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创伤后癫痫的药物干预:前沿研究进展

Pharmacological Intervention of Post-traumatic Seizure: Advanced Research Progress.

作者信息

Zeng Weiwei, Ou Juanfeng, Li Ruitong, Yin Yong, Lin Xiaoying, Lu Yingting, Tang Mimi

机构信息

Department of Pharmacy, Shenzhen Longgang Second People's Hospital, Shenzhen, China.

Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China.

出版信息

Dose Response. 2025 Sep 29;23(3):15593258251384796. doi: 10.1177/15593258251384796. eCollection 2025 Jul-Sep.

Abstract

Traumatic brain injury (TBI) is an important condition with high rates of disability and mortality worldwide. Post-traumatic seizure (PTS) frequently occur following TBI, manifesting in both early and late stages. Recurrent PTS without timely intervention may progress to post-traumatic epilepsy (PTE), which defined as the occurrence of two or more unprovoked seizures. Early pharmacological intervention is essential to mitigate the risk of PTE and enhance the prognosis for patients with TBI. Antiepileptic drugs (AEDs) offer a viable strategy for managing PTS. Recent studies indicated that AEDs are more effective in early post-traumatic seizure compared to late post-traumatic seizure, and their efficacy and safety require further evaluation. As research advances in the pathophysiological changes after TBI and the pathogenesis of PTS, current investigations are increasingly focused on neurological damage. Novel compounds targeting various pathways, including antioxidants, anti-neuroinflammatory agents, glutamate modulators and anti-oxidative stress compounds, have demonstrated promising potential in preclinical studies for PTS intervention. This review focuses on the research progress of different AEDs in PTS intervention and discusses the recent developments of emerging PTS intervention strategies based on multiple pathways, providing insights into the clinical application of AEDs and new directions for the development of new drugs for PTS intervention.

摘要

创伤性脑损伤(TBI)是一种在全球范围内导致高致残率和高死亡率的重要疾病。创伤后癫痫(PTS)在TBI后频繁发生,可分为早期和晚期。未经及时干预的复发性PTS可能会发展为创伤后癫痫(PTE),后者被定义为发生两次或更多次无诱因的癫痫发作。早期药物干预对于降低PTE风险和改善TBI患者的预后至关重要。抗癫痫药物(AEDs)为管理PTS提供了一种可行的策略。最近的研究表明,与晚期创伤后癫痫相比,AEDs在早期创伤后癫痫发作中更有效,其疗效和安全性需要进一步评估。随着对TBI后病理生理变化和PTS发病机制研究的进展,目前的研究越来越关注神经损伤。针对各种途径的新型化合物,包括抗氧化剂、抗神经炎症药物、谷氨酸调节剂和抗氧化应激化合物,在PTS干预的临床前研究中已显示出有前景的潜力。本综述重点关注不同AEDs在PTS干预中的研究进展,并讨论基于多种途径的新兴PTS干预策略的最新发展,为AEDs的临床应用以及PTS干预新药的开发提供新方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/feb8/12480794/61368d058b82/10.1177_15593258251384796-img01.jpg

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