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“持续性”海马刺激诱发的自主持续性边缘叶癫痫持续状态:脑电图及行为学特征

Self-sustaining limbic status epilepticus induced by 'continuous' hippocampal stimulation: electrographic and behavioral characteristics.

作者信息

Lothman E W, Bertram E H, Bekenstein J W, Perlin J B

机构信息

Department of Neurology, University of Virginia School of Medicine, Charlottesville 22908.

出版信息

Epilepsy Res. 1989 Mar-Apr;3(2):107-19. doi: 10.1016/0920-1211(89)90038-7.

Abstract

A model of status epilepticus centered in the limbic system and elicited by 'continuous' focal electrical stimulation of the hippocampus is presented. Under appropriate conditions, the status epilepticus persisted for many hours after discontinuing the electrical stimulus. The critical determinant for the establishment of this self-sustaining limbic status epilepticus (SSLSE) was the length of stimulation, rather than the side (left vs. right) of stimulation or kindling before stimulation. Observations, obtained from stimulus-free intervals spaced regularly during the stimulus protocol and from the period after stimulation had been completed, revealed a distinct and stereotyped electrographic progression of SSLSE though several stages. Brief monitoring periods throughout the stimulus protocol yielded electrographic criteria that predicted which animals would experience experience SSLSE. The presence of synchronous, stimulus-independent seizure activity bilaterally in the hippocampi during stimulation was necessary to establish SSLSE. Intense motor seizure activity, like that seen with kindled motor seizures, occurred intermittently during SSLSE. However, 'limbic' behavioral seizures identical to those seen after low doses of kainic acid or during the early stages of kindling were nearly continuous. These studies indicate that there is a predictable course to limbic status epilepticus and point to the hippocampus as a key element involved in initiating and maintaining this syndrome.

摘要

本文介绍了一种以边缘系统为中心、由海马体“持续”局灶性电刺激诱发的癫痫持续状态模型。在适当条件下,电刺激停止后癫痫持续状态会持续数小时。建立这种自我维持的边缘性癫痫持续状态(SSLSE)的关键决定因素是刺激的时长,而非刺激的侧别(左侧 vs 右侧)或刺激前的点燃情况。在刺激方案期间定期安排的无刺激间隔期以及刺激完成后的时间段所进行的观察显示,SSLSE 会经历几个阶段,呈现出独特且刻板的脑电图进展。在整个刺激方案期间进行的简短监测期得出了脑电图标准,可预测哪些动物会出现 SSLSE。刺激期间双侧海马体中出现同步、与刺激无关的癫痫发作活动是建立 SSLSE 的必要条件。在 SSLSE 期间,会间歇性出现强烈的运动性癫痫发作活动,类似于点燃性运动性癫痫发作时所见。然而,与低剂量 kainic 酸后或点燃早期所见相同的“边缘性”行为性癫痫发作几乎持续存在。这些研究表明,边缘性癫痫持续状态有可预测的病程,并指出海马体是引发和维持该综合征的关键因素。

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