迷走神经刺激治疗慢波睡眠期癫痫性电持续状态
Vagus Nerve Stimulation for Electrographic Status Epilepticus in Slow-Wave Sleep.
作者信息
Carosella Christopher M, Greiner Hansel M, Byars Anna W, Arthur Todd M, Leach James L, Turner Michele, Holland Katherine D, Mangano Francesco T, Arya Ravindra
机构信息
Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
出版信息
Pediatr Neurol. 2016 Jul;60:66-70. doi: 10.1016/j.pediatrneurol.2016.02.016. Epub 2016 Mar 4.
BACKGROUND
Electrographic status epilepticus in slow sleep or continuous spike and waves during slow-wave sleep is an epileptic encephalopathy characterized by seizures, neurocognitive regression, and significant activation of epileptiform discharges during nonrapid eye movement sleep. There is no consensus on the diagnostic criteria and evidence-based optimal treatment algorithm for children with electrographic status epilepticus in slow sleep.
PATIENT DESCRIPTION
We describe a 12-year-old girl with drug-resistant electrographic status epilepticus in slow wave sleep that was successfully treated with vagus nerve stimulation. Her clinical presentation, presurgical evaluation, decision-making, and course after vagus nerve stimulator implantation are described in detail.
FINDINGS
After vagus nerve stimulator implantation, the girl remained seizure free for more than a year, resolved the electrographic status epilepticus in slow sleep pattern on electroencephalography, and exhibited significant cognitive improvement.
CONCLUSION
Vagus nerve stimulation may be considered for electrographic status epilepticus in slow sleep.
背景
慢波睡眠期的电持续状态或慢波睡眠期持续棘慢波是一种癫痫性脑病，其特征为发作、神经认知功能衰退以及非快速眼动睡眠期癫痫样放电显著激活。对于患有慢波睡眠期电持续状态的儿童，目前在诊断标准和基于证据的最佳治疗方案上尚未达成共识。
患者描述
我们报告一名12岁女孩，患有慢波睡眠期耐药性电持续状态，通过迷走神经刺激成功治愈。详细描述了她的临床表现、术前评估、决策过程以及植入迷走神经刺激器后的病程。
研究结果
植入迷走神经刺激器后，该女孩无癫痫发作超过一年，脑电图显示慢波睡眠模式下的电持续状态消失，且认知功能有显著改善。
结论
对于慢波睡眠期的电持续状态，可考虑采用迷走神经刺激治疗。
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