Kiviranta T, Tuomisto L, Airaksinen E M
Department of Pediatrics, Kuopio University Hospital, Finland.
Epilepsia. 1995 Mar;36(3):276-80. doi: 10.1111/j.1528-1157.1995.tb00996.x.
Febrile convulsions (FC) are frequent acute neurologic disturbances of childhood. The cellular and neurochemical mechanisms causing FC are unclear. Among other mechanisms, the CNS histamine (HA) has been suggested to participate in seizure control and thermoregulation. We evaluated the possible role of HA in regulation of FC by measuring HA and tele-methylhistamine (t-MH) concentrations in the cerebrospinal fluid (CSF) of children with FC. The study group consisted of 35 children treated for acute FC in the hospital. The control groups consisted of (a) feverish children without seizures (n = 23), (b) convulsive children without fever (n = 7), and (c) children with neither fever nor convulsions (n = 21). HA was assayed by high-performance liquid chromatography (HPLC) with fluorescence detection, and t-MH was measured by gas chromatography-mass spectrometry. CSF HA concentration in the group of febrile children without seizures was significantly higher (0.69 +/- 0.16 pmol/ml, mean +/- SE) than in children with FC (0.36 +/- 0.07 pmol/ml, p < 0.05, analysis of variance, ANOVA). HA concentration was 0.37 +/- 0.18 pmol/ml in the group of nonfebrile convulsive children and 0.36 +/- 0.08 pmol/ml in the nonfebrile nonconvulsive group. No statistical differences in t-MH were detected between groups. The increased susceptibility to seizures during fever may be connected to the lack of increase in CSF HA in the FC group. The data support the hypothesis that the central histaminergic neuron system may be involved in inhibition of seizures associated with febrile illnesses in childhood.
热性惊厥(FC)是儿童期常见的急性神经功能紊乱。导致FC的细胞和神经化学机制尚不清楚。在其他机制中,中枢神经系统组胺(HA)被认为参与癫痫控制和体温调节。我们通过测量FC患儿脑脊液(CSF)中HA和甲基组胺(t-MH)的浓度,评估HA在FC调节中的可能作用。研究组由35名在医院接受急性FC治疗的儿童组成。对照组包括:(a)无惊厥的发热儿童(n = 23),(b)无发热的惊厥儿童(n = 7),以及(c)既无发热也无惊厥的儿童(n = 21)。HA采用高效液相色谱(HPLC)荧光检测法测定,t-MH采用气相色谱-质谱法测定。无惊厥的发热儿童组CSF中HA浓度(0.69±0.16 pmol/ml,均值±标准误)显著高于FC患儿组(0.36±0.07 pmol/ml,p < 0.05,方差分析,ANOVA)。非发热惊厥儿童组HA浓度为0.37±0.18 pmol/ml,非发热非惊厥组为0.36±0.08 pmol/ml。各组间t-MH未检测到统计学差异。发热期间癫痫易感性增加可能与FC组CSF中HA未增加有关。数据支持中枢组胺能神经元系统可能参与抑制儿童期与发热性疾病相关癫痫发作的假说。