states; thus, a level of stimulus that cannot provoke a convulsion may evoke a seizure or epileptic seizure. OBJECTIVE： To...BACKGROUND： Physiological convulsive thresholds degrade when the brain is in some pathologic states; thus, a level of stimulus that cannot provoke a convulsion may evoke a seizure or epileptic seizure. OBJECTIVE： To investigate the changes that occur in the brain when the physiological convulsive threshold becomes pathological, and to determine what differences occur in pathological and physiological convulsive thresholds during the development of epilepsy. DESIGN： A randomized controlled animal experiment. SETTING： Research Institute of Epilepsy of Shanxi Medical University; Department of Neurology, The Third Hospital of Shanxi Medical University; Research Institute of Function of Shanxi Medical University. MATERIALS： Thirty-six female Wistar rats were selected for this study. The rats were obtained from the experimental animal center of Shanxi Medical University. All laboratory procedures complied with animal ethical standards. The animals were randomly divided into three groups： a strong current group, a weak current group and a control group, with 12 rats in each group. An automatic determinator of seizure threshold was made at Shanxi Medical University and Taiyuan University of Technology. Two bipolar stainless steel stimulating electrodes and an electrode connector （diameter 1.2 ram） were made at Taiyuan University of Technology. METHODS： This study was performed in the laboratory of Research Institute of the Epilepsy of Shanxi Medical University between December 2005 and August 2006. The threshold of localized seizures was measured by performing direct cortical stimulation in rats under anesthesia. After 1 week of post-operative recovery, electric stimulation was started with three different kinds of stimulation. Seizure activity was induced by a ramp-shaped single train of biphasic pulses （50 Hz, total pulse duration of 2 ms, increasing from 0 to 2 000μ A in 15 seconds）. The threshold of localized seizures （TLS） has been defined as the minimum current intensity necessary to provoke convulsion of the forelimbs and/or facial muscles. Up to the TLS, if stimulation continued, the current intensity necessary to provoke the generalized seizures is called the threshold of generalized seizures （TGS）. If stimulation is continued for about 2 seconds when the TGS is reached, rats still showed generalized clonic activity after stimulation ceased. When seizures stopped, a short period of immobility can be observed. The current intensity is called the threshold of prolonged seizures （TPS）. The rats in the strong current group were stimulated up to the current level required to reach the TPS. In the course of stimulation, first, the TLS was recorded, then the TGS, and finally the TPS. The stimulation interval in one session was 10 minutes, repeated twice daily. The rats in the weak current group were only stimulated up to the current levels required to reach the TGS; first, the TLS was recorded and then the TGS was measured at the same time as the strong current group. Control animals were also equipped with a full electrode set and placed in the same conditions, but no stimulation took place, only electroencephalogram （EEG） recording at the same times as the experimental groups. MAIN OUTCOME MEASURES： ① Stimulation of the two experimental groups lasted for 11 weeks and then observation of their behavior and electroencephalogram recording continued for 4 weeks. The control group was also observed over a total of 15 weeks. ② Observing neuronal damage/loss in the hippocampus with a light microscope using a 250x visual field. RESULTS： All 36 Wistar rats were included in the final analysis. At the beginning of the experiment, the convulsive thresholds were all above 1 100 μA, although there were significant individual variations among rats of the same group. Those thresholds quickly declined during the initial 4 weeks of repetitive electrical stimulation. The convulsive thresholds approached a constant level in the 10^th week after commencement of stimulation. There were no significant changes in thresholds when stimulations lasted longer; the convulsive thresholds and the variations in rats of the same group were significantly lower than at the beginning of the trial （P 〈 0.01）. An interictal discharge was also recorded in the 3^rd week in the strong current group, and in the 8th week in the weak current group; these discharges were concomitant with neuronal damage and loss in the hippocampus. There was no abnormality observed in the control group. CONCLUSION： These findings indicated that the convulsion threshold in the brain should be divided into two stages： a physiological convulsive threshold and a pathological convulsive threshold （epileptic threshold） The epileptic threshold is created by pathologically acquired factors, which give rise to brain damage. The increase in the intensity of these pathologically acquired factors led to aggravation of damage.展开更多
Fructose-1,6-diphosphate is a metabolic intermediate that promotes cell metabolism. We hypothesize that fructose-1,6-diphosphate can protect against neuronal damage induced by febrile convulsions. Hot-water bathing wa...Fructose-1,6-diphosphate is a metabolic intermediate that promotes cell metabolism. We hypothesize that fructose-1,6-diphosphate can protect against neuronal damage induced by febrile convulsions. Hot-water bathing was used to establish a repetitive febrile convulsion model in rats aged 21 days, equivalent to 3–5 years in humans. Ninety minutes before each seizure induction, rats received an intraperitoneal injection of low- or high-dose fructose-1,6-diphosphate（500 or 1,000 mg/kg, respectively）. Low- and high-dose fructose-1,6-diphosphate prolonged the latency and shortened the duration of seizures. Furthermore, high-dose fructose-1,6-diphosphate effectively reduced seizure severity. Transmission electron microscopy revealed that 24 hours after the last seizure, high-dose fructose-1,6-diphosphate reduced mitochondrial swelling, rough endoplasmic reticulum degranulation, Golgi dilation and synaptic cleft size, and increased synaptic active zone length, postsynaptic density thickness, and synaptic interface curvature in the hippocampal CA1 area. The present findings suggest that fructose-1,6-diphosphate is a neuroprotectant against hippocampal neuron and synapse damage induced by repeated febrile convulsion in immature rats.展开更多
BACKGROUND Febrile convulsions are a common pediatric emergency that imposes significant psychological stress on children and their families.Targeted emergency care and psychological nursing are widely applied in clin...BACKGROUND Febrile convulsions are a common pediatric emergency that imposes significant psychological stress on children and their families.Targeted emergency care and psychological nursing are widely applied in clinical practice,but their value and impact on the management of pediatric febrile convulsions are unclear.AIM To determine the impact of targeted emergency nursing combined with psychological nursing on satisfaction in children with febrile convulsions.METHODS Data from 111 children with febrile convulsions who received treatment at Nantong Maternal and Child Health Care Hospital between June 2021 and October 2022 were analyzed.The control group consisted of 44 children who received conventional nursing care and the research group consisted of 67 children who received targeted emergency and psychological nursing.The time to fever resolution,time to resolution of convulsions,length of hospital stays,Pittsburgh Sleep Quality Index,patient compliance,nursing satisfaction of the parents,occurrence of complications during the nursing process,and parental anxiety and depression were compared between the control and research groups.Parental anxiety and depression were assessed using the Hamilton Rating Scale for Depression(HAMD)and the Hamilton Rating Scale for Anxiety(HAMA).RESULTS The fever resolution,convulsion disappearance,and hospitalization times were longer in the control group compared with the research group(P<0.0001).The time to falling asleep,sleep time,sleep quality,sleep disturbance,sleep efficiency,and daytime status scores were significantly better in the research group compared with the control group(P<0.0001).The HAMD and HAMA scores for parents of children in the research group were lower than the scores in the control group after nursing(P<0.05).Compliance with treatment of children in the research group was higher than in the control group(P<0.05).Parental satisfaction with nursing in the research group was higher than in the control group(P<0.05).The total complication rate of children in the control group was higher than in the research group(P<0.05).CONCLUSION Combining psychological nursing with targeted emergency nursing improved the satisfaction of children’s families and compliance with treatment and promoted early recovery of clinical symptoms and improvement of sleep quality.展开更多
