遗传性癫痫中的难治性癫痫持续状态——迷走神经刺激是一种选择吗？
Refractory Status Epilepticus in Genetic Epilepsy-Is Vagus Nerve Stimulation an Option?
作者信息
Specchio Nicola, Ferretti Alessandro, Pietrafusa Nicola, Trivisano Marina, Calabrese Costanza, Carfì Pavia Giusy, De Benedictis Alessandro, Marras Carlo Efisio, de Palma Luca, Vigevano Federico
机构信息
Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Member of European Reference Network EpiCARE, Rome, Italy.
Neurosurgery Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
出版信息
Front Neurol. 2020 Jun 12;11:443. doi: 10.3389/fneur.2020.00443. eCollection 2020.
Refractory and super-refractory status epilepticus (RSE, SRSE) are severe conditions that can have long-term neurological consequences with high morbidity and mortality rates. The usefulness of vagus nerve-stimulation (VNS) implantation during RSE has been documented by anecdotal cases and in systematic reviews; however, the use of VNS in RSE has not been widely adopted. We successfully implanted VNS in two patients with genetic epilepsy admitted to hospital for SRSE; detailed descriptions of the clinical findings and VNS parameters are provided. Our patients were implanted 25 and 58 days after status epilepticus (SE) onset, and a stable remission of SE was observed from the seventh and tenth day after VNS implantation, respectively, without change in anti-seizure medication. We used a fast ramp-up of stimulation without evident side effects. Our results support the consideration of VNS implantation as a safe and effective adjunctive treatment for SRSE.
难治性和超难治性癫痫持续状态（RSE，SRSE）是严重病症，可产生长期神经学后果，发病率和死亡率很高。RSE期间植入迷走神经刺激（VNS）的有效性已在个案报道和系统评价中得到证实；然而，VNS在RSE中的应用尚未得到广泛采用。我们成功地为两名因SRSE入院的遗传性癫痫患者植入了VNS；提供了临床发现和VNS参数的详细描述。我们的患者在癫痫持续状态（SE）发作后25天和58天植入VNS，分别在VNS植入后第七天和第十天观察到SE稳定缓解，抗癫痫药物无变化。我们采用了快速增加刺激的方法，且无明显副作用。我们的结果支持将VNS植入作为SRSE的一种安全有效的辅助治疗方法。
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