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韦斯特综合征模型:寻则得之。

West syndrome model: seek and you will find.

作者信息

Kábová R, Veresová S, Velísek L

机构信息

Department of Pathological Physiology, Third Faculty of Medicine, Charles University Prague, Czech Republic.

出版信息

Sb Lek. 1997;98(2):115-26.

PMID:9601804
Abstract

West syndrome is an age-specific epileptic syndrome with onset in infancy. It comprises infantile spasms (usually flexion convulsions), EEG pattern of hypsarrhythmia and mental retardation. Current therapy involves ACTH, corticosteroids, valproic acid, pyridoxine and vigabatrine. The treatment is difficult and more effective antiepileptic drugs are required. Unfortunately, there is no animal model of West syndrome that would accurately depict the situation found in humans. N-methyl-D-asparate (NMDA)-induced seizures in infant rats have certain features of the West syndrome model. These seizures are age-specific (they occur before 25 days of age), include hyperflection (emprosthotonus), their EEG is not specific and they somewhat respond to treatment with the benzodiazepine clonazepam. In 12 and 18 day old rats, we tested the effects of hydrocortisone, pyridoxine and sodium valproate against the seizures induced by 15 and 45 mg/kg of NMDA i.p., respectively. There were weak effects of sodium valproate against the NMDA-induced emprosthotonus. In contrast, high doses of pyridoxine were proconvulsant and hydrocortisone worsened the damage of nerve cells induced by NMDA. The data show that NMDA-induced seizures although similar to West syndrome are extremely resistant to therapy and may not be a good model of the West syndrome. However, the search for an adequate model that would allow for determination of possible mechanisms and testing of putative antiepileptic drugs will continue.

摘要

韦斯特综合征是一种特定年龄的癫痫综合征,起病于婴儿期。它包括婴儿痉挛(通常为屈曲性惊厥)、高峰节律紊乱的脑电图模式和智力发育迟缓。目前的治疗方法包括使用促肾上腺皮质激素、皮质类固醇、丙戊酸、吡哆醇和氨己烯酸。治疗困难,需要更有效的抗癫痫药物。不幸的是,没有一种韦斯特综合征的动物模型能准确描绘人类的情况。N-甲基-D-天冬氨酸(NMDA)诱导的幼鼠惊厥具有韦斯特综合征模型的某些特征。这些惊厥具有年龄特异性(发生在25日龄之前),包括过度屈曲(角弓反张),其脑电图不具有特异性,并且对苯二氮䓬类氯硝西泮的治疗有一定反应。在12日龄和18日龄的大鼠中,我们分别测试了氢化可的松、吡哆醇和丙戊酸钠对腹腔注射15mg/kg和45mg/kg NMDA诱导的惊厥的影响。丙戊酸钠对NMDA诱导的角弓反张作用较弱。相比之下,高剂量的吡哆醇具有惊厥作用,氢化可的松会加重NMDA诱导的神经细胞损伤。数据表明,NMDA诱导的惊厥虽然与韦斯特综合征相似,但对治疗极具抗性,可能不是韦斯特综合征的良好模型。然而,寻找一种合适的模型以确定可能的机制并测试潜在的抗癫痫药物的工作仍将继续。

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