Cat scratch's disease caused by Bartonella henselae,is known to be a self-limited benign process in immunocompetent children.The association with neurologic manifestations is very uncommon especially in patient wi...Cat scratch's disease caused by Bartonella henselae,is known to be a self-limited benign process in immunocompetent children.The association with neurologic manifestations is very uncommon especially in patient with no immunologic defects and in cases without specific treatment.A 7 years old male patient,without any immunocromised defect,presented an atypic presentation of the cat scratch disease.The patient came to the hospital in two opportunities in a status epilepticus,in both cases the diagnosis was encephalitis by Bartonella henselae and the evolution with treatment was monitored with PCR(polymerase chain reaction)in cerebrospinal fluid and blood,as well as IFI(IgM,IgG)serology(indirect immunofluorescence).The patient had a favorable clinical and laboratory evolution for 6 months showing no recurrence of the disease.展开更多
BACKGROUND： Studies on febrile convulsion （FC）-caused brain injury are disputed in many aspects. How FC cause nervous system injury in the developmental period and what are the characteristics of these pathological...BACKGROUND： Studies on febrile convulsion （FC）-caused brain injury are disputed in many aspects. How FC cause nervous system injury in the developmental period and what are the characteristics of these pathological injury are unknown. The current studies have demonstrated that berne oxygenase-1 （HO-1） exerts effects on brain injury mainly by catalyzing hemoglobin to produce degradation products, and HO-1 not only has neuroprotective effects, but also has neurotoxic effects during the FC-caused brain injury. Study on the effect of zinc protoporphyrin （ZnPP） on brain injury is still in the stage of animal experiment. OBJECTIVE： To observe the effects of ZnPP on carbon monoxide （CO）/HO-1 system of rats subjected to FC, and to analyze the action pathway of ZnPP in brain protective effect. DESIGN： A randomized controlled animal experiment. SETTING： Department of Pediatrics, First Hospital Affiliated to Jiamusi University. MATERIALS： Sixty-five Wistar rats, of either gender, were involved in this study. They were randomized into normal control group（ n =14, 37℃ water bath） and febrile treatment group （n =51, 44.5℃ hot water bath）. Febrile treatment group was sub-divided into febrile non-convulsion group （FNC group, n =16） and FC group （n =35）. FC group was further sub-divided into simple convulsion group （n =20） and ZnPP treatment group （n =15）. HO-1 mRNA in situ hybridization kit was provided by Boster Bioengineering Co.,Ltd. ZnPP（dark brown powder） was the product of Jingmei Bioengineering Company. METHODS： This study was carried out in the postgraduate laboratory of Jiamusi University between January 2004 and January 2007. Rats in the febrile treatment group were placed in the 44.5℃ hot water bath box. If rats did not convulse in the water within 5 minutes, they were taken out, namely FNC group （n = 16）, and those, which were convulsed within 5 minutes, were taken out immediately when they presented such a phenomenon, namely FC group （n =35）. Convulsion induction was conducted once every other day, totally 10 times. Rats were euthanized for analysis at 24 hours after the last induction. Rats in the control group were placed in the 37℃ water. Rats in the ZnPP treatment group were intraperitoneally injected with ZnPP at 45 μ mol/kg before FC attack. Rats in the simple convulsion group were only induced to be convulsed but not administrated. MAIN OUTCOME MEASURES： CO level in the brain tissue homogenate and plasma of rats in each group was detected with a spectrophotometer. HO-1 mRNA expression in the hippocampal CAI region, CA3 region and dentate gyrus of rats was observed by in situ hybridization technique. RESULTS： Sixty-five Wistar rats were involved in the study. Two rats died respectively due to drowning and convulsion in the FC group. One rat died due to convulsion drowning in the ZnPP treatment group. ①Plasma CO concentration of control group and ZnPP treatment group was significantly lower than that of the FC group （P 〈 0.01）, and was significantly higher in the ZnPP treatment group than in the FNC group （P 〈 0.05）. ②CO level in the brain tissue homogenate was significantly lower in the control group and ZnPP treatment group than in the FC group （P 〈 0.01）, and was very significantly higher in the ZnPP treatment group than in the control group （P 〈 0.01）. ③HO-1 mRNA expressions in the neuron of hippocampal CAl region, CA3 region and dentate gyrus of the control group were the lowerest, and those in the FC group were the highest. HO-1 mRNA expression in the neuron of dentate gyrus in the FC group was significantly higher than that in the ZnPP treatment group （P 〈 0.01）, and those in the FNC group and control group was significantly lower than that in the ZnPP treatment group （P 〈 0.01）. CONCLUSION： FC can cause brain injury. Over-expression of HO-I mRNA and the increase of CO are involved in the patho-physiological process of FC. ZnPP can inhibit HO-lmRNA activity and decrease CO level, which is one of pathways for protecting brain.展开更多
Gentianine has been shown to have a protective effect on hippocampal CA1 neurons in rats subjected to recurrent febrile convulsion（FC）.The present study sought to explore the possible mechanism of gentianine by intr...Gentianine has been shown to have a protective effect on hippocampal CA1 neurons in rats subjected to recurrent febrile convulsion（FC）.The present study sought to explore the possible mechanism of gentianine by intraperitoneally injecting gentianine into rats with warm water-induced FC.The results revealed that neuronal organelle injury was slightly ameliorated in the hippocampal CA1 region.The level of glutamate was decreased,but the level of γ-aminobutyric acid was increased,as detected by ninhydrin staining.In addition,glutamate acid decarboxylase expression in hippocampal CA1 was increased,as determined by immunohistochemistry.The results demonstrated that gentianine can ameliorate FC-induced neuronal injury by enhancing glutamate acid decarboxylase activity,decreasing glutamate levels and increasing γ-aminobutyric acid levels.展开更多
BACKGROUND： The traditional Chinese medicine acrous gramimeus is the dry rhizome of Acrous gramimeus Soland, a kind of Araceae familial perennial herb, which has a sedation action, anticonvulsant and antiepileptic ef...BACKGROUND： The traditional Chinese medicine acrous gramimeus is the dry rhizome of Acrous gramimeus Soland, a kind of Araceae familial perennial herb, which has a sedation action, anticonvulsant and antiepileptic effect. Its effective component has not been known yet, and α-asarone, the major component of the volatile oil extracted from acrous gramineus, has been supposed to play a necessary role in it. OBJECTIVE： To explore the effects of acrous gramimeu and α-asarone on the reactivity and convulsive threshold to electric stimulation in immature rats, furthermore, attempt to definitize the anticonvulsant effect of α-asarone. DESIGN： A randomized controlled study.SETTINGS： Department of Pediatrics, First Hospital of Jilin University; Department of Histology and Embryology, School of Basic Medical Sciences of Jilin University; Department of Neurology, First Clinical Hospital affiliated to Harbin Medical University; Department of Internal Medicine, Children＇s Hospital of Changchun City. MATERIALS ： Seventy 3-week immature Wistar rats （either males or females） of 34-40 g were used. Acrous gramimeu （1 g/bag, the content of α-oasarone was 0.046 26%-0.070 16%） with the batch number of 0307113 was provided by Tianjiang Medicine Company Limited, Jiangyin City. α-asarone tablet （60 mg per tablet） with the batch number of 030219 was provided by Tianwei Pharmaceutical Factory, Shenyang City. α-asarone injectable preparation （2 mL per piece） with the batch number of 030105 was provided by Shuanghe Medicine Limited Company, Beijing City. METHODS ： The experiments were carried out in the Neurological Laboratory of the First Hospital of Jilin University between August and October in 2004.