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Analysis of diabetic epilepsy(浅析糖尿病性癫痫)Diabetic acute onset, severe symptoms, often the initial diagnosis in neurology, emergency department, in the absence of clear history of diabetes cases, was not easy to diagnosis. And in recent years of diabetic epilepsy and epileptic status in clinical reports of increasing, at present that is also one of the neurological complications of diabetes. On some without a clear history of diabetes patients are often first visits to the Department of neurology.糖尿病性发病急、症状重,常首诊于神经科、急诊科,在无明确的糖尿病史情况下,不易被诊断。且近年来糖尿病性癫痫及癫痫状态的临床报告日见增多,目前认为亦是糖尿病神经系统并发症之一。对一些无明确糖尿病史的患者常常首先就诊于神经科。Diabetic seizure occurrence mechanism has not been fully elucidated, combined with summarizing the related information below:糖尿病性癫痫的发生机制至今尚未完全阐明,结合患者总结其相关资料如下:( 1) the disease, elderly, ( in particular, mainly the elderly, accompanied by fundamental disease diabetes or diabetes mellitus, patients have different degree of cerebral atherosclerosis and impaired brain function, local cerebral blood flow regulation function declines, may become seizure based factors;(1)本病好发于中、老年,(尤其以老年人为多,同时伴有基础疾病的糖尿病或隐性糖尿病,患者存在不同程度的脑动脉粥样硬化和脑功能受损,局部脑血流的调节功能下降,可能成为癫痫发作的基础因素;( 2) the rapid onset of hyperglycemia and hypertonic state, can result in neuronal large discharge; another polyol metabolic disorders, brain cells in glucose by aldose reductase into sorbitol and inositol, fructose increased with reduced, these factors can be caused by cerebral edema, exacerbation of cerebral pathological changes, induce epileptic seizures:(2)迅速发生的高血糖及高渗状态,可致神经元大量放电;另外多元醇代谢障碍,脑细胞中的葡萄糖经醛糖还原酶转化为山梨醇,果糖增多和伴有肌醇减少,这些因素均可致脑组织细胞水肿,加重脑的病理改变,促使癫痫发作:( 3) has argued that focal seizures often occur in blood glucose concentration, because the cells and osmotic pressure caused by the changes of cell dehydration, thus changing the cell membrane stability and induced epilepsy;(3)有人认为局灶性癫痫发作常发生在血糖浓度升高时,由于细胞内外渗透压改变造成细胞脱水,从而改变了细胞膜的稳定性而诱发癫痫;( 4) study found, nonketotic hyperglycemia in vivo three tricarboxylic acid cycle by inhibiting GABA metabolism, increased cerebral energy consumption, thereby lowering the seizure threshold;(4)研究发现,非酮症性高血糖症时体内三羧酸循环受到抑制,-氨基丁酸代谢升高而增加脑能耗,进而降低了癫痫阈;( 5) some scholars propose glucose metabolic disorder caused by excessive load conversion mechanism, leading to the enzyme system failure, metabolites accumulation of electrolyte disorders, and cerebral ischemia, induced by cortical cell function changes, become epileptic cells , such cells to metabolic disorder of extremely sensitive under high glucose conditions, evoked seizures;(5)有的学者提出糖代谢障碍引起转换机制负荷过度,导致酶系统功能衰竭、代谢产物积聚电解质紊乱,加之脑局部缺血,引起皮质细胞机能变化,成为“癫痫细胞”,此种细胞对代谢紊乱极敏感在高血糖状况下,诱发癫痫发作;( 6) some people think is likely due to biochemical metabolic disorders and cerebral atherosclerosis, multiple cerebral hypoxia and factors.(6)也有人认为可能是由于生化代谢紊乱及脑动脉粥样硬化、多发性脑梗死和缺氧等多种因素共同作用的结果。The application of antiepileptic drug treatment when the effect is not obvious, especially the elderly focal epilepsy or persistent state, consideration should be given to diabetic epilepsy may, need timely detection of glucose, glucose, electrolytes in blood and plasma osmotic pre
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