Jakob Bie Granild-Jensen , Kian Yousefi Kousha , Ayako Ochi , Hiroshi Otsubo , Rajesh RamchandranNair , Karen Choong , Burke Baird , Emma Cory , Shelly Weiss , Cecil Hahn , Elizabeth J Donner , Robyn Whitney , Kevin C Jones , Puneet Jain
{"title":"Critical care EEG monitoring in children with abusive head trauma: A retrospective study of seizure burden and predictors of neurological outcomes","authors":"Jakob Bie Granild-Jensen , Kian Yousefi Kousha , Ayako Ochi , Hiroshi Otsubo , Rajesh RamchandranNair , Karen Choong , Burke Baird , Emma Cory , Shelly Weiss , Cecil Hahn , Elizabeth J Donner , Robyn Whitney , Kevin C Jones , Puneet Jain","doi":"10.1016/j.seizure.2024.11.002","DOIUrl":"10.1016/j.seizure.2024.11.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Abusive Head Trauma (AHT) remains an important cause of acute seizures, morbidity, and mortality in children. We aimed to assess the clinical and electrographic seizure burden in children with AHT and to explore predictors of morbidity and mortality.</div></div><div><h3>Methods</h3><div>We conducted a retrospective chart review of all children admitted with AHT who underwent continuous electroencephalographic monitoring (cEEG) between January 1st, 2015, and April 15th, 2021. Their clinical, EEG and imaging variables were extracted and summarized.</div></div><div><h3>Results</h3><div>A total of 31 children (17 female) were included. The median age was 3 months (IQR 1.75–5). Forty-five percent of cases presented in the winter season (<em>p</em> = 0.024). In 25 cases out of 31, cEEG detected electrographic seizures, with 6 of these children not manifesting clinical seizures. A shorter time to first recorded seizure during cEEG was a significant predictor of in-hospital mortality (<em>p</em> = 0.012) and the maximum 1-hour seizure count was higher in children with worse cerebral outcomes (<em>p</em> = 0.008). A normal EEG background activity during cEEG was associated with favorable neurological outcomes (<em>p</em> = 0.008). The hospital mortality rate was 23 %.</div></div><div><h3>Conclusion</h3><div>Almost 20 % of children with AHT had seizures recognized exclusively by cEEG. Normal cEEG background activity predicted a better outcome, while a shorter time to the first recorded seizure was associated with a higher in-hospital mortality. Corroborating prior reports, we found a significant clustering of cases during the winter. These results could enhance AHT prevention strategies and case prognostication.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 142-147"},"PeriodicalIF":2.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander Grote , Daniel Delev , Hendrik Hoffmann , Christian Elger , Marec von Lehe
{"title":"Epilepsy-surgery for fronto-basal lesions: Management, outcome, and review of literature","authors":"Alexander Grote , Daniel Delev , Hendrik Hoffmann , Christian Elger , Marec von Lehe","doi":"10.1016/j.seizure.2024.11.003","DOIUrl":"10.1016/j.seizure.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>In this study, we isolated a cohort of patients who have refractory epilepsy who underwent surgery with frontobasal focus. This work aimed to develop prognostic factors associated with a better seizure outcome and identify risk factors determining postoperative morbidity.</div></div><div><h3>Methods</h3><div>We identified all patients with frontobasal epilepsy who underwent surgery due to refractory epilepsy at the University Hospital Bonn over 22 years. Although this is a retrospective study, all data sets were collected prospectively. We evaluated both surgical and functional outcomes.</div></div><div><h3>Results</h3><div>In total, 32 patients were identified for inclusion in this study. With a long and stable postoperative seizure outcome averaging 109 months, we were able to show that patients with frontobasal epilepsy can achieve a better outcome (53 % seizure-free, ILAE1) than patients with frontal epilepsy. In contrast to other brain regions, the resection size (isolated or extended) did not influence the outcome. Low-grade tumors, on the other hand, were associated with a better seizure outcome, and gliosis or non-specific histological findings with a worse seizure outcome. Stereo-EEG with depth electrodes is more suitable for invasive diagnostics at the frontal base than strip or grid electrodes. Patients who did not become seizure-free after surgery and underwent a second surgery did not profit significantly concerning seizure outcome.</div></div><div><h3>Conclusion</h3><div>Patients with frontobasal epilepsy who are operated on early in the course of the disease, are MRI-positive, and have a tumor as an epileptogenic pathology have the best chance of seizure freedom.