① The 70 rats were randomly divided into intragastric subset and intraperitoneal subset. The intragastric subset included four groups of control, phenobarbital sodium, acrous gramimeu and α-asarone; the intraperitoneal subset included three groups of control, phenobarbital sodium and α-asarone. There were 10 rats per group. ② In the intragastric subset, different group was treated with saline （1 mL for each time, phenobarbital sodium （18 mg/kg per day）, acrous gramineu （2 350 mg/kg per day） and α-asarone （29 mg/kg per day） respectively twice every day for 5 days. In the intraperitoneal subset, different group was treated with saline （0.5 mL）, phenobarbital sodium （29 mg/kg） and α-asarone （2.9 mg/kg） respectively. ③ Before and after administration for 5 days in the intragastric subset as well as before and after administration for about 1 hour in the intraperitoneal subset respectively, the rats were given electric stimulation with the NIHOM KOMDEM multifunctional electrophysiological recorder, and the reactivity and convulsive threshold to electric stimulation of the rats were recorded. MAIN OUTCOME MEASURES： The reactivity and convulsive threshold to electric stimulation in immature rats were compared. RESULTS： All the rats were involved in the analysis of results. ① Results for intragastric administration： Before intragastric administration, there were no obvious differences in the reactivity and convulsive threshold to electric stimulation among the groups （P 〉 0.05）. After intragastric administration for 5 days, the reactivity and convulsive threshold to the electric stimulation had no obvious changes in the control group, but those were significantly higher than before administration in the drug administration groups （t=-3.317-7.401, P 〈 0.01）, which were also obviously higher than those in the control group （t=3.027-8.941, P 〈 0.01）, and those in the acrous gramimeu group and α-asarone group were not markedly different from those in the phenobarbital sodium group. ② Results for intraperitoneal injection： Before intraperitoneal injection, the reactivity and convulsive threshold to the electric stimulation had no obvious differences among the groups. After the intraperitoneal injection for 1 hour, the reactivity and convulsive threshold to the electric stimulation had no obvious change in the control group, but those were significantly higher than before administration in the drug administration groups （P 〈 0.01）, which were also obviously higher than those in the control group （t=6.211-7.237, P 〈 0.01; t=4.085-5.633, P 〈 0.05）, and there was no marked difference between α-asarone group and phenobarbital sodium group （P 〉 0.05）.CONCLUSION ： ① As effective anticonvulsants, both acrous gramineu and α-asarone can enhance the reactivity and convulsive threshold of immature rats to electric stimulation. ② As one of the major effective components against convulsion of acrous gramineu, α-asarone is equivalent to phenobarbital sodium.展开更多
Dissociative convulsions, a prominent form of dissociative (conversion) disorder formerly known as hysteria, are a common and elusive differential diagnosis from epilepsy. However, the treatment of such patients is al...Dissociative convulsions, a prominent form of dissociative (conversion) disorder formerly known as hysteria, are a common and elusive differential diagnosis from epilepsy. However, the treatment of such patients is always challenging and frustrating due to poor response to the routinely used interventions in most situations. Here, we present a case with dissociative convulsions in order to catch the eye of the clinicians and researchers on the recognition of clinical manifestation and exploration of therapeutic strategies.展开更多
The content of somatostatin(SS) in hippocampus,striatum and frontal cortex tissues of rats exposed to 600 kpa hyperbaric oxygen was determined by means of radioimmunoassay. Initial time of convulsion, severity of conv...The content of somatostatin(SS) in hippocampus,striatum and frontal cortex tissues of rats exposed to 600 kpa hyperbaric oxygen was determined by means of radioimmunoassay. Initial time of convulsion, severity of convulsion and survival time of rats with convulsion exposed to 700 kPa hyperbaric oxygen after intraperitoneal injection of cysteamine (CSH) or intracerebroventricular injection of anti-somatostatin serum(ASS) were also observed. The results showed that the content of SS in hippocampus and striatum tissues increased remarkably when rats were at near-convulsion ; by the time the rats developed convulsion,it had a significant increase in all brain areas observed. Intraperitoneal injection of CSH or intracerebroventricular injection of ASS could delay initial time of convulsion (ITC),prolong survival time (ST) and reduce severity of convulsion (SOC). These results suggest that SS might play a role in oxygen-induced convulsion and be one of the endogenous agents which caused oxygeninduced convulsion.展开更多
Background: Neonatal seizures are the most prominent feature of neurological dysfunction during neonatal period, which are abnormal electrical discharges in the central nervous system of neonates, usually manifest as ...Background: Neonatal seizures are the most prominent feature of neurological dysfunction during neonatal period, which are abnormal electrical discharges in the central nervous system of neonates, usually manifest as stereotyped muscular activity or autonomic changes, occurring in approximately 1.8 - 3.5/1000 live birth. Objective: The aims of study are to determine prevalence rate, natural history, time of onset, etiological factors, clinical types and the short term outcome of neonatal convulsion. Settings: This study conducted in Neonatal Department at Benghazi Children Hospital—Libya. Patients and Methods: Descriptive cross sectional study, included all neonates who developing clinically identifiable seizures, admitted from 1st of March 2013 to 1st of March 2014. The data collected by using a designed perform including;gender, nationality, residence, place of transfer, gestational age, time of onset, mode of delivery, and history of maternal diseases, family history of neonatal seizures in previous siblings or death, jaundice and exchange transfusion were taken. Details examination include dysmorphic features, weight, head circumference were recorded. Types of seizures were diagnosed by clinical observations, and the etiology of neonatal seizures had been identified from imaging study and from initial relevant investigations which include blood glucose levels, arterial blood gases, serum calcium, electrolytes, phosphate and cerebrospinal fluid examination for evidence of infection. In addition to treatments received, as well as causes of deaths. Results: A total of 2842 neonates were admitted to NNW, out of which 150 had seizures. 86 (57%) were male with M:F ratio of 1.3:1. (97%) were Libyan and (76%) from Benghazi, (42%) admitted directly from home. 131 (87%) were term and 15 (10%) preterm. Most of neonatal seizures (76%) were seen in the 1st week of life, and during initial 72 hours of life (63%), with 24% presented in 1st 24 hours of life. Vaginal delivery conducted in 101 (67%), C/S 49 (33%). Among babies with birth asphyxia, 76% delivered vaginally. 43/150 mothers presented with different medical problems, 32% of them had preeclampsia followed by diabetes in 28%. 127 (85%) babies had normal birth weight and 128 (86%) lie within normal range of head circumference. The most common type of seizure was subtle (48%) followed by clonic (36%). Cranial ultrasound performed to 110 (73%), among them, 16 babies MRI or CT scan were done. The most common cause of seizure was birth asphyxia (30%) followed by infection (16%), hypocalcemia (14%). Phenobarbitone was the most common drug used in treatment (60%), followed by phenytoin (40%) and resistant cases for treatment received pyridoxine (2%). 77 (52%) improved and discharged home without treatment. Mortality rate was 15%;among them 44% from IEM, followed by birth asphyxia 22%. There is strong association between main causes and the outcome with p = 0.005. Conclusion: The majority of neonates in our study were full term and male. The most common etiology of seizures is birth asphyxia. Hypocalcemia is the most common biochemical abnormality. Subtle represents the commonest type of seizure. Phenobarbitone is still the most commonly prescribed anticonvulsant. Inborn error of metabolism carries a higher mortality rate. Statically analysis showed there is significant association between main causes of neonatal convulsions and the outcome with p = 0.005.展开更多
