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癲癇與女性激素

祝由網 2023-11-12 22:59:11

癲(dian)癇與女性(xing)激素

在(zai)(zai)月(yue)(yue)經(jing)(jing)周期(qi)(qi)(qi)(qi)的(de)過程中,人們可以(yi)(yi)預見到癲癇發(fa)作(zuo)(zuo)(zuo)的(de)頻率變化(經(jing)(jing)期(qi)(qi)(qi)(qi)性(xing)癲癇)多(duo)年(nian)來已(yi)報告,發(fa)作(zuo)(zuo)(zuo)頻率在(zai)(zai)月(yue)(yue)經(jing)(jing)期(qi)(qi)(qi)(qi)時(shi)(shi)常增多(duo),這個特征(zheng)性(xing)的(de)表(biao)(biao)現是(shi)由(you)于此時(shi)(shi)雌(ci)激素的(de)/孕激素的(de)比值較(jiao)(jiao)高(gao)所致(正在(zai)(zai)月(yue)(yue)經(jing)(jing)前期(qi)(qi)(qi)(qi)、月(yue)(yue)經(jing)(jing)期(qi)(qi)(qi)(qi)中和排卵期(qi)(qi)(qi)(qi))。雌(ci)激素可以(yi)(yi)誘發(fa)海馬神經(jing)(jing)元的(de)結構和功能(neng)發(fa)生變化,增加了癲癇發(fa)作(zuo)(zuo)(zuo)的(de)易(yi)感(gan)性(xing)。在(zai)(zai)癲癇動物模型中,孕激素可經(jing)(jing)降(jiang)低癲癇發(fa)作(zuo)(zuo)(zuo)的(de)易(yi)感(gan)性(xing)。對(dui)已(yi)存在(zai)(zai)的(de)癲癇發(fa)作(zuo)(zuo)(zuo)的(de)加重同樣也是(shi)一個危險因素。其原因可能(neng)是(shi)女性(xing)初期(qi)(qi)(qi)(qi)時(shi)(shi)雌(ci)激素水(shui)平較(jiao)(jiao)高(gao),而且具有神經(jing)(jing)毒(du)性(xing)的(de)類固醇脫氫表(biao)(biao)雄酮以(yi)(yi)及(ji)孕烯醇酮和水(shui)平也相(xiang)對(dui)較(jiao)(jiao)高(gao)。

許(xu)多生育婦女(nv)的癲(dian)(dian)癇(xian)發(fa)作(zuo)(zuo)在(zai)(zai)月(yue)經(jing)(jing)(jing)來潮前(qian)或月(yue)經(jing)(jing)(jing)期(qi)加重。一(yi)些(xie)患者(zhe)的發(fa)作(zuo)(zuo)只出現(xian)在(zai)(zai)月(yue)經(jing)(jing)(jing)前(qian)或月(yue)經(jing)(jing)(jing)期(qi),稱之為(wei)月(yue)經(jing)(jing)(jing)性癲(dian)(dian)癇(xian)。月(yue)經(jing)(jing)(jing)加重發(fa)作(zuo)(zuo)在(zai)(zai)癥狀性癲(dian)(dian)癇(xian)中更為(wei)突出,那些(xie)已經(jing)(jing)(jing)有(you)頻繁發(fa)作(zuo)(zuo)者(zhe),或有(you)月(yue)經(jing)(jing)(jing)前(qian)緊張者(zhe)更可能在(zai)(zai)月(yue)經(jing)(jing)(jing)前(qian)發(fa)和(he),或在(zai)(zai)月(yue)經(jing)(jing)(jing)性出血時(shi)發(fa)作(zuo)(zuo)。月(yue)經(jing)(jing)(jing)與癲(dian)(dian)癇(xian)發(fa)作(zuo)(zuo)之間的聯系可見于單純性部分性、復雜(za)部分性及全身強直-陣攣性發(fa)作(zuo)(zuo),但不同(tong)類(lei)型(xing)發(fa)作(zuo)(zuo)和(he)月(yue)經(jing)(jing)(jing)周期(qi)的不同(tong)時(shi)期(qi)有(you)關。這與月(yue)經(jing)(jing)(jing)周期(qi)中體(ti)內雌激(ji)素和(he)孕激(ji)素的水平變(bian)化,以及抗癇(xian)藥(yao)血藥(yao)濃度(du)的變(bian)化有(you)關。

