Saul R Korey Department of Neurology and Montefiore/Einstein Epilepsy Management Center, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Epilepsia. 2010 Jul;51 Suppl 3(Suppl 3):27-33. doi: 10.1111/j.1528-1167.2010.02605.x.
Infantile spasms are the classical seizure type of West syndrome. Infantile spasms often herald a dismal prognosis, due to the high probability to evolve into intractable forms of epilepsies with significant cognitive deficits, especially if not adequately treated. The current therapies-high doses of adrenocorticotropic hormone, steroids, or the gamma-aminobutyric acid (GABA) transaminase inhibitor vigabatrin--are often toxic and may not always be effective. The need to identify new therapies for spasms has led to the generation of a number of rodent models of infantile spasms. These include acute and chronic models of infantile spasms, with cryptogenic or symptomatic origin, many of which are based on specific etiologies. In this review, we summarize the clinical experience with treating infantile spasms and the main features of the new animal models of infantile spasms and discuss their utility in the preclinical development of new therapies for infantile spasms.
婴儿痉挛症是 West 综合征的典型发作类型。由于婴儿痉挛症很可能发展为治疗困难的癫痫类型,伴有明显的认知缺陷,因此预后较差,尤其是如果治疗不充分的话。目前的治疗方法——大剂量促肾上腺皮质激素、类固醇或γ-氨基丁酸(GABA)转氨酶抑制剂氨己烯酸——往往具有毒性,而且并非总是有效。为了寻找痉挛的新疗法,人们已经建立了多种幼鼠痉挛模型。这些模型包括起源于隐源性或症状性的急性和慢性婴儿痉挛模型,其中许多模型是基于特定病因的。在这篇综述中,我们总结了治疗婴儿痉挛症的临床经验以及新的婴儿痉挛动物模型的主要特征,并讨论了它们在婴儿痉挛症新疗法的临床前开发中的应用。