The efficacy and safety of patent Foramen Ovale Closure for Refractory Epilepsy (PFOC-RE): a prospectively randomized control trial of an innovative surgical therapy for refractory epilepsy patients with PFO of high-grade right-to-left shunt.

BACKGROUND: A significant proportion of patients with epilepsy have an unknown etiology and lack effective targeted therapeutic drugs. Patent Foramen Ovale (PFO) induces hypoxia and microembolism, leading to cerebral neurological dysfunction and increased epilepsy risk. This study aims to assess the efficacy and safety of PFO closure for relieving epileptic seizures in patients with refractory epilepsy associated with PFO. METHODS/DESIGN: Recruitment takes place at the West China Hospital of Sichuan University, China, for an open-label, randomized controlled clinical trial. The trial will include 110 patients with refractory epilepsy and PFO. Disease diagnoses will conform to the diagnostic criteria of the International League Against Epilepsy (ILAE) for refractory epilepsy and the American Society of Echocardiography (ASE) for PFO. Refractory epilepsy and high-grade right-to-left shunt (RLS) of the PFO will be further diagnosed using 24-hour video electroencephalogram and transthoracic echocardiography with contrast injection, respectively. Eligible participants require a secondary or higher volume of RLS. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2200065681). Registered on November 11, 2022.

Functional Magnetic Resonance Imaging Study of Oxcarbazepine Effect on Auditory Cortex / 医学研究杂志

Objective Functional magnetic resonance imaging was used to explore the effects of oxcarbazepine on auditory cortex function in patients with epilepsy.Methods 21 patients with epilepsy treated with oxcarbazepine and twenty-one patients with epilepsy who matched age and gender but did not treat with oxcarbazepine were collected.Amplitude of low frequency fluctuation(ALFF)and re-gional homogeneity(ReHo)were used to compare the differences in the functional activity of the auditory cortex between the two groups.Results Compared with the patients without oxcarbazepine,the patients with oxcarbazepine had higher ALFF values in the right superior temporal gyrus,bilateral middle temporal gyrus and visual union cortex,and lower ALFF values in the bilateral orbitofrontal area and infe-rior temporal gyrus,the patients with oxcarbazepine had higher ReHo values in right superior temporal gyrus,bilateral middle temporal gy-rus,orbitofrontal area,and left visual union cortex,and lower ReHo values in bilateral superior temporal gyrus,inferior temporal gyrus and right middle temporal gyrus.In the same cross-sectional area,ALFF and ReHo values were enhanced in the right superior temporal gyrus,right cingulate gyrus,right somatosensory cortex and left visual union cortex,while ALFF and ReHo values were weakened in the bilateral inferior temporal gyrus.However,there was no significant difference in ALFF and ReHo values of bilateral transverse temporal gyrus and transverse temporal sulcus between the two groups.Conclusion Oxcarbazepine may affect auditory cortex function in patients with epilepsy,and it mainly acts on the secondary auditory cortex or regulates the excitatory balance of the auditory network.

Aviation flight and neurological diseases / 中国医师杂志

In the air flight, individuals rise rapidly to the environment of low-pressure hypoxia, low humidity and high noise. If we can't adapt to the change of the environment, we may suffer headache, stroke, epilepsy and other common nervous system diseases. With the increasing popularity of aviation, more and more in-flight medical emergencies are reported. Aviation medical is gradually concerned and studied by social people, medical internists and scientific research workers. This article will summarize the clinical characteristics and pathogenesis of common paroxysmal nervous system diseases in flight, and discuss the prospect of early warning and prevention of in-flight medical emergencies.