一般認(ren)為(wei),雌(ci)(ci)激(ji)(ji)(ji)素可能(neng)增加對(dui)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)的(de)敏感(gan)性(xing),引起月(yue)經(jing)期(qi)癲癇的(de)發(fa)(fa)(fa)作(zuo)(zuo)(zuo),而(er)孕激(ji)(ji)(ji)素可以增加抑制性(xing)神經(jing)遞質的(de)活(huo)性(xing),使(shi)神經(jing)細胞的(de)興奮性(xing)下(xia)(xia)降,從而(er)起到抑制發(fa)(fa)(fa)作(zuo)(zuo)(zuo)的(de)作(zuo)(zuo)(zuo)用。從月(yue)經(jing)前期(qi)開始(shi),雌(ci)(ci)激(ji)(ji)(ji)素和孕激(ji)(ji)(ji)素的(de)比值逐漸下(xia)(xia)升,孕激(ji)(ji)(ji)素水平(ping)急劇下(xia)(xia)降,故此階(jie)段為(wei)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)高峰(feng)期(qi)。月(yue)經(jing)來潮后10天,孕激(ji)(ji)(ji)素水平(ping)達高峰(feng),雌(ci)(ci)激(ji)(ji)(ji)素和孕激(ji)(ji)(ji)素的(de)比值下(xia)(xia)降,故此階(jie)段為(wei)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)期(qi)的(de)低峰(feng)期(qi)。抗癇藥物的(de)代謝也隨月(yue)經(jing)周(zhou)期(qi)變(bian)化。

許多(duo)婦女(nv)在(zai)月經(jing)期前(qian)出(chu)現手足腫脹以(yi)及(ji)體重增加,這種體內的水鈉潴留,也可(ke)能是月經(jing)期癲(dian)癇發作的原因之一。

月(yue)經(jing)期癲癇的(de)(de)(de)治(zhi)(zhi)療首先應選(xuan)(xuan)(xuan)取用(yong)(yong)合適(shi)的(de)(de)(de)抗癇藥(yao)物。選(xuan)(xuan)(xuan)擇藥(yao)物的(de)(de)(de)原則非同(tong)月(yue)經(jing)性癲癇。在(zai)服藥(yao)的(de)(de)(de)同(tong)時,應仔細記(ji)錄發作(zuo)次數與月(yue)經(jing)周期的(de)(de)(de)關系。如果二(er)者的(de)(de)(de)確存(cun)在(zai)相(xiang)互關系,則可選(xuan)(xuan)(xuan)用(yong)(yong)一些相(xiang)應的(de)(de)(de)治(zhi)(zhi)療措(cuo)施(shi)。

多(duo)囊(nang)(nang)性(xing)(xing)(xing)卵(luan)巢在(zai)普(pu)通人群中較為常(chang)(chang)見。多(duo)囊(nang)(nang)性(xing)(xing)(xing)卵(luan)巢綜(zong)合癥(zheng)(多(duo)毛(mao)癥(zheng)、痤瘡、肥(fei)胖、生(sheng)殖能力低(di)下(xia)、雄激素(su)過多(duo)和月(yue)經(jing)紊亂)并不(bu)常(chang)(chang)見。有資料顯示,在(zai)女(nv)(nv)性(xing)(xing)(xing)癲癇(xian)病人中,多(duo)囊(nang)(nang)性(xing)(xing)(xing)卵(luan)巢疾病的(de)發病率增(zeng)加,而且服用丙戊酸后發病率更高。當然,這(zhe)還是個極有爭議性(xing)(xing)(xing)的(de)問題(ti)。也有證據表明,丙戊酸還可以增(zeng)加無排(pai)卵(luan)性(xing)(xing)(xing)月(yue)經(jing)周期(qi)的(de)危險。因此,作(zuo)者在(zai)實(shi)踐中,對育(yu)齡期(qi)的(de)婦女(nv)(nv)不(bu)使用丙戊酸,避(bi)免引起出生(sheng)缺陷(脊柱裂)、多(duo)囊(nang)(nang)性(xing)(xing)(xing)卵(luan)巢綜(zong)合性(xing)(xing)(xing)、無排(pai)卵(luan)性(xing)(xing)(xing)月(yue)經(jing)周期(qi)和體(ti)重(zhong)增(zeng)加的(de)諸多(duo)問題(ti)。

有些治療癲癇(xian)的(de)藥物還可能(neng)影(ying)響女性(xing)激素的(de)分泌代謝,引起月經周期紊亂,甚或閉經,卵(luan)巢萎(wei)縮,導致(zhi)不(bu)孕(yun)等嚴重后果。因此出現閉經應聯系您的(de)主治醫師。

