Sankar Raman, Rho Jong M
David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
J Child Neurol. 2007 May;22(5 Suppl):21S-9S. doi: 10.1177/0883073807303072.
Laboratory models of prolonged seizures and status epilepticus in developing animals demonstrate age- and model-dependent propensity for brain injury. Even in models without overt brain injury, plasticity, which leads to epileptogenicity as well as to behavioral and cognitive effects, has been demonstrated. Brief, recurrent seizures in the neonatal period not only appear to exhibit plasticity that can be anatomically and physiologically meaningful but also seem to produce cognitive deficits. Translation of these findings into clinical practice is limited by the effects chronic therapy may have on brain development. There is little evidence that available treatments can effectively alter epileptogenesis. However, it is widely agreed that prolonged seizures and status epilepticus can carry negative consequences. Preventing epileptogenesis remains an important goal to modify the development of comorbidities, and it represents an area of research in need of much progress. For now, prevention of prolonged seizures with early intervention is important and is the most effective available option to minimize the potential short- and long-term adverse effects of prolonged seizures and optimize patient outcomes.
发育中动物的长时间癫痫发作和癫痫持续状态的实验室模型表明,脑损伤存在年龄和模型依赖性倾向。即使在没有明显脑损伤的模型中,也已证明可塑性会导致致痫性以及行为和认知效应。新生儿期短暂的反复癫痫发作不仅似乎表现出在解剖学和生理学上有意义的可塑性,而且似乎还会导致认知缺陷。将这些发现转化为临床实践受到长期治疗可能对脑发育产生的影响的限制。几乎没有证据表明现有治疗方法能有效改变癫痫发生。然而,人们普遍认为长时间癫痫发作和癫痫持续状态会带来负面后果。预防癫痫发生仍然是改变合并症发展的一个重要目标,并且这是一个急需取得很大进展的研究领域。目前,通过早期干预预防长时间癫痫发作很重要,并且是将长时间癫痫发作的潜在短期和长期不良影响降至最低并优化患者预后的最有效可用选择。