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氨甲环酸相关性癫痫发作:病因与治疗

Tranexamic acid-associated seizures: Causes and treatment.

作者信息

Lecker Irene, Wang Dian-Shi, Whissell Paul D, Avramescu Sinziana, Mazer C David, Orser Beverley A

机构信息

Departments of Physiology, University of Toronto.

Psychology, University of Toronto.

出版信息

Ann Neurol. 2016 Jan;79(1):18-26. doi: 10.1002/ana.24558. Epub 2015 Dec 15.

Abstract

Antifibrinolytic drugs are routinely used worldwide to reduce the bleeding that results from a wide range of hemorrhagic conditions. The most commonly used antifibrinolytic drug, tranexamic acid, is associated with an increased incidence of postoperative seizures. The reported increase in the frequency of seizures is alarming, as these events are associated with adverse neurological outcomes, longer hospital stays, and increased in-hospital mortality. However, many clinicians are unaware that tranexamic acid causes seizures. The goal of this review is to summarize the incidence, risk factors, and clinical features of these seizures. This review also highlights several clinical and preclinical studies that offer mechanistic insights into the potential causes of and treatments for tranexamic acid-associated seizures. This review will aid the medical community by increasing awareness about tranexamic acid-associated seizures and by translating scientific findings into therapeutic interventions for patients.

摘要

抗纤溶药物在全球范围内被常规用于减少各种出血性疾病导致的出血。最常用的抗纤溶药物氨甲环酸与术后癫痫发作的发生率增加有关。所报道的癫痫发作频率增加令人担忧,因为这些事件与不良神经结局、更长的住院时间以及住院死亡率增加相关。然而,许多临床医生并未意识到氨甲环酸会引发癫痫。本综述的目的是总结这些癫痫发作的发生率、危险因素和临床特征。本综述还重点介绍了几项临床和临床前研究,这些研究为氨甲环酸相关癫痫发作的潜在原因和治疗提供了机制性见解。本综述将通过提高对氨甲环酸相关癫痫发作的认识,并将科学发现转化为针对患者的治疗干预措施,来帮助医学界。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f988/4738442/6497fe1cbf29/ANA-79-18-g001.jpg

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