抗癫痫药物对癫痫患者皮质兴奋性影响

发布时间：2018-04-13 12:45

本文选题：经颅磁刺激 + 抗癫痫药物　；参考：《浙江大学》2014年硕士论文

【摘要】：目的：利用单脉冲经颅磁刺激(Transcranial magnetic stimulation, TMS)技术来研究抗癫痫药物对癫痫患者大脑皮质兴奋性和抑制性的影响作用,并寻找早期评价抗癫痫药物疗效的客观指标。方法：对40例新诊断癫痫的患者在服用抗癫痫药物单药治疗前行经颅磁刺激测定并记录双侧大脑的静息期运动皮质阈值(rest motor threshold, rMT),并在坚持规律服用抗癫痫药物2-3月时再次行经颅磁刺激测定并记录双侧大脑的静息期运动皮质阈值。对比癫痫患者服药前后静息期运动皮质阈值。结果： 40例新诊断癫痫患者服药前的右侧大脑运动皮质阈值为52.5±9.3,左侧为49.8±8.4,服药2-3月后右侧大脑运动皮质阈值升至57.2±9.0,左侧升至55.2±7.2,服药前后左右侧运动皮质阈值升高都具有显著统计学意义(P0.05)。其中服用奥卡西平26例,服药前右侧MT是52.9±8.4,左侧MT是50.6±8.4,服药后右侧MT是58.1±8.7,左侧55.7±8.0,服药前后左右侧对比均有统计学意义。根据抗癫痫药物疗效分组,癫痫控制总有效组治疗前后左右侧大脑MT变化有统计学意义,而癫痫控制无效组治疗前后左右侧大脑MT变化无统计学意义。结论：抗癫痫药物如奥卡西平能显著提升患者大脑皮质运动阈值,降低大脑运动皮质兴奋性,减少癫痫发作频率,可能与细胞膜钠离子通道阻滞有关。TMS能作为早期客观地评估抗癫痫药物疗效的有效工具。
[Abstract]:Objective:The effects of antiepileptic drugs on the excitability and inhibition of cerebral cortex of epileptic patients were studied by transcranial magnetic stimulation (TMS) technique, and the objective indexes for early evaluation of antiepileptic effects were found.Methods:In 40 newly diagnosed epileptic patients, transcranial magnetic stimulation (TMS) was used to measure and record the resting phase motor cortex threshold (rest motor threshold, rMTT) of bilateral cerebrum before taking antiepileptic drugs alone, and then to take antiepileptic drugs on a regular basis for 2-3 months.Transcranial magnetic stimulation (TMS) was performed to measure and record the resting motor cortex threshold of bilateral cerebrum.To compare the threshold of motor cortex before and after taking medicine in epileptic patients.Results:The threshold of right cerebral motor cortex and left side were 52.5 卤9.3 and 49.8 卤8.4 before medication in 40 newly diagnosed epileptic patients. After 2-3 months, the threshold of right cerebral motor cortex rose to 57.2 卤9.0 and 55.2 卤7.2 to 55.2 卤7.2 respectively. The threshold of left and right motor cortex increased before and after taking medicine.There was significant statistical significance (P 0.05).Twenty-six patients were treated with oxcarbazepine, the right MT was 52.9 卤8.4, the left MT was 50.6 卤8.4, the right MT was 58.1 卤8.7, and the left 55.7 卤8.0.According to the therapeutic effect of antiepileptic drugs, the changes of MT in left and right brain were statistically significant before and after treatment in the total effective group of epilepsy control, but there was no significant difference between the control group and the control group before and after treatment.Conclusion:Antiepileptic drugs such as oxcarbazepine can significantly increase the cerebral cortex motor threshold, reduce the excitability of the cerebral motor cortex, and reduce the frequency of epileptic seizures.TMS may be associated with cell membrane sodium channel arrest as an effective tool for early and objective evaluation of antiepileptic drug efficacy.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1

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