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儿童癫痫发作与褪黑素的关系。

The relationship between epileptic seizure and melatonin in children.

机构信息

Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey.

Okmeydanı Training and Research Hospital, Department of Pediatric Neurology, Istanbul, Turkey.

出版信息

Epilepsy Behav. 2020 Nov;112:107345. doi: 10.1016/j.yebeh.2020.107345. Epub 2020 Aug 27.

Abstract

OBJECTIVE

Studies about the relationship between epileptic seizures (ESs) and melatonin are limited in children and have been performed in heterogeneous patient groups and with different methods. In this study, it was planned to investigate this relationship according to seizure and epilepsy characteristics.

MATERIAL AND METHODS

In 91 children with ES, serum melatonin levels were measured within half an hour following the seizure and on a seizure-free day. Seizures were categorized according to the diagnosis, semiology, etiology, duration, electroencephalography (EEG) findings, and response to treatment. Melatonin levels were compared between each group and control group. In addition, basal melatonin levels of 21 patients with electrical status epilepticus in sleep (ESES) were compared with a control group.

RESULTS

Basal melatonin levels were found to be lower in children with ESs and ESES group compared with the control group (p < 0.001, p < 0.001). Likewise, similar results were obtained in subgroups except for remote symptomatic etiology, severe EEG findings, and refractory epilepsy. No significant difference was observed between basal and postseizure levels of melatonin.

CONCLUSION

This is the first study to reveal the relationship between ESs and basal melatonin levels according to all the characteristics of seizure and epilepsy in the largest patient group. It also demonstrates the need for more detailed studies on the role of melatonin in the pathogenesis of both ESs and ESES, which may provide a basis for a future treatment.

摘要

目的

关于癫痫发作(ESs)与褪黑素之间关系的研究在儿童中较为有限,且这些研究在异质患者群体中采用不同方法进行。在本研究中,计划根据发作和癫痫特征来研究这种关系。

材料和方法

在 91 例 ES 患儿中,在发作后半小时内和无发作日测量血清褪黑素水平。根据诊断、症状学、病因、持续时间、脑电图(EEG)发现以及对治疗的反应对发作进行分类。比较各亚组与对照组之间的褪黑素水平。此外,还比较了 21 例睡眠中电持续状态癫痫样放电(ESES)患者的基础褪黑素水平与对照组。

结果

与对照组相比,ESs 患儿和 ESES 组的基础褪黑素水平较低(p<0.001,p<0.001)。除了远因症状性病因、严重的脑电图发现和难治性癫痫外,在亚组中也得到了类似的结果。褪黑素的基础水平和发作后水平之间无显著差异。

结论

这是第一项根据发作和癫痫的所有特征,在最大的患者群体中揭示 ESs 与基础褪黑素水平之间关系的研究。它还表明需要对褪黑素在 ESs 和 ESES 发病机制中的作用进行更详细的研究,这可能为未来的治疗提供依据。

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