Molaie M, Kadzielawa K
Department of Neurology, SUNY Health Science Center, Syracuse.
Epilepsia. 1989 Mar-Apr;30(2):194-200. doi: 10.1111/j.1528-1157.1989.tb05454.x.
In experimental studies, endogenous opioids have shown protective effects on seizure recurrence and facilitatory effects on postictal inhibition that were reversed by the opioid antagonist, naloxone. We evaluated the effect of all-night continuous infusion of 10 mg naloxone on the rate of focal interictal epileptiform discharges (FIEDs) during sleep in eight men with complex partial seizures (CPS) during 2 consecutive nights. Patients with abundant FIEDs during the control night showed a mean increase of 39% in the rate of FIEDs per unit of time during the naloxone infusion night. During the naloxone infusion night, mean nocturnal plasma prolactin (PRL) concentrations in this group of patients showed significant elevation, which was correlated with increased density of FIEDs. All-night infusion of naloxone failed to show any effect on the remaining three patients with minimal or no FIEDs during the control night. Mean nocturnal plasma PRL concentrations in this group of patients was significantly lower than in the former group. Our data support the notion that, in response to interictal or ictal discharges, endogenous opioid peptides may exert an inhibitory action that is reversible by administration of naloxone.
在实验研究中，内源性阿片类物质已显示出对癫痫复发的保护作用以及对发作后抑制的促进作用，而阿片类拮抗剂纳洛酮可逆转这些作用。我们评估了连续两晚对8名患有复杂部分性发作（CPS）的男性患者整夜持续输注10毫克纳洛酮对睡眠期间局灶性发作间期癫痫样放电（FIEDs）发生率的影响。在对照夜有大量FIEDs的患者在纳洛酮输注夜每单位时间的FIEDs发生率平均增加了39%。在纳洛酮输注夜，该组患者夜间血浆催乳素（PRL）平均浓度显著升高，这与FIEDs密度增加相关。对于对照夜FIEDs极少或无FIEDs的其余三名患者，整夜输注纳洛酮未显示出任何效果。该组患者夜间血浆PRL平均浓度显著低于前一组。我们的数据支持这样一种观点，即响应发作间期或发作期放电，内源性阿片肽可能发挥一种可通过给予纳洛酮逆转的抑制作用。