癲癇的誘(you)發因素有哪些

癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)是(shi)(shi)指腦神經(jing)(jing)(jing)元異常和過度超同步化(hua)放電(dian)(dian)所造成(cheng)的(de)(de)(de)(de)(de)臨(lin)床現(xian)(xian)象。癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)的(de)(de)(de)(de)(de)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)使(shi)患(huan)者(zhe)(zhe)(zhe)的(de)(de)(de)(de)(de)身心(xin)健康都面(mian)(mian)臨(lin)著很(hen)大(da)的(de)(de)(de)(de)(de)威(wei)脅。而誘(you)(you)(you)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)的(de)(de)(de)(de)(de)因(yin)素(su)也有(you)很(hen)多(duo)。下(xia)(xia)面(mian)(mian)就為大(da)家(jia)具(ju)體介紹一下(xia)(xia),? (一) 精神壓(ya)力(li) 有(you)研究(jiu)顯示,癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)在(zai)(zai)精神壓(ya)力(li)過大(da)、焦(jiao)慮或抑(yi)郁時(shi)(shi)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)次數增加(jia)。造成(cheng)這(zhe)一現(xian)(xian)象的(de)(de)(de)(de)(de)部(bu)分(fen)原(yuan)因(yin)可(ke)(ke)(ke)(ke)能(neng)(neng)是(shi)(shi)在(zai)(zai)這(zhe)種狀態(tai)下(xia)(xia)睡(shui)(shui)眠(mian)(mian)(mian)不(bu)好。現(xian)(xian)代社會生(sheng)活節奏快、壓(ya)力(li)大(da)。癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)不(bu)僅要(yao)(yao)(yao)忍受(shou)疾病本(ben)身的(de)(de)(de)(de)(de)痛苦,還要(yao)(yao)(yao)承受(shou)比(bi)正常人(ren)更多(duo)的(de)(de)(de)(de)(de)壓(ya)力(li),心(xin)理負擔很(hen)重,嚴重者(zhe)(zhe)(zhe)出現(xian)(xian)焦(jiao)慮、抑(yi)郁及其(qi)它各種心(xin)理問題。 (二)光及其(qi)他(ta)的(de)(de)(de)(de)(de)形式(shi)的(de)(de)(de)(de)(de)刺激 有(you)些(xie)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)被診斷為反射(she)性(xing)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian),主(zhu)要(yao)(yao)(yao)是(shi)(shi)指這(zhe)些(xie)患(huan)者(zhe)(zhe)(zhe)在(zai)(zai)某個(ge)特定的(de)(de)(de)(de)(de)感(gan)覺(jue)(jue)(jue)性(xing)刺激下(xia)(xia),可(ke)(ke)(ke)(ke)誘(you)(you)(you)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)出來的(de)(de)(de)(de)(de)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)。最(zui)常見(jian)的(de)(de)(de)(de)(de)是(shi)(shi)光敏(min)性(xing)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian),是(shi)(shi)由反復閃爍的(de)(de)(de)(de)(de)光刺激誘(you)(you)(you)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)的(de)(de)(de)(de)(de)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)。常見(jian)的(de)(de)(de)(de)(de)如看電(dian)(dian)視(shi)、玩視(shi)頻(pin)游戲、坐(zuo)車在(zai)(zai)路上看透過樹(shu)叢間(jian)隙的(de)(de)(de)(de)(de)太陽(yang)光等均可(ke)(ke)(ke)(ke)誘(you)(you)(you)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)。 (三(san))睡(shui)(shui)眠(mian)(mian)(mian)不(bu)足 睡(shui)(shui)眠(mian)(mian)(mian)不(bu)足可(ke)(ke)(ke)(ke)誘(you)(you)(you)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)。保持規(gui)(gui)律(lv)睡(shui)(shui)眠(mian)(mian)(mian)對于癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)是(shi)(shi)十分(fen)必要(yao)(yao)(yao)的(de)(de)(de)(de)(de),應(ying)該盡量避免睡(shui)(shui)眠(mian)(mian)(mian)太晚或整夜(ye)不(bu)睡(shui)(shui)(如值夜(ye)班(ban)或旅行(xing)時(shi)(shi)間(jian)差(cha))。在(zai)(zai)選擇(ze)工作(zuo)(zuo)(zuo)方面(mian)(mian),盡量避免選擇(ze)需(xu)(xu)要(yao)(yao)(yao)熬夜(ye)、值夜(ye)班(ban)的(de)(de)(de)(de)(de)工作(zuo)(zuo)(zuo)。 (四)疲(pi)勞 過度疲(pi)勞可(ke)(ke)(ke)(ke)以誘(you)(you)(you)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)各型癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)。癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)要(yao)(yao)(yao)養(yang)成(cheng)規(gui)(gui)律(lv)、健康的(de)(de)(de)(de)(de)生(sheng)活方式(shi),避免過度勞累。 (五(wu))激素(su) 一些(xie)女(nv)性(xing)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)的(de)(de)(de)(de)(de)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)與月(yue)(yue)經(jing)(jing)(jing)周(zhou)期(qi)有(you)關,往(wang)往(wang)在(zai)(zai)月(yue)(yue)經(jing)(jing)(jing)前期(qi)和月(yue)(yue)經(jing)(jing)(jing)期(qi)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)次數增加(jia)。這(zhe)主(zhu)要(yao)(yao)(yao)與體內雌激素(su)、孕激素(su)水平發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)生(sheng)變化(hua)有(you)關。如果患(huan)者(zhe)(zhe)(zhe)存(cun)在(zai)(zai)這(zhe)方面(mian)(mian)的(de)(de)(de)(de)(de)傾向(xiang),應(ying)該詳細記錄發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)與月(yue)(yue)經(jing)(jing)(jing)期(qi)的(de)(de)(de)(de)(de)關系(xi)并向(xiang)專科(ke)醫生(sheng)咨詢(參見(jian)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)與女(nv)性(xing))。 (六)食(shi)(shi)物(wu)(wu) 有(you)些(xie)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)認為食(shi)(shi)用某些(xie)食(shi)(shi)物(wu)(wu)可(ke)(ke)(ke)(ke)誘(you)(you)(you)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo),但沒有(you)證據表(biao)明癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)必需(xu)(xu)禁(jin)食(shi)(shi)某種食(shi)(shi)物(wu)(wu)。需(xu)(xu)要(yao)(yao)(yao)強調的(de)(de)(de)(de)(de)是(shi)(shi)挑食(shi)(shi)或不(bu)平衡的(de)(de)(de)(de)(de)飲(yin)食(shi)(shi)習慣(guan)可(ke)(ke)(ke)(ke)能(neng)(neng)是(shi)(shi)誘(you)(you)(you)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)的(de)(de)(de)(de)(de)因(yin)素(su)。 (七)停(ting)藥 突然停(ting)用抗(kang)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)藥物(wu)(wu),可(ke)(ke)(ke)(ke)促使(shi)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo),甚(shen)至(zhi)(zhi)導致癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)持續狀態(tai)。 (八)感(gan)覺(jue)(jue)(jue)因(yin)素(su) 有(you)些(xie)患(huan)者(zhe)(zhe)(zhe)對特定的(de)(de)(de)(de)(de)感(gan)覺(jue)(jue)(jue)因(yin)素(su)較(jiao)為敏(min)感(gan),最(zui)主(zhu)要(yao)(yao)(yao)的(de)(de)(de)(de)(de)如視(shi)、聽(ting)、嗅、味、前庭、軀體覺(jue)(jue)(jue)等。這(zhe)些(xie)感(gan)覺(jue)(jue)(jue)刺激可(ke)(ke)(ke)(ke)激發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)腦神經(jing)(jing)(jing)元過度異常放電(dian)(dian),引起各種類型的(de)(de)(de)(de)(de)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)(稱為反射(she)性(xing)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian))。 (九) 酒(jiu)(jiu)精 過量的(de)(de)(de)(de)(de)飲(yin)酒(jiu)(jiu)可(ke)(ke)(ke)(ke)誘(you)(you)(you)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo),甚(shen)至(zhi)(zhi)沒有(you)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)的(de)(de)(de)(de)(de)人(ren)亦可(ke)(ke)(ke)(ke)誘(you)(you)(you)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)發(fa)(fa)(fa)(fa)(fa)(fa)(fa)(fa)作(zuo)(zuo)(zuo)。目(mu)前,飲(yin)酒(jiu)(jiu)已經(jing)(jing)(jing)成(cheng)為許(xu)多(duo)人(ren)生(sheng)活中的(de)(de)(de)(de)(de)一部(bu)分(fen)。許(xu)多(duo)癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)很(hen)迫(po)切(qie)地想(xiang)知道(dao)飲(yin)酒(jiu)(jiu)對癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)究(jiu)竟有(you)多(duo)大(da)的(de)(de)(de)(de)(de)影響。下(xia)(xia)面(mian)(mian)提供給癲(dian)(dian)(dian)(dian)癇(xian)(xian)(xian)(xian)患(huan)者(zhe)(zhe)(zhe)及其(qi)家(jia)屬一些(xie)清(qing)晰的(de)(de)(de)(de)(de)、無(wu)偏見(jian)的(de)(de)(de)(de)(de)信息(xi)。

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