Lessons from the laboratory: the pathophysiology, and consequences of status epilepticus.

Lessons from the laboratory: the pathophysiology, and consequences of status epilepticus.
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DOI:
10.1016/j.spen.2010.06.002
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发表时间:
2010-09
影响因子:
2.7
通讯作者:
Goodkin, Howard P.
Goodkin, Howard P.
中科院分区:
医学4区
文献类型:
--
作者:
Rajasekaran, Karthik;Zanelli, Santina A.;Goodkin, Howard P.

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癫痫持续状态(SE)是儿童期最常见的神经系统急症。实验模型与SE的几个临床特征相似,包括:(1)随着癫痫发作持续时间的增加,苯二氮卓类药物治疗失败的可能性增加,使治疗变得复杂;(2)结局随年龄和病因而变化。使用这些模型的研究表明,GABAA受体的活性依赖性运输部分导致GABA介导的抑制作用的逐渐下降和苯二氮卓类药物的失败。此外,实验室研究提供的证据表明,年龄和刺激相互作用,以确定在SE(即功能解剖)激活的神经元回路,功能解剖的差异可以部分解释SE结果的变化。未来的实验室研究可能会提供一个额外的理解的细胞和分子机制的基础SE及其后果。这些研究对于SE的合理紧急治疗及其长期结局的发展是必要的。
Status epilepticus (SE) is the most common neurological emergency of childhood. Experimental models parallel several clinical features of SE including: (1) treatment is complicated by an increasing probability that benzodiazepines will fail with increasing seizure duration and (2) outcome varies with age and etiology. Studies using these models demonstrated that the activity-dependent trafficking of GABAA receptors contributes, in part, to the progressive decline in GABA-mediated inhibition and the failure of the benzodiazepines. Furthermore, laboratory studies have provided evidence that age and inciting stimulus interact to determine the neuronal circuits activated during SE (i.e. functional anatomy), and that differences in functional anatomy can partially account for variations in SE outcome. Future laboratory studies are likely to provide an additional understanding of the cellular and molecular mechanisms that underlie SE and its consequences. Such studies are necessary in the development of rational emergent therapy for SE and its long term outcomes.
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