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 104-112"},"PeriodicalIF":2.7,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Computed tomography of the head with and without contrast in imaging focal and unknown epilepsy – A prospective observational study","authors":"Jasmine Parihar , Mamta Bhushan Singh , Ajay Garg , Leve Joseph Devarajan , Rohit Bhatia , Anuj Prabhakar , Shailesh Gaikwad , MV Padma Srivastava , Vinay Goyal , Garima Shukla , Vishnu VY , Maroof Ahmad Khan","doi":"10.1016/j.seizure.2024.10.020","DOIUrl":"10.1016/j.seizure.2024.10.020","url":null,"abstract":"<div><h3>Purpose</h3><div>Brain imaging is needed when investigating epilepsy. Imaging options available include MRI and CT scan which may be non-contrast (NCCT) or contrast-enhanced (CECT). The specific clinical question and probable epilepsy substrate in the epidemiological context and socioeconomic milieu are important in determining the choice of imaging. In patients with well-controlled focal or unknown epilepsy who are unlikely to be surgical candidates, is CECT essential or can NCCT be an acceptable choice?</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted at a tertiary care centre in India. Consecutive patients with focal or unknown epilepsy who were relatively well-controlled on medical treatment underwent NCCT followed by CECT brain. Three neuroradiologists independently reported the images. Proportion of abnormalities missed on NCCT and picked only on CECT were determined. How often abnormalities picked on CECT changed patient management was also analysed.</div></div><div><h3>Results</h3><div>Two hundred and nineteen patients with focal (87 %) or unknown (13 %) epilepsy underwent NCCT followed by CECT brain. Most had epilepsy for >3 months and an annual seizure frequency of 2–10 seizures. There was a nearly perfect inter-observer agreement between 3 neuroradiologists in reporting the NCCT and CECT as 'normal' or 'abnormal' with kappa (κ) values of 0.9 and 1.0 respectively. The sensitivity of NCCT compared to CECT in detecting an abnormality was 97 % (CI 92.6 - 99.5 %) and the specificity was 99 % (CI 94.9 - 99.9 %). There was no significant difference in the proportion of NCCTs and CECTs found abnormal (50.22 % vs 51.14 %, <em>p</em> = 0.91). A solitary calcified granuloma was the most common abnormality reported on NCCT as well as CECT, 21.0 % and 19.1 % respectively. New findings picked on CECT alone, did not change management in any patient.</div></div><div><h3>Conclusion</h3><div>When imaging focal or unknown epilepsy, an NCCT performs as well as a CECT, especially in regions where calcified lesions contribute a significant etiological burden. The role of imaging in epilepsy varies between patients and a universal recommendation of an MRI or a CECT in all patients is neither cost-efficient nor evidence-based. In drug responsive focal or unknown epilepsy of longstanding duration, CT scans are either normal or have calcified lesions that are easily picked on NCCT.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 123-127"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Before the variant c.541A>G in UGT1A6 can be held responsible for valproate-induced tremor, alternative causes must be ruled out","authors":"Josef Finsterer","doi":"10.1016/j.seizure.2024.07.021","DOIUrl":"10.1016/j.seizure.2024.07.021","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"122 ","pages":"Pages 179-180"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matilde Velasco-Mérida , Marian Lázaro , John S Duncan , Gonzalo Alarcon , Ioannis Stavropoulos , Antonio Valentín
{"title":"Neuromodulation with Transcranial Magnetic Stimulation in Epilepsia Partialis Continua: Scoping review and clinical experience","authors":"Matilde Velasco-Mérida , Marian Lázaro , John S Duncan , Gonzalo Alarcon , Ioannis Stavropoulos , Antonio Valentín","doi":"10.1016/j.seizure.2024.10.018","DOIUrl":"10.1016/j.seizure.2024.10.018","url":null,"abstract":"<div><h3>Introduction</h3><div>Epilepsia Partialis Continua (EPC) is a challenging condition in which repetitive transcranial magnetic stimulation (rTMS) can induce a neuromodulation effect of potential diagnostic and therapeutic value.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted using Pubmed and Web of Science databases to identify cases of EPC who underwent rTMS, including children and adults. Additionally, we present two patients from our centre who underwent rTMS at a low frequency (0.5 Hz) with simultaneous EEG recording with the aim of assessing potential improvement in seizure frequency and severity.</div></div><div><h3>Results</h3><div>Eight articles were selected comprising 16 patients (15 with EPC and one with continuous myoclonia). In three of these patients, no clinical or EEG changes were noted; the remaining cases showed transitory clinical improvements. We report two patients with EPC, in whom low frequency rTMS was associated with transient reduction in frequency and severity of seizures and improvements in hand function and dexterity. In one of these cases, rTMS suggested a potential target for intracranial recordings, subacute cortical stimulation and localised resection.</div></div><div><h3>Conclusion</h3><div>In selected patients with EPC, rTMS can be used as a potential diagnostic and therapeutic tool.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 74-81"},"PeriodicalIF":2.7,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