AIM:To determine the prevalence of recent immunisation amongst children under 7 years of age presenting for febrile convulsions.METHODS:This is a retrospective study of all children under the age of seven presenting w...AIM:To determine the prevalence of recent immunisation amongst children under 7 years of age presenting for febrile convulsions.METHODS:This is a retrospective study of all children under the age of seven presenting with febrile convulsions to a tertiary referral hospital in Sydney.A total of 78 cases occurred in the period January 2011 to July 2012 and were included in the study.Data was extracted from medical records to provide a retrospective review of the convulsions.RESULTS:Of the 78 total cases,there were five medical records which contained information on whether or not immunisation had been administered in the preceding 48 h to presentation to the emergency department.Of these five patients only one patient(1.28%of the study population) was confirmed to have received a vaccination with Infanrix,Prevnar and Rotavirus.The majority of cases reported a current infection as a likely precipitant to the febrile convulsion.CONCLUSION:This study found a very low prevalence of recent immunisation amongst children with febrile convulsions presenting to an emergency department at a tertiary referral hospital in Sydney.This finding,however,may have been distorted by underreporting of vaccination history.展开更多
Spinal anesthesia involves the introduction of local anesthetics into the subarachnoid space leading to the loss of sensation of pain. Common complications following spinal anesthesia include hypotension leading to na...Spinal anesthesia involves the introduction of local anesthetics into the subarachnoid space leading to the loss of sensation of pain. Common complications following spinal anesthesia include hypotension leading to nausea and vomiting, failure of the spinal and post dural puncture. Other uncommon complications include high and total spinal and spinal haematoma. In this report the patient experienced uncontrollable jerking of the lower limbs, hypertension, arrhythmias and cardiac arrest refractory to resuscitation.展开更多
A fifty-five-year-old male patient with malignant lymphoma who took oral valproic acid (VPA) tablets and itraconazole (ITZ) capsles received 3 courses of cancer chemotherapy, including 2 courses of a combination of ri...A fifty-five-year-old male patient with malignant lymphoma who took oral valproic acid (VPA) tablets and itraconazole (ITZ) capsles received 3 courses of cancer chemotherapy, including 2 courses of a combination of rituximab/methotrexate/ifosphamide/etoposide/ carboplatin/ methylpredonisolon (R-IMVP16/CBDCA regimen) and subsequent one course of a combination of rituximab/ranimustine/citara bine/etoposide/merphalan (R-MEAM regimen). Plasma concentration of VPA dramatically decreased below the therapeutic concentration after the first and second chemotherapy and seizures appeared in both cases. Plasma concentration of ITZ was also lowered after the second chemotherapy course. At the third chemotherapy, Rikkunshi-to, a Japanese herbal medicine, was prescribed for 14 days. Plasma VPA concentration decreased, though to a lesser extent, after chemotherapy, in which the level was near the border of therapeutic concentration. No convulsion was observed. Therefore, care should be taken to monitor plasma drug concentration during cancer chemotherapy. Rikkunshi-to may be useful to alleviate the chemotherapy-induced decrease in plasma concentrations of orally administered drugs.展开更多
Hypomagnesemia with secondary hypocalcemia (HSH) is a rare inherited disorder, characterized by extremely low levels of serum magesium associated with symptomatic hypocalcemia. HSH manifests in the new born period wit...Hypomagnesemia with secondary hypocalcemia (HSH) is a rare inherited disorder, characterized by extremely low levels of serum magesium associated with symptomatic hypocalcemia. HSH manifests in the new born period with neurological symptoms, including generalized seizures, which are refractory to anticonvulsant treatment. In this disorder, the basic abnormality is the defective intestinal absorption of magnesium. Mutations in TRPM6, the gene encoding the transient receptor potential cation channel subfamily member 6 have been found to be responsible for this disease. We report on a four-month-old Tunisian girl who presented with convulsions. Laboratory evaluation yielded extremely low serum magnesium levels, low calcium levels, and abnormal PTH levels. The diagnosis of HSH was confirmed by mutation analysis which identified the novel mutation c.1307A >G in exon 11 of TRPM6 (Lys436Arg). Our patient was homozygous for this mutation. Prenatal diagnosis was done during second pregnancy. DNA from trophoblast biopsy showed the same mutation as the proband.展开更多
Background: Brain malformations (BMs) are congenital abnormalities of the shape or structure of the brain, with corpus callosum agenesis known as the most frequent. Diagnosis of most BMs can be prenatal with ultrasoun...Background: Brain malformations (BMs) are congenital abnormalities of the shape or structure of the brain, with corpus callosum agenesis known as the most frequent. Diagnosis of most BMs can be prenatal with ultrasound and fetal magnetic resonance imaging (MRI);post-natal diagnosis is based on transfontanellar ultrasound, CT-scan, and head MRI which is the imaging gold standard technique. MRI has been recently introduced and the CT-scan was previously the reference technique for the diagnosis of BMs in our context. Almost no publication has been made in sub-Saharan Africa on the clinical and CT scan characteristics of Brain malformations in children. Objective: The aim of this study was, in the absence of MRI, to describe the clinical and CT-scan presentations of brain malformations in children at the Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH). Patients and method: This was a cross-sectional descriptive study conducted from February to May 2016 at the YGOPH, including all children of 15-year-old and less with BM diagnosed on CT-scan at YGOPH between April 2006 and March 2016. The studied variables were clinical (age at diagnosis, sex, clinical manifestations) and CT findings (type of cerebral malformation). The data was analyzed using the SPSS 20.0 software with the estimation of hospital prevalence of BMs, frequencies and associations. The chi-square test was used to seek for an association between variables. The threshold of significance was p Results: The prevalence of BMs was 0.52%, with 29 cases of BMs identified out of 5590 patients followed up at the pediatric neurology outpatient unit over a period of 10 years. The mean age at diagnosis was 37.2 months (3.1 years) and the most represented age groups were 0 - 1 year (37.9%) and 1 - 5 years (37.9%). The sex ratio was 0.81 (55.2% girls). The clinical presentation was represented by neurological signs (93.1%) with convulsions (65.5%) and psychomotor retardation (58.8%) associated with skin lesions (34.5%) and/or facial dysmorphic features (27.6%). BM was suspected on antenatal ultrasound in 14.3% of cases (4/28). Abnormalities of cortical development accounted for 65.5% of BM followed by abnormalities of brain separation (31%). Tuberous sclerosis complex was the most common BM (31%) followed by agenesis of the corpus callosum (27.6%). The presence of dysmorphic facial features was associated (p = 0.007) with disorders of brain separation (DBS) while the presence of cutaneous lesions was associated (p = 0.013) with anomalies of the cortical development (ACD) especially tuberous sclerosis complex. Conclusion: BMs are infrequent, dominated by tuberous sclerosis complex and agenesis of the corpus callosum. They are mainly revealed by convulsions and psychomotor retardation. Efforts are needed to improve antenatal diagnosis and facilitate access to cerebral MRI.展开更多
文摘Amiodarone hydrochloride is a potent anti-arrhythmic agent, known as a multiple ion-channel blocker in the heart. Although it has been detected in the rat brain, there are no data related to its central nervous system （CNS） effects. In this study, we evaluated anticonvulsant and hypnotic effects of amiodarone. Convulsions were induced by phentylenetetrazole （PTZ） （100 mg/kg） or caffeine （300 mg/kg） in mice. In both models, amiodarone prolonged both latency period and time to death, and acted as an anticonvulsant drug. It was found to be more effective in the PTZ model than in the caffeine model; none of the animals treated with 150 mg/kg dose amiodarone had died in the PTZ model. For hypnotic effect, sleeping was induced with pentobarbital （35 mg/kg） in rats. Amiodarone dose-dependently increased the sleeping time （677.7%-725.9%）. In the sleeping test, all rats in 200 mg/kg amiodarone group died. In conclusion, anticonvulsant and hypnotic effects of amiodarone have shown the depressant effects on CNS. These effects may be dependent on its pharmacological properties.
