Jaseja Harinder
Physiology Department, G.R. Medical College, Gwalior 474001, MP, India.
Clin Neurol Neurosurg. 2008 Sep;110(8):755-62. doi: 10.1016/j.clineuro.2008.05.005. Epub 2008 Jun 24.
Cerebral palsy (CP) continues to pose a cause for major socioeconomic concern and medical challenge worldwide. It is associated with a multi-faceted symptomatology warranting a multi-dimensional management-approach. Recent recognition of neurocognitive impairment and its hopefully possible treatment has opened up a new dimension in its management to the neurologists. Vagal nerve stimulation (VNS) technique is presently emerging as an effective alternative anti-epileptic therapeutic measure in intractable epilepsy. VNS has recently been shown to possess a suppressive effect also on interictal epileptiform discharges (IEDs) that are now being widely accepted as established associates of neurocognitive impairment. In this paper, the author proposes VNS technique implantation in CP patients on account of its dual therapeutic effectiveness, i.e. anti-epileptic and IED-suppression. These two effects are likely to control seizures that are quite often drug-resistant and also improve neurocognition in CP patients, thus hoping for a better overall prognostic outcome and an improved quality of life of the CP patients by VNS.
脑瘫(CP)在全球范围内仍然是引起重大社会经济关注和医学挑战的原因。它与多方面的症状相关,需要采取多维度的管理方法。最近对神经认知障碍及其有望的可能治疗方法的认识,为神经科医生在其管理方面开辟了一个新的维度。迷走神经刺激(VNS)技术目前正在成为治疗难治性癫痫的一种有效的替代抗癫痫治疗措施。最近研究表明,VNS对发作间期癫痫样放电(IEDs)也具有抑制作用,而IEDs现在已被广泛认为是神经认知障碍的确立相关因素。在本文中,作者提议在脑瘫患者中植入VNS技术,因为它具有双重治疗效果,即抗癫痫和抑制IEDs。这两种效果可能控制常常耐药的癫痫发作,并改善脑瘫患者的神经认知,从而有望通过VNS获得更好的总体预后结果和改善脑瘫患者的生活质量。