通过改变颅内压可降低癫痫发作频率：耐药性癫痫的一例病例报告
Seizure frequency can be reduced by changing intracranial pressure: A case report in drug-resistant epilepsy.
作者信息
Uchida Daiki, Fujimoto Ayataka, Yamazoe Tomohiro, Yamamoto Takamichi, Enoki Hideo
机构信息
Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka, Japan.
出版信息
Epilepsy Behav Case Rep. 2018 Jan 10;10:14-17. doi: 10.1016/j.ebcr.2017.12.005. eCollection 2018.
Abstract
A relationship between seizures and intracranial pressure (ICP) has been proposed, but not clearly identified. Whether changes in ICP can evoke seizures remains controversial. We report the case of a 23-year-old man who had undergone shunt surgery in childhood and later presented with focal impaired awareness seizures and behavior arrest. Seizures were uncontrolled despite 3 years of pharmacotherapy, but suddenly stopped after shunt removal. Our case supports the hypothesis that drug-resistant epilepsy can be influenced by changes in ICP. In particular, this case indicates that elevations in ICP may help reduce some seizures.
摘要
癫痫发作与颅内压（ICP）之间的关系已被提出，但尚未明确确定。颅内压的变化是否能引发癫痫发作仍存在争议。我们报告了一名23岁男性的病例，该患者童年时接受了分流手术，后来出现局灶性意识障碍性癫痫发作和行为停止。尽管进行了3年的药物治疗，癫痫发作仍无法控制，但在移除分流管后突然停止。我们的病例支持这样一种假设，即耐药性癫痫可能受颅内压变化的影响。特别是，该病例表明颅内压升高可能有助于减少一些癫痫发作。
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本文引用的文献
1
Pseudotumor cerebri syndrome in childhood: incidence, clinical profile and risk factors in a national prospective population-based cohort study.儿童假性脑瘤综合征：一项基于全国前瞻性人群队列研究的发病率、临床特征及危险因素
Arch Dis Child. 2017 Aug;102(8):715-721. doi: 10.1136/archdischild-2016-312238. Epub 2017 Mar 29.
2
Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology.国际抗癫痫联盟对癫痫发作类型的操作性分类：国际抗癫痫联盟分类和术语委员会立场文件
Epilepsia. 2017 Apr;58(4):522-530. doi: 10.1111/epi.13670. Epub 2017 Mar 8.
3
Changes in Rat Brain Tissue Microstructure and Stiffness during the Development of Experimental Obstructive Hydrocephalus.实验性梗阻性脑积水发展过程中大鼠脑组织微观结构和硬度的变化
PLoS One. 2016 Feb 5;11(2):e0148652. doi: 10.1371/journal.pone.0148652. eCollection 2016.
4
Possible causes of seizure after spine surgery.脊柱手术后癫痫发作的可能原因。
J Pediatr Neurosci. 2010 Jan;5(1):36-8. doi: 10.4103/1817-1745.66661.
5
Absence of electroencephalographic seizure activity in patients treated for head injury with an intracranial pressure-targeted therapy.接受颅内压靶向治疗的颅脑损伤患者脑电图癫痫活动缺失。
J Neurosurg. 2009 Feb;110(2):300-5. doi: 10.3171/2008.4.17538.
6
Rapid and severe rise in static and pulsatile intracranial pressures during a generalized epileptic seizure.
Seizure. 2008 Dec;17(8):740-3. doi: 10.1016/j.seizure.2008.05.006. Epub 2008 Jun 12.
7
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8
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Pediatr Neurosurg. 2006;42(3):165-7. doi: 10.1159/000091860.
9
Myoclonic seizure in the postanesthesia care unit after thoracic laminectomy.
Anesth Analg. 2002 Sep;95(3):777-9, table of contents. doi: 10.1097/00000539-200209000-00046.
10
The Monro-Kellie hypothesis: applications in CSF volume depletion.门罗-凯利假说：在脑脊液容量减少中的应用
Neurology. 2001 Jun 26;56(12):1746-8. doi: 10.1212/wnl.56.12.1746.
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