基金Supported by the University Research Fund 2014/2015 of the University of Camerino under the grant number FPI000044
文摘Objective: To evaluate the anticonvulsant effect of the essential oil of Myrothamnus moschatus(M. moschatus) in convulsion induced by pentylenetetrazole and picrotoxin in rodent models.Methods: The essential oil of the aerial parts of M. moschatus was extracted by steam distillation. Thereafter, it was injected subcutaneously to rats and mice at escalating doses(0.1–0.8 m L/kg). Ten minutes after drug injection, pentylenetetrazole was injected intraperitoneally to rats and picrotoxin was administered to mice by the same route.Diazepam served as the positive control. Every single animal was placed into transparent cage and observed for convulsive behavior for 30 min by using ordinary security cameras connected to a video recorder. Death occurring for a period of 24 h was also recorded.Results: The essential oil at 0.8 m L/kg completely arrested the pentylenetetrazole-induced convulsion without any sedative effect and delayed its appearance at lower doses, but showed moderate activities on picrotoxin-induced convulsion. For the rats treated with pentylenetetrazole alone, the mortality was 100% within 1 h, but for the rats pre-treated with the essential oil, the mortality was 0%. For the mice treated with picrotoxin, the mortality rate was also 100%, while 20%–100% died in those that had been pre-treated with the oil.Conclusions: The results confirmed at least partly the traditional uses of the smoke of M. moschatus for the management of convulsion, and implied that the essential oil may inhibit the convulsion by GABAergic neuromodulation.
基金Supported by Education Trust Fund of the University of Uyo(Grant No.ETF 057).
文摘Objective:To assess the anticonvulsant potentials of ethanolic extract of Eleusine indica.Methods:Albino Wistar mice were separated into five groups with six animals in each group and thereafter pretreated with distilled water,various doses of the extract(200-600 mg/kg)and standard drug diazepam(0.5 mg/kg).Thirty minutes later,pentylenetetrazole(70 mg/kg),aminophylline(280 mg/kg)and isoniazid(250 mg/kg)were used to induce convulsions by intraperitoneal administration.These mice were then placed in plexiglas cages and monitored for the occurrence of seizures over a thirty-minute time period.The latency of convulsions,duration of tonic convulsions and mortality protection were recorded.Data obtained were analyzed using GraphPad InStat 3.10.Results:The results showed that the extract exhibited a dose-dependent increase in the latency of clonic convulsions and decrease in duration of tonic convulsions as compared to the control and these effects were statistically significant(P<0.001).The extract also provided protection against the mortality which was similar to that produced by the standard drug diazepam.Conclusions:The significant increase in the latency of clonic convulsions and decrease in duration of tonic convulsions caused by the extract show anticonvulsant activity and corroborate with the claims of the traditional use of the plant as an anticonvulsant remedy.
文摘Human herpesvirus 6(HHV-6)is a common childhood infection but rarely causes severe complications.In immunocompetent children,conditions such as febrile convulsions and roseola infantum are typical,with occasional severe manifestations like meningoencephalitis and myocarditis.
文摘This paper introduces one case of a child with hyperpyretic convulsion treated successfully by acupuncture. It is considered that acupuncture therapy have synergistic effect with western medicine treatment during the treatment of children with continuous convulsion.
文摘BACKGROUND： Physiological convulsive thresholds degrade when the brain is in some pathologic states; thus, a level of stimulus that cannot provoke a convulsion may evoke a seizure or epileptic seizure. OBJECTIVE： To investigate the changes that occur in the brain when the physiological convulsive threshold becomes pathological, and to determine what differences occur in pathological and physiological convulsive thresholds during the development of epilepsy. DESIGN： A randomized controlled animal experiment. SETTING： Research Institute of Epilepsy of Shanxi Medical University; Department of Neurology, The Third Hospital of Shanxi Medical University; Research Institute of Function of Shanxi Medical University. MATERIALS： Thirty-six female Wistar rats were selected for this study. The rats were obtained from the experimental animal center of Shanxi Medical University. All laboratory procedures complied with animal ethical standards. The animals were randomly divided into three groups： a strong current group, a weak current group and a control group, with 12 rats in each group. An automatic determinator of seizure threshold was made at Shanxi Medical University and Taiyuan University of Technology. Two bipolar stainless steel stimulating electrodes and an electrode connector （diameter 1.2 ram） were made at Taiyuan University of Technology. METHODS： This study was performed in the laboratory of Research Institute of the Epilepsy of Shanxi Medical University between December 2005 and August 2006. The threshold of localized seizures was measured by performing direct cortical stimulation in rats under anesthesia. After 1 week of post-operative recovery, electric stimulation was started with three different kinds of stimulation. Seizure activity was induced by a ramp-shaped single train of biphasic pulses （50 Hz, total pulse duration of 2 ms, increasing from 0 to 2 000μ A in 15 seconds）. The threshold of localized seizures （TLS） has been defined as the minimum current intensity necessary to provoke convulsion of the forelimbs and/or facial muscles. Up to the TLS, if stimulation continued, the current intensity necessary to provoke the generalized seizures is called the threshold of generalized seizures （TGS）. If stimulation is continued for about 2 seconds when the TGS is reached, rats still showed generalized clonic activity after stimulation ceased. When seizures stopped, a short period of immobility can be observed. The current intensity is called the threshold of prolonged seizures （TPS）. The rats in the strong current group were stimulated up to the current level required to reach the TPS. In the course of stimulation, first, the TLS was recorded, then the TGS, and finally the TPS. The stimulation interval in one session was 10 minutes, repeated twice daily. The rats in the weak current group were only stimulated up to the current levels required to reach the TGS; first, the TLS was recorded and then the TGS was measured at the same time as the strong current group. Control animals were also equipped with a full electrode set and placed in the same conditions, but no stimulation took place, only electroencephalogram （EEG） recording at the same times as the experimental groups. MAIN OUTCOME MEASURES： ① Stimulation of the two experimental groups lasted for 11 weeks and then observation of their behavior and electroencephalogram recording continued for 4 weeks. The control group was also observed over a total of 15 weeks. ② Observing neuronal damage/loss in the hippocampus with a light microscope using a 250x visual field. RESULTS： All 36 Wistar rats were included in the final analysis. At the beginning of the experiment, the convulsive thresholds were all above 1 100 μA, although there were significant individual variations among rats of the same group. Those thresholds quickly declined during the initial 4 weeks of repetitive electrical stimulation. The convulsive thresholds approached a constant level in the 10^th week after commencement of stimulation. There were no significant changes in thresholds when stimulations lasted longer; the convulsive thresholds and the variations in rats of the same group were significantly lower than at the beginning of the trial （P 〈 0.01）. An interictal discharge was also recorded in the 3^rd week in the strong current group, and in the 8th week in the weak current group; these discharges were concomitant with neuronal damage and loss in the hippocampus. There was no abnormality observed in the control group. CONCLUSION： These findings indicated that the convulsion threshold in the brain should be divided into two stages： a physiological convulsive threshold and a pathological convulsive threshold （epileptic threshold） The epileptic threshold is created by pathologically acquired factors, which give rise to brain damage. The increase in the intensity of these pathologically acquired factors led to aggravation of damage.
