Doba N, Beresford H R, Reis D J
Brain Res. 1975 Jun 6;90(1):115-32. doi: 10.1016/0006-8993(75)90686-1.
Changes in cardiodynamics and regional blood flow were examined in chronically prepared paralyzed cats during seizures induced electrically by transcerebral or direct cortical stimulation or by administration of flurothyl ether (Indoklon) or pentylenetetrazol (Metrazol). Transcerebral and chemical stimuli produced the greatest vascular responses. During seizures there was an abrupt elevation of arterial pressure unassociated with consistent changes in heart rate. Vascular resistance was increased in femoral, renal and mesenteric arteries with variable reductions in blood flow. Resistance was decreased and flow passively increased in the common carotid artery reflecting the loss of cerebral autoregulation. Cardiac output was unchanged. With seizures associated with large elevations of arterial pressure, the central venous and left ventricular end-diastolic pressures were markedly increased indicating incipient congestive failure. The pressor response was blocked by alpha-adrenergic blockade with phentolamine. Increased regional vascular resistance was abolished by regional sympathectomy. While either adrenalectomy or treatment with 6-hydroxydopamine alone failed to abolish the pressor response, combined, they did. Such treatment unmasked an atropine-sensitive bradycardia. The pressor response with seizures is a consequence of increased vascular resistance in viscera and muscles due to widespread activation of sympathetic neurons and release of adrenomedullary catecholamines. Co-activation of cardiovagal and cardiosympathetic neurons may underlie some associated arrhythmias. Cardiovascular events may severe, by redistribution of the cardiac output, to assure increased availability of oxygen and nutrients to brain to meet the metabolic demands of convulsions.
在经慢性制备的麻痹猫中,通过经脑或直接皮层刺激、给予氟烷(Indoklon)或戊四氮(Metrazol)进行电诱导癫痫发作期间,对心脏动力学和局部血流变化进行了研究。经脑刺激和化学刺激产生了最大的血管反应。癫痫发作期间,动脉压突然升高,与心率的持续变化无关。股动脉、肾动脉和肠系膜动脉的血管阻力增加,血流有不同程度的减少。颈总动脉的阻力降低,血流被动增加,这反映了脑自动调节功能的丧失。心输出量不变。在与动脉压大幅升高相关的癫痫发作时,中心静脉压和左心室舒张末期压力明显升高,表明早期出现充血性心力衰竭。酚妥拉明的α-肾上腺素能阻断可阻断升压反应。局部交感神经切除术可消除局部血管阻力的增加。虽然单独进行肾上腺切除术或用6-羟基多巴胺治疗均未能消除升压反应,但两者联合应用则可做到。这种治疗揭示了一种对阿托品敏感的心动过缓。癫痫发作时的升压反应是由于交感神经元广泛激活和肾上腺髓质儿茶酚胺释放导致内脏和肌肉血管阻力增加的结果。心血管迷走神经和心血管交感神经神经元的共同激活可能是一些相关心律失常的基础。心血管事件可能很严重,通过心输出量的重新分布,以确保增加向大脑输送氧气和营养物质,以满足惊厥的代谢需求。