Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Chongqing 400016, China.
Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Chongqing 400016, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing 100871, China.
Seizure. 2018 Oct;61:177-185. doi: 10.1016/j.seizure.2018.08.010. Epub 2018 Aug 12.
To summarize information on the history, incidence, clinical manifestation, best treatment, as well as prognosis of seizures in transplant recipients.
In October 2017, we searched the literature on PubMed in English with the search terms: "transplantation" AND "seizure", "transplantation" AND "epilepsy", "transplantation"AND "status epilepticus", "immunosuppressant" AND "seizure", "immunosuppressant" AND "epilepsy". Publications not based on new data and original research were not included in this article.
Seizures including generalized seizures, focal seizures and status epilepticus are a common central nervous system complication after transplantation. The incidence of seizures varied between different kinds of transplantations. The reported incidence of seizures was 7%-27% in association with solid organ transplantations and 1.6%-15.4% with hematopoietic stem cell transplantation. Most of seizures appeared in the early post-transplantation period. Patients often had a favorable prognosis, however, in some conditions, recurrent or intractable seizures may occur.
The underlying pathogenesis of new-onset seizures or epilepsy in recipients of transplantation needs to be further elucidated. In addition, more information is required from prospective studies and research focusing on therapeutic strategies.
总结移植受者癫痫发作的历史、发病率、临床表现、最佳治疗方法以及预后的信息。
2017 年 10 月，我们用英文在 PubMed 上搜索了“移植”和“癫痫发作”、“移植”和“癫痫”、“移植”和“癫痫持续状态”、“免疫抑制剂”和“癫痫发作”、“免疫抑制剂”和“癫痫”等关键词，检索了相关文献。本文未纳入无新数据和原始研究的出版物。
包括全身性癫痫发作、局灶性癫痫发作和癫痫持续状态在内的癫痫发作是移植后常见的中枢神经系统并发症。癫痫发作的发病率在不同类型的移植中有所不同。据报道，与实体器官移植相关的癫痫发作发生率为 7%-27%，与造血干细胞移植相关的癫痫发作发生率为 1.6%-15.4%。大多数癫痫发作发生在移植后早期。患者的预后通常较好，但在某些情况下，可能会出现反复发作或难治性癫痫发作。
需要进一步阐明移植受者新发癫痫发作或癫痫的潜在发病机制。此外，还需要更多来自前瞻性研究和专注于治疗策略的研究的信息。