基金financially supported by the Medical Innovations Fund of Xi’an Jiaotong University,No.GH0203214Shaanxi Provincial People’s Hospital Incubator Fund Projects+1 种基金the National Natural Science Foundation of China,No.30901600Shaanxi Provincial Scientific and Technological Research Projects,No.2006K14-G12,2005K14-G7
文摘Fructose-1,6-diphosphate is a metabolic intermediate that promotes cell metabolism. We hypothesize that fructose-1,6-diphosphate can protect against neuronal damage induced by febrile convulsions. Hot-water bathing was used to establish a repetitive febrile convulsion model in rats aged 21 days, equivalent to 3–5 years in humans. Ninety minutes before each seizure induction, rats received an intraperitoneal injection of low- or high-dose fructose-1,6-diphosphate（500 or 1,000 mg/kg, respectively）. Low- and high-dose fructose-1,6-diphosphate prolonged the latency and shortened the duration of seizures. Furthermore, high-dose fructose-1,6-diphosphate effectively reduced seizure severity. Transmission electron microscopy revealed that 24 hours after the last seizure, high-dose fructose-1,6-diphosphate reduced mitochondrial swelling, rough endoplasmic reticulum degranulation, Golgi dilation and synaptic cleft size, and increased synaptic active zone length, postsynaptic density thickness, and synaptic interface curvature in the hippocampal CA1 area. The present findings suggest that fructose-1,6-diphosphate is a neuroprotectant against hippocampal neuron and synapse damage induced by repeated febrile convulsion in immature rats.
文摘BACKGROUND Febrile convulsions are a common pediatric emergency that imposes significant psychological stress on children and their families.Targeted emergency care and psychological nursing are widely applied in clinical practice,but their value and impact on the management of pediatric febrile convulsions are unclear.AIM To determine the impact of targeted emergency nursing combined with psychological nursing on satisfaction in children with febrile convulsions.METHODS Data from 111 children with febrile convulsions who received treatment at Nantong Maternal and Child Health Care Hospital between June 2021 and October 2022 were analyzed.The control group consisted of 44 children who received conventional nursing care and the research group consisted of 67 children who received targeted emergency and psychological nursing.The time to fever resolution,time to resolution of convulsions,length of hospital stays,Pittsburgh Sleep Quality Index,patient compliance,nursing satisfaction of the parents,occurrence of complications during the nursing process,and parental anxiety and depression were compared between the control and research groups.Parental anxiety and depression were assessed using the Hamilton Rating Scale for Depression(HAMD)and the Hamilton Rating Scale for Anxiety(HAMA).RESULTS The fever resolution,convulsion disappearance,and hospitalization times were longer in the control group compared with the research group(P<0.0001).The time to falling asleep,sleep time,sleep quality,sleep disturbance,sleep efficiency,and daytime status scores were significantly better in the research group compared with the control group(P<0.0001).The HAMD and HAMA scores for parents of children in the research group were lower than the scores in the control group after nursing(P<0.05).Compliance with treatment of children in the research group was higher than in the control group(P<0.05).Parental satisfaction with nursing in the research group was higher than in the control group(P<0.05).The total complication rate of children in the control group was higher than in the research group(P<0.05).CONCLUSION Combining psychological nursing with targeted emergency nursing improved the satisfaction of children’s families and compliance with treatment and promoted early recovery of clinical symptoms and improvement of sleep quality.
基金supported by the Programa Nacional de Innovación para la Competitividad y Productividad(Innóvate Perú)under the contract 116-PNICP-PIAP-2015
文摘Cat scratch's disease caused by Bartonella henselae,is known to be a self-limited benign process in immunocompetent children.The association with neurologic manifestations is very uncommon especially in patient with no immunologic defects and in cases without specific treatment.A 7 years old male patient,without any immunocromised defect,presented an atypic presentation of the cat scratch disease.The patient came to the hospital in two opportunities in a status epilepticus,in both cases the diagnosis was encephalitis by Bartonella henselae and the evolution with treatment was monitored with PCR(polymerase chain reaction)in cerebrospinal fluid and blood,as well as IFI(IgM,IgG)serology(indirect immunofluorescence).The patient had a favorable clinical and laboratory evolution for 6 months showing no recurrence of the disease.
基金Key Program of Science and Technology Research of Heilongjiang Province in 2006, No.11511400
文摘BACKGROUND： Studies on febrile convulsion （FC）-caused brain injury are disputed in many aspects. How FC cause nervous system injury in the developmental period and what are the characteristics of these pathological injury are unknown. The current studies have demonstrated that berne oxygenase-1 （HO-1） exerts effects on brain injury mainly by catalyzing hemoglobin to produce degradation products, and HO-1 not only has neuroprotective effects, but also has neurotoxic effects during the FC-caused brain injury. Study on the effect of zinc protoporphyrin （ZnPP） on brain injury is still in the stage of animal experiment. OBJECTIVE： To observe the effects of ZnPP on carbon monoxide （CO）/HO-1 system of rats subjected to FC, and to analyze the action pathway of ZnPP in brain protective effect. DESIGN： A randomized controlled animal experiment. SETTING： Department of Pediatrics, First Hospital Affiliated to Jiamusi University. MATERIALS： Sixty-five Wistar rats, of either gender, were involved in this study. They were randomized into normal control group（ n =14, 37℃ water bath） and febrile treatment group （n =51, 44.5℃ hot water bath）. Febrile treatment group was sub-divided into febrile non-convulsion group （FNC group, n =16） and FC group （n =35）. FC group was further sub-divided into simple convulsion group （n =20） and ZnPP treatment group （n =15）. HO-1 mRNA in situ hybridization kit was provided by Boster Bioengineering Co.,Ltd. ZnPP（dark brown powder） was the product of Jingmei Bioengineering Company. METHODS： This study was carried out in the postgraduate laboratory of Jiamusi University between January 2004 and January 2007. Rats in the febrile treatment group were placed in the 44.5℃ hot water bath box. If rats did not convulse in the water within 5 minutes, they were taken out, namely FNC group （n = 16）, and those, which were convulsed within 5 minutes, were taken out immediately when they presented such a phenomenon, namely FC group （n =35）. Convulsion induction was conducted once every other day, totally 10 times. Rats were euthanized for analysis at 24 hours after the last induction. Rats in the control group were placed in the 37℃ water. Rats in the ZnPP treatment group were intraperitoneally injected with ZnPP at 45 μ mol/kg before FC attack. Rats in the simple convulsion group were only induced to be convulsed but not administrated. MAIN OUTCOME MEASURES： CO level in the brain tissue homogenate and plasma of rats in each group was detected with a spectrophotometer. HO-1 mRNA expression in the hippocampal CAI region, CA3 region and dentate gyrus of rats was observed by in situ hybridization technique. RESULTS： Sixty-five Wistar rats were involved in the study. Two rats died respectively due to drowning and convulsion in the FC group. One rat died due to convulsion drowning in the ZnPP treatment group. ①Plasma CO concentration of control group and ZnPP treatment group was significantly lower than that of the FC group （P 〈 0.01）, and was significantly higher in the ZnPP treatment group than in the FNC group （P 〈 0.05）. ②CO level in the brain tissue homogenate was significantly lower in the control group and ZnPP treatment group than in the FC group （P 〈 0.01）, and was very significantly higher in the ZnPP treatment group than in the control group （P 〈 0.01）. ③HO-1 mRNA expressions in the neuron of hippocampal CAl region, CA3 region and dentate gyrus of the control group were the lowerest, and those in the FC group were the highest. HO-1 mRNA expression in the neuron of dentate gyrus in the FC group was significantly higher than that in the ZnPP treatment group （P 〈 0.01）, and those in the FNC group and control group was significantly lower than that in the ZnPP treatment group （P 〈 0.01）. CONCLUSION： FC can cause brain injury. Over-expression of HO-I mRNA and the increase of CO are involved in the patho-physiological process of FC. ZnPP can inhibit HO-lmRNA activity and decrease CO level, which is one of pathways for protecting brain.