James W. Wheless , Jeffrey S. Raskin , Anthony L. Fine , Kelly G. Knupp , John Schreiber , Adam P. Ostendorf , Gregory W. Albert , Eric H. Kossoff , Joseph R. Madsen , Prakash Kotagal , Adam L. Numis , Nisha Gadgil , Deborah L. Holder , Elizabeth A. Thiele , George M. Ibrahim
{"title":"Expert opinion on use of vagus nerve stimulation therapy in the management of pediatric epilepsy: A Delphi consensus study","authors":"James W. Wheless , Jeffrey S. Raskin , Anthony L. Fine , Kelly G. Knupp , John Schreiber , Adam P. Ostendorf , Gregory W. Albert , Eric H. Kossoff , Joseph R. Madsen , Prakash Kotagal , Adam L. Numis , Nisha Gadgil , Deborah L. Holder , Elizabeth A. Thiele , George M. Ibrahim","doi":"10.1016/j.seizure.2024.10.013","DOIUrl":"10.1016/j.seizure.2024.10.013","url":null,"abstract":"<div><h3>Purpose</h3><div>To provide consensus-based recommendations for use of vagus nerve stimulation (VNS) therapy in the management of pediatric epilepsy.</div></div><div><h3>Methods</h3><div>Delphi methodology with two rounds of online survey was used to build consensus. A steering committee developed 43 statements related to pediatric epilepsy and the use of VNS therapy, which were evaluated by a panel of 12 neurologists/neurosurgeons with expertise in pediatric epilepsy, who graded their agreement with each statement on a scale of 1 (“I do not agree at all”) to 5 (“I strongly agree”). For each statement, consensus was established if ≥70% of the agreement scores were 4 or 5 and <30% were 1 or 2 in the final survey.</div></div><div><h3>Results</h3><div>Twenty-four statements regarding the need for seizure reduction in pediatric epilepsy, the recommended treatment algorithm, the benefits and safety of VNS therapy, management of side effects of VNS therapy, patient selection for VNS therapy, and the use, dosing, and titration of VNS therapy achieved consensus. VNS and other neuromodulation therapies should be considered for pediatric patients with drug-resistant epilepsy who are not candidates for resective surgery, or who do not remain seizure free after resective surgery. When VNS therapy is initiated, the target dose range should be achieved via the fastest and safest titration schedule for each patient. Scheduled programming can be helpful in dose titration.</div></div><div><h3>Conclusion</h3><div>The expert consensus statements represent the panelists’ collective opinion on the best practice use of VNS therapy to optimize outcomes in the management of pediatric epilepsy.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 97-103"},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hsiang-Yu Yu , Mamta Bhushan Singh , Josephine Chan , Pauline Samia , Amza Ali , Ji Yeoun Yoo , Yanin Rivera , Jitendra Kumar Sahu , Patricia Osborne Shafer , Bosanka Jocic-Jakubi , Johan Zelano , Ana Carolina Coan , Roberto Horacio Caraballo , Pablo Sebastián Fortini , Najib Kissani , J Helen Cross
{"title":"A global survey of telemedicine use in epilepsy care – practices before, during and after the COVID-19 pandemic","authors":"Hsiang-Yu Yu , Mamta Bhushan Singh , Josephine Chan , Pauline Samia , Amza Ali , Ji Yeoun Yoo , Yanin Rivera , Jitendra Kumar Sahu , Patricia Osborne Shafer , Bosanka Jocic-Jakubi , Johan Zelano , Ana Carolina Coan , Roberto Horacio Caraballo , Pablo Sebastián Fortini , Najib Kissani , J Helen Cross","doi":"10.1016/j.seizure.2024.10.012","DOIUrl":"10.1016/j.seizure.2024.10.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Telemedicine was widely adopted for epilepsy care during the COVID-19 pandemic. Its role extends beyond preventing disease transmission, offering an efficient and high-quality care alternative. To understand the global scenario, an international group conducted a survey comparing telemedicine practices in epilepsy care before, during, and after the pandemic.</div></div><div><h3>Methods</h3><div>The survey included 26 questions on demographics, telemedicine use for epilepsy care, regulations, reimbursement mechanisms, and tools used. Responses were collected via an online survey platform from June to October 2023.