Liệu pháp cho bệnh não kèm theo tình trạng động kinh trong giấc ngủ (Hội chứng ESES/CSWS): Cập nhật

Epileptic Disorders - Tập 14 - Trang 1-11 - 2012
Pierangelo Veggiotti1,2, Maria Carmela Pera1, Federica Teutonico1, Daniela Brazzo1, Umberto Balottin1, Carlo Alberto Tassinari3
1National Neurologic Institute “C. Mondino”, Child Neuropsychiatry Unit, University of Pavia, Pavia, Italy
2Istituto Neurologico “C. Mondino”, Pavia, Italy
3Neuroscience Department, University of Parma, Parma, Italy

Tóm tắt

Tình trạng động kinh kéo dài trong giấc ngủ (ESES)/hoạt động sóng liên tục trong giấc ngủ chậm (CSWS) là một rối loạn liên quan đến độ tuổi, tự giới hạn, được đặc trưng bởi động kinh với nhiều loại co giật khác nhau, thoái hóa thần kinh tâm lý toàn cầu hoặc chọn lọc, suy giảm vận động, và mô hình EEG điển hình với hoạt động động kinh liên tục chiếm hơn 85% thời gian ngủ không chuyển động mắt nhanh (NREM). Mặc dù mô tả đầu tiên về ESES/CSWS có từ năm 1971, vẫn chưa có sự đồng thuận về phương pháp điều trị tối ưu cho tình trạng này. ESES/CSWS là một tình trạng hiếm gặp (tỷ lệ mắc khoảng 0.2–0.5% trong tổng số các bệnh động kinh ở trẻ em) và chưa có thử nghiệm lâm sàng đối chứng nào được thực hiện để xác định hiệu quả của các loại thuốc chống động kinh khác nhau; chỉ có các nghiên cứu không đối chứng và báo cáo trường hợp xuất hiện trong tài liệu. Các tùy chọn điều trị cho ESES/CSWS bao gồm một số thuốc chống động kinh (axit valproic, ethosuximide, levetiracetam và benzodiazepine), steroid, immunoglobulin, chế độ ăn ketogenic, và phẫu thuật (cắt lớp dưới màng não nhiều lần). Trong nghiên cứu này, giá trị so sánh của từng phương pháp điều trị này được xem xét và một phương pháp điều trị cá nhân được đề xuất.

Từ khóa

#ESES #CSWS #động kinh #điều trị #trẻ em #thuốc chống động kinh #EEG #thoái hóa thần kinh tâm lý

Tài liệu tham khảo

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