基金the Key Project of Technology of Ministry of Education, No. 2007029
文摘Gentianine has been shown to have a protective effect on hippocampal CA1 neurons in rats subjected to recurrent febrile convulsion（FC）.The present study sought to explore the possible mechanism of gentianine by intraperitoneally injecting gentianine into rats with warm water-induced FC.The results revealed that neuronal organelle injury was slightly ameliorated in the hippocampal CA1 region.The level of glutamate was decreased,but the level of γ-aminobutyric acid was increased,as detected by ninhydrin staining.In addition,glutamate acid decarboxylase expression in hippocampal CA1 was increased,as determined by immunohistochemistry.The results demonstrated that gentianine can ameliorate FC-induced neuronal injury by enhancing glutamate acid decarboxylase activity,decreasing glutamate levels and increasing γ-aminobutyric acid levels.
基金grants from Changchun Bureau of Science and Technology, No. 20030430 Traditional Chinese Medicine and Drug Administration of Jilin Province, No. 2004079
文摘BACKGROUND： The traditional Chinese medicine acrous gramimeus is the dry rhizome of Acrous gramimeus Soland, a kind of Araceae familial perennial herb, which has a sedation action, anticonvulsant and antiepileptic effect. Its effective component has not been known yet, and α-asarone, the major component of the volatile oil extracted from acrous gramineus, has been supposed to play a necessary role in it. OBJECTIVE： To explore the effects of acrous gramimeu and α-asarone on the reactivity and convulsive threshold to electric stimulation in immature rats, furthermore, attempt to definitize the anticonvulsant effect of α-asarone. DESIGN： A randomized controlled study.SETTINGS： Department of Pediatrics, First Hospital of Jilin University; Department of Histology and Embryology, School of Basic Medical Sciences of Jilin University; Department of Neurology, First Clinical Hospital affiliated to Harbin Medical University; Department of Internal Medicine, Children＇s Hospital of Changchun City. MATERIALS ： Seventy 3-week immature Wistar rats （either males or females） of 34-40 g were used. Acrous gramimeu （1 g/bag, the content of α-oasarone was 0.046 26%-0.070 16%） with the batch number of 0307113 was provided by Tianjiang Medicine Company Limited, Jiangyin City. α-asarone tablet （60 mg per tablet） with the batch number of 030219 was provided by Tianwei Pharmaceutical Factory, Shenyang City. α-asarone injectable preparation （2 mL per piece） with the batch number of 030105 was provided by Shuanghe Medicine Limited Company, Beijing City. METHODS ： The experiments were carried out in the Neurological Laboratory of the First Hospital of Jilin University between August and October in 2004.① The 70 rats were randomly divided into intragastric subset and intraperitoneal subset. The intragastric subset included four groups of control, phenobarbital sodium, acrous gramimeu and α-asarone; the intraperitoneal subset included three groups of control, phenobarbital sodium and α-asarone. There were 10 rats per group. ② In the intragastric subset, different group was treated with saline （1 mL for each time, phenobarbital sodium （18 mg/kg per day）, acrous gramineu （2 350 mg/kg per day） and α-asarone （29 mg/kg per day） respectively twice every day for 5 days. In the intraperitoneal subset, different group was treated with saline （0.5 mL）, phenobarbital sodium （29 mg/kg） and α-asarone （2.9 mg/kg） respectively. ③ Before and after administration for 5 days in the intragastric subset as well as before and after administration for about 1 hour in the intraperitoneal subset respectively, the rats were given electric stimulation with the NIHOM KOMDEM multifunctional electrophysiological recorder, and the reactivity and convulsive threshold to electric stimulation of the rats were recorded. MAIN OUTCOME MEASURES： The reactivity and convulsive threshold to electric stimulation in immature rats were compared. RESULTS： All the rats were involved in the analysis of results. ① Results for intragastric administration： Before intragastric administration, there were no obvious differences in the reactivity and convulsive threshold to electric stimulation among the groups （P 〉 0.05）. After intragastric administration for 5 days, the reactivity and convulsive threshold to the electric stimulation had no obvious changes in the control group, but those were significantly higher than before administration in the drug administration groups （t=-3.317-7.401, P 〈 0.01）, which were also obviously higher than those in the control group （t=3.027-8.941, P 〈 0.01）, and those in the acrous gramimeu group and α-asarone group were not markedly different from those in the phenobarbital sodium group. ② Results for intraperitoneal injection： Before intraperitoneal injection, the reactivity and convulsive threshold to the electric stimulation had no obvious differences among the groups. After the intraperitoneal injection for 1 hour, the reactivity and convulsive threshold to the electric stimulation had no obvious change in the control group, but those were significantly higher than before administration in the drug administration groups （P 〈 0.01）, which were also obviously higher than those in the control group （t=6.211-7.237, P 〈 0.01; t=4.085-5.633, P 〈 0.05）, and there was no marked difference between α-asarone group and phenobarbital sodium group （P 〉 0.05）.CONCLUSION ： ① As effective anticonvulsants, both acrous gramineu and α-asarone can enhance the reactivity and convulsive threshold of immature rats to electric stimulation. ② As one of the major effective components against convulsion of acrous gramineu, α-asarone is equivalent to phenobarbital sodium.
文摘Dissociative convulsions, a prominent form of dissociative (conversion) disorder formerly known as hysteria, are a common and elusive differential diagnosis from epilepsy. However, the treatment of such patients is always challenging and frustrating due to poor response to the routinely used interventions in most situations. Here, we present a case with dissociative convulsions in order to catch the eye of the clinicians and researchers on the recognition of clinical manifestation and exploration of therapeutic strategies.
文摘The content of somatostatin(SS) in hippocampus,striatum and frontal cortex tissues of rats exposed to 600 kpa hyperbaric oxygen was determined by means of radioimmunoassay. Initial time of convulsion, severity of convulsion and survival time of rats with convulsion exposed to 700 kPa hyperbaric oxygen after intraperitoneal injection of cysteamine (CSH) or intracerebroventricular injection of anti-somatostatin serum(ASS) were also observed. The results showed that the content of SS in hippocampus and striatum tissues increased remarkably when rats were at near-convulsion ; by the time the rats developed convulsion,it had a significant increase in all brain areas observed. Intraperitoneal injection of CSH or intracerebroventricular injection of ASS could delay initial time of convulsion (ITC),prolong survival time (ST) and reduce severity of convulsion (SOC). These results suggest that SS might play a role in oxygen-induced convulsion and be one of the endogenous agents which caused oxygeninduced convulsion.