</div></div><div><h3>Results</h3><div>Two hundred eighty-five respondents from 60 countries participated. The average telemedicine use in daily practice was 0 %, 0–10 % (median, IQR) before the pandemic, 65 %, 30–90 % during the pandemic, and 20 %,10–50 % after the COVID pandemic. Female respondents reported higher telemedicine use than males after the pandemic (25 %, 10–50 % vs 15 %, 5 %-30 %, <em>p</em> = 0.002). According to respondents' perceptions, post-pandemic telemedicine regulations flexibilities were reported as expanded by 36.8 %, restricted by 17.2 %, and unchanged by 46 %. Reimbursement for telemedicine increased during the pandemic but decreased afterward (Cochran's Q test, <em>p</em> < 0.001). Voice calls were the most used telemedicine platform (46.6 %). Privacy issues were reported by 49 respondents (18.3 %).</div></div><div><h3>Conclusion</h3><div>Telemedicine use for epilepsy care increased during the pandemic and remained higher than pre-pandemic levels. However, improvements are needed in telemedicine applications, regulations, reimbursement, and patient privacy. International collaboration and experience sharing can enhance telemedicine's acceptance and practice globally.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 82-87"},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cristina Barcia Aguilar , Marta Amengual-Gual , J. Nicholas Brenton , Kevin E. Chapman , Justice Clark , William D. Gaillard , Joshua L. Goldstein , Howard P. Goodkin , Robert Kahoud , Yi-Chen Lai , Mohamad A. Mikati , Lindsey A. Morgan , Eric T. Payne , Craig A. Press , Latania Reece , Tristan T. Sands , Kumar Sannagowdara , Theodore Sheehan , Renée A. Shellhaas , Robert C. Tasker , Tobias Loddenkemper
{"title":"Lack of association of first and second-line medication dosing and progression to refractory status epilepticus in children","authors":"Cristina Barcia Aguilar , Marta Amengual-Gual , J. Nicholas Brenton , Kevin E. Chapman , Justice Clark , William D. Gaillard , Joshua L. Goldstein , Howard P. Goodkin , Robert Kahoud , Yi-Chen Lai , Mohamad A. Mikati , Lindsey A. Morgan , Eric T. Payne , Craig A. Press , Latania Reece , Tristan T. Sands , Kumar Sannagowdara , Theodore Sheehan , Renée A. Shellhaas , Robert C. Tasker , Tobias Loddenkemper","doi":"10.1016/j.seizure.2024.10.017","DOIUrl":"10.1016/j.seizure.2024.10.017","url":null,"abstract":"<div><h3>Purpose</h3><div>Evaluate the relationship between first and second-line medication dosing and progression to refractory status epilepticus (RSE) in children.</div></div><div><h3>Methods</h3><div>This is a retrospective analysis of prospectively collected data from September 2014 to February 2020 of children with status epilepticus (SE) who received at least two antiseizure medications (ASMs). We evaluated the risk of developing RSE after receiving a low total benzodiazepine dose (lower than 100 % of the minimum recommended dose for each benzodiazepine dose administered within 10 min) and a low first non-benzodiazepine ASM dose (lower than 100 % of the minimum recommended dose of non-benzodiazepine ASM given as the first single-dose) using a logistic regression model, adjusting for confounders such as time to ASMs. The proportion of patients receiving low first non-benzodiazepine ASM doses was calculated and a logistic regression model was used to evaluate risk factors for low dosing of the first non-benzodiazepine ASM.</div></div><div><h3>Results</h3><div>Among 320 children, 170 (53.1 %) developed RSE, and 150 (46.9 %) responded to the first non-benzodiazepine ASM dose (non-RSE). One hundred thirty-seven (42.8 %) received a low total benzodiazepine dose, and 128 (40 %) received a low first non-benzodiazepine ASM dose. The odds of developing RSE were not higher after a low total benzodiazepine dose (OR=0.76, 95 %CI 0.47–1.23, <em>p</em> = 0.27) or low first non-benzodiazepine ASM dose (OR=0.85, 95 %CI 0.42–1.71, <em>p</em> = 0.65). Receiving a low first non-benzodiazepine ASM dose was independently associated with having received a low total benzodiazepine dose (OR=1.65, 95 %CI 1.01–2.70, <em>p</em> = 0.04).</div></div><div><h3>Conclusion</h3><div>For most patients, dosing variability in first and second-line medications for SE was not the sole clinical feature predicting progression to RSE in this cohort of benzodiazepine-resistant patients. Identification of additional modifiable clinical biomarkers that predict progression to RSE is needed. Though lower ASM doses did not predict RSE in this model, the administration of ASMs at doses likely to prevent RSE remains crucial in SE treatment.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 133-141"},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mengyao Zhang , Yu Jia , Huifang Wang , Aihua Liu , Lehong Gao , Yuping Wang
{"title":"Epileptic seizure as the prominent symptom in Fahr syndrome, case report and literature review","authors":"Mengyao Zhang , Yu Jia , Huifang Wang , Aihua Liu , Lehong Gao , Yuping Wang","doi":"10.1016/j.seizure.2024.09.023","DOIUrl":"10.1016/j.seizure.2024.09.023","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 88-91"},"PeriodicalIF":2.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}