ObjectiveTo analyze the clinical features of psychogenic non-epileptic seizures (Psychogenic nonepileptic seizures, PNES) in Tibetan population in Tibet, so as to help clinicians identify the disease.MethodsRetrospective analyzed the clinical data of patients with PNES in the Department of Neurology, People's Hospital of Tibet Autonomous Region from June 2016 to December 2018.ResultsIn general clinical data, there were significant differences between male and female patients in the results of video electroencephalogram (EEG) monitoring the non-epileptic seizures (P< 0.05). There were no significant differences in mean age, mean onset time, family history of epilepsy, head injury and marital status between male and female patients (P> 0.05). There was no significant difference in symptoms between male and female, but there were differences among different age groups (P> 0.05). In the onset age, the main manifestation was young women, but there was no significant difference in the onset of PNES among different age groups.ConclusionsThere was significant differences between male and female PNES petients, but no significant differences in onset time, marriage and family history of epilepsy between the male and female patients with PNES in Tibet. The clinical manifestations of PNES were different in different ages of patients in Tibet.
ObjectiveThe purpose of the research is to study the distribution and early warning of electroencephalogram (EEG) in acute mountain sickness (AMS). MethodsA total of 280 healthy young men were recruited from September 2016 to October 2016. The basic data were collected by the centralized flow method, the general situation of the division of the investigators after the training, the Lewis Lake score, the computer self-rating anxiety scale and depression scale, and the collection of EEG. Follow up in three months. Results94 of the patients with AMS, morbidity is 33%, 21 (22.34%) of the patients are moderate to severe, 73 (77.66%) are mild, morbidity is 26.67%. The abnormal detection rate of electrogram was 7.9% (22/280), which were mild EEG, normal EEG abnormal rate was 8.6% (16/186), abnormal detection rate of mild AMS was 4.1% (3/73), and the abnormal detection rate was 14.3% (3/21) in the medium / heavy AMS. The latter was significantly different from the previous (P < 0.05). Three months follow-up of this group of patients with 0 case of high altitude disease. Conclusions The EEG in AMS is mainly a rhythm irregular, unstable, poor amplitude modulation; or two hemisphere volatility difference of more than 50% or slightly increased activity. The result is statistically significant, suggesting that EEG distributions has possible early warning of AMS.
Objective To explore the clinical characteristics of patients with combined use of ≥2 kinds of anti-seizure medications in Tibetan plateau. Methods Epilepsy patients who were hospitalized in the People’s Hospital of Tibet Autonomous Region from September 2018 to September 2023 and used ≥2 kinds of anti-seizure medications in combination were selected. Their demographic data such as gender, age, and ethnicity, as well as diagnostic information, medication and other clinical data were collected, and relevant demographic and clinical characteristics were analyzed. In the later stage, telephone follow-up was used to record medication and epileptic seizure control. Results A total of 2295 patients with epilepsy were included, of which 142 (6.2%) met the inclusion criteria, of which 133 (93.7%) were Tibetans. There were more males than females (86 vs. 56, P<0.05), and more minors and young patients than middle-aged and elderly patients (106 vs. 36, P<0.05). 87.3% of the patients underwent magnetic resonance imaging (MRI) or computed tomography (CT), and 71.1% of the patients were abnormal. The main cause of epilepsy was structural etiology (84/142, 59.2%). The most common combination was two drugs (127/142, 89.4%). The largest proportion of combination was sodium valproate and levetiracetam (46/142, 32.4%). After standardized multi-drug combination therapy, the average frequency of epilepsy seizures was significantly reduced compared with the baseline, and the difference was statistically significant (P<0.05). Among the 98 patients aged ≥14 years, 15 cases (15.3%) had drug-refractory epilepsy, 18 cases (18.4%) had seizures controlled by standardized combination medication, 16 cases (16.3%) had seizures controlled by reducing combination medication to a single drug, 5 cases (5.1%) had good control and had stopped medication, 3 cases (3.1%) had frequent epileptic seizures due to poor medication compliance, 15 cases (15.3%) had irregular medication, 17 cases (17.3%) died, and 9 cases (9.2%) were lost. Conclusion The proportion of epilepsy treated with multiple drugs and refractory to drugs was lower than the conclusion of previous studies, and the anti-epileptic effect of multiple drugs was positive. Structural causes (stroke, etc.) are the main causes of epilepsy, and brain parasitic infection is a unique factor of high-altitude epilepsy. Strengthening the standardized use of drugs will help improve the treatment status and prognosis of patients.