文摘Background: Neonatal seizures are the most prominent feature of neurological dysfunction during neonatal period, which are abnormal electrical discharges in the central nervous system of neonates, usually manifest as stereotyped muscular activity or autonomic changes, occurring in approximately 1.8 - 3.5/1000 live birth. Objective: The aims of study are to determine prevalence rate, natural history, time of onset, etiological factors, clinical types and the short term outcome of neonatal convulsion. Settings: This study conducted in Neonatal Department at Benghazi Children Hospital—Libya. Patients and Methods: Descriptive cross sectional study, included all neonates who developing clinically identifiable seizures, admitted from 1st of March 2013 to 1st of March 2014. The data collected by using a designed perform including;gender, nationality, residence, place of transfer, gestational age, time of onset, mode of delivery, and history of maternal diseases, family history of neonatal seizures in previous siblings or death, jaundice and exchange transfusion were taken. Details examination include dysmorphic features, weight, head circumference were recorded. Types of seizures were diagnosed by clinical observations, and the etiology of neonatal seizures had been identified from imaging study and from initial relevant investigations which include blood glucose levels, arterial blood gases, serum calcium, electrolytes, phosphate and cerebrospinal fluid examination for evidence of infection. In addition to treatments received, as well as causes of deaths. Results: A total of 2842 neonates were admitted to NNW, out of which 150 had seizures. 86 (57%) were male with M:F ratio of 1.3:1. (97%) were Libyan and (76%) from Benghazi, (42%) admitted directly from home. 131 (87%) were term and 15 (10%) preterm. Most of neonatal seizures (76%) were seen in the 1st week of life, and during initial 72 hours of life (63%), with 24% presented in 1st 24 hours of life. Vaginal delivery conducted in 101 (67%), C/S 49 (33%). Among babies with birth asphyxia, 76% delivered vaginally. 43/150 mothers presented with different medical problems, 32% of them had preeclampsia followed by diabetes in 28%. 127 (85%) babies had normal birth weight and 128 (86%) lie within normal range of head circumference. The most common type of seizure was subtle (48%) followed by clonic (36%). Cranial ultrasound performed to 110 (73%), among them, 16 babies MRI or CT scan were done. The most common cause of seizure was birth asphyxia (30%) followed by infection (16%), hypocalcemia (14%). Phenobarbitone was the most common drug used in treatment (60%), followed by phenytoin (40%) and resistant cases for treatment received pyridoxine (2%). 77 (52%) improved and discharged home without treatment. Mortality rate was 15%;among them 44% from IEM, followed by birth asphyxia 22%. There is strong association between main causes and the outcome with p = 0.005. Conclusion: The majority of neonates in our study were full term and male. The most common etiology of seizures is birth asphyxia. Hypocalcemia is the most common biochemical abnormality. Subtle represents the commonest type of seizure. Phenobarbitone is still the most commonly prescribed anticonvulsant. Inborn error of metabolism carries a higher mortality rate. Statically analysis showed there is significant association between main causes of neonatal convulsions and the outcome with p = 0.005.
文摘AIM:To determine the prevalence of recent immunisation amongst children under 7 years of age presenting for febrile convulsions.METHODS:This is a retrospective study of all children under the age of seven presenting with febrile convulsions to a tertiary referral hospital in Sydney.A total of 78 cases occurred in the period January 2011 to July 2012 and were included in the study.Data was extracted from medical records to provide a retrospective review of the convulsions.RESULTS:Of the 78 total cases,there were five medical records which contained information on whether or not immunisation had been administered in the preceding 48 h to presentation to the emergency department.Of these five patients only one patient(1.28%of the study population) was confirmed to have received a vaccination with Infanrix,Prevnar and Rotavirus.The majority of cases reported a current infection as a likely precipitant to the febrile convulsion.CONCLUSION:This study found a very low prevalence of recent immunisation amongst children with febrile convulsions presenting to an emergency department at a tertiary referral hospital in Sydney.This finding,however,may have been distorted by underreporting of vaccination history.
文摘Spinal anesthesia involves the introduction of local anesthetics into the subarachnoid space leading to the loss of sensation of pain. Common complications following spinal anesthesia include hypotension leading to nausea and vomiting, failure of the spinal and post dural puncture. Other uncommon complications include high and total spinal and spinal haematoma. In this report the patient experienced uncontrollable jerking of the lower limbs, hypertension, arrhythmias and cardiac arrest refractory to resuscitation.
文摘A fifty-five-year-old male patient with malignant lymphoma who took oral valproic acid (VPA) tablets and itraconazole (ITZ) capsles received 3 courses of cancer chemotherapy, including 2 courses of a combination of rituximab/methotrexate/ifosphamide/etoposide/ carboplatin/ methylpredonisolon (R-IMVP16/CBDCA regimen) and subsequent one course of a combination of rituximab/ranimustine/citara bine/etoposide/merphalan (R-MEAM regimen). Plasma concentration of VPA dramatically decreased below the therapeutic concentration after the first and second chemotherapy and seizures appeared in both cases. Plasma concentration of ITZ was also lowered after the second chemotherapy course. At the third chemotherapy, Rikkunshi-to, a Japanese herbal medicine, was prescribed for 14 days. Plasma VPA concentration decreased, though to a lesser extent, after chemotherapy, in which the level was near the border of therapeutic concentration. No convulsion was observed. Therefore, care should be taken to monitor plasma drug concentration during cancer chemotherapy. Rikkunshi-to may be useful to alleviate the chemotherapy-induced decrease in plasma concentrations of orally administered drugs.
文摘Hypomagnesemia with secondary hypocalcemia (HSH) is a rare inherited disorder, characterized by extremely low levels of serum magesium associated with symptomatic hypocalcemia. HSH manifests in the new born period with neurological symptoms, including generalized seizures, which are refractory to anticonvulsant treatment. In this disorder, the basic abnormality is the defective intestinal absorption of magnesium. Mutations in TRPM6, the gene encoding the transient receptor potential cation channel subfamily member 6 have been found to be responsible for this disease. We report on a four-month-old Tunisian girl who presented with convulsions. Laboratory evaluation yielded extremely low serum magnesium levels, low calcium levels, and abnormal PTH levels. The diagnosis of HSH was confirmed by mutation analysis which identified the novel mutation c.1307A >G in exon 11 of TRPM6 (Lys436Arg). Our patient was homozygous for this mutation. Prenatal diagnosis was done during second pregnancy. DNA from trophoblast biopsy showed the same mutation as the proband.
文摘Background: Brain malformations (BMs) are congenital abnormalities of the shape or structure of the brain, with corpus callosum agenesis known as the most frequent. Diagnosis of most BMs can be prenatal with ultrasound and fetal magnetic resonance imaging (MRI);post-natal diagnosis is based on transfontanellar ultrasound, CT-scan, and head MRI which is the imaging gold standard technique. MRI has been recently introduced and the CT-scan was previously the reference technique for the diagnosis of BMs in our context. Almost no publication has been made in sub-Saharan Africa on the clinical and CT scan characteristics of Brain malformations in children. Objective: The aim of this study was, in the absence of MRI, to describe the clinical and CT-scan presentations of brain malformations in children at the Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH). Patients and method: This was a cross-sectional descriptive study conducted from February to May 2016 at the YGOPH, including all children of 15-year-old and less with BM diagnosed on CT-scan at YGOPH between April 2006 and March 2016. The studied variables were clinical (age at diagnosis, sex, clinical manifestations) and CT findings (type of cerebral malformation). The data was analyzed using the SPSS 20.0 software with the estimation of hospital prevalence of BMs, frequencies and associations. The chi-square test was used to seek for an association between variables. The threshold of significance was p Results: The prevalence of BMs was 0.52%, with 29 cases of BMs identified out of 5590 patients followed up at the pediatric neurology outpatient unit over a period of 10 years. The mean age at diagnosis was 37.2 months (3.1 years) and the most represented age groups were 0 - 1 year (37.9%) and 1 - 5 years (37.9%). The sex ratio was 0.81 (55.2% girls). The clinical presentation was represented by neurological signs (93.1%) with convulsions (65.5%) and psychomotor retardation (58.8%) associated with skin lesions (34.5%) and/or facial dysmorphic features (27.6%). BM was suspected on antenatal ultrasound in 14.3% of cases (4/28). Abnormalities of cortical development accounted for 65.5% of BM followed by abnormalities of brain separation (31%). Tuberous sclerosis complex was the most common BM (31%) followed by agenesis of the corpus callosum (27.6%). The presence of dysmorphic facial features was associated (p = 0.007) with disorders of brain separation (DBS) while the presence of cutaneous lesions was associated (p = 0.013) with anomalies of the cortical development (ACD) especially tuberous sclerosis complex. Conclusion: BMs are infrequent, dominated by tuberous sclerosis complex and agenesis of the corpus callosum. They are mainly revealed by convulsions and psychomotor retardation. Efforts are needed to improve antenatal diagnosis and facilitate access to cerebral MRI.
