Insulinoma_seizure 雪貂之胰島素瘤與癲癇症

[雪貂胰島素瘤抽蓄發作]

1. ferrets can have seizures from several different diseases, but the most common cause is from low blood-sugar due to an insulinoma.
2. Insulinoma胰島素瘤 causes the pancreas胰腺 to overproduce insulin胰島素.  Too much insulin will cause the blood sugar too low.  When the blood sugar gets too low, the problems begin.
3. PROCESS
• insulinoma→overproduce insulin→blood sugar too low→problems begin: seizure, screaming fit with a very high-pitched vocalization→→→→。
4. THREATMENT
• 靜脈注射葡萄糖液. An IV catheter was put into the small vein in her front arm. An injection of sugar (dextrose) into the IV catheter.
• anti-seizure medications need to be used. such as valium.
• continued seizure activity, phenobarbital, propofol or general anesthesiz (with a gas such as Sevo or Iso) is the next thing to try.  

[seizire抽蓄]
[導致癲癇症的可能原因 ]
[誘發因素 ]
低血糖. 胰島素過度分泌導致血糖過低,引起的身體抽蓄(癲癇).
癲癇藥物突然停藥或減量。
睡眠不足，過度勞累。
身體不適：如感冒、發燒。
情緒不穩。
外界刺激：如聲、光-----等。
[癲癇症發作時常見的症狀 ]
[癲癇症大發作時的照顧與處理 ]
[居家照顧 ]
規律的日常生活，作息正常，勿熬夜、太疲累或太興奮。
按時服藥，定時回診，不可擅自調藥或停藥。
避免受到聲、光的刺激。
認識所服用藥物的名稱、作用及副作用。
多予病患心理支持。 病情穩定者可參加正常活動、目前使用的藥物及劑量。
 

癲癇症是由於腦細胞突發性放出不正常的電波，導致病患會不定時而且反覆的出現的現象，這些發作會在任何時刻出現，其症狀是千變萬化的。

先天性感染、腦先天發寓異常、先天缺養性病變、腦炎或腦膜炎、腦出血及某些代謝性疾病，少部分是遺傳。

1. 大叫一聲倒地不起→兩眼上吊→口吐白沫→四肢緊縮抽動→嘴唇發紫→意識喪失→抽動停止→清醒或沉睡，此屬大發作。
2. 半邊臉與手腳抽，但意識清楚。
3. 瞬間全身抖一下或如同斷了線的木偶墜落倒地。 全身僵硬、兩眼無神，呆滯的凝視前方、數秒後又回神。
4. 有些病患會有先兆症狀出現，如眼前會有閃光或突然聽見奇怪的聲音。

1. 先讓病患躺下，移開四周尖銳物品，側臥或頭側邊使口腔分泌物流出，以防阻塞呼吸道。
2. 解開衣領、鈕釦等身上束縛物，遣散四周圍觀人群，讓空氣流通。
3. 勿放置任何物品至病患口中；勿強制約束病患肢體。
4. 不須特殊處理，靜待其發作過程過去即可，發作後病患可能會覺得疲倦、嗜睡。
5. 記錄其發作時間、型態、次數。
6. 提醒兵病患當有發作前兆時，就近找出個較安全之處坐下或躺下。
7. 若病患連續發作應立刻就醫。 

 以上內容僅供參考用. 中文部分是來自人類癲癇症, 英文部分則來自雪貂胰島素瘤抽蓄發作資料. 兩者有部分雷同可參考,有些則存疑.

[原文參考]

I had a ferret case that was quite challenging to treat. The ferret was brought in because she was having seizure activity. Ferrets can have seizures from several different diseases, but the most common cause is from low blood-sugar due to an insulinoma
我有一隻雪貂的情況下，這是相當具有挑戰性的治療。雪貂被帶來了，因為她有癲癇發作。雪貂可以有幾個不同的疾病發作，但最常見的原因是由低血糖，由於胰島素瘤。

Insulinoma is a type of cancer in the pancreas. It causes the pancreas to overproduce insulin. Too much insulin will cause the blood sugar to become too low. When the blood sugar gets too low, the problems begin.
胰島素是胰腺的癌症類型。這造成胰腺過量胰島素。過多的胰島素會導致血糖變得太低。當血糖太低，問題的開始。

The ferret’s blood sugar was checked, and it was very low. The ferret had an insulinoma that was causing the seizures. An IV catheter was put into the small vein in her front arm. She was then given an injection of sugar (dextrose) into the IV catheter. IV fluids were started to rehydrate her, and an injection of cortisone was given to help raise her blood glucose level. She began to improve some and was alert enough to drink some liquid dextrose.
雪貂的血糖被檢查，這是非常低的。鼬不得不說是導致癲癇發作的胰島素瘤。靜脈導管放入小靜脈在她的前臂。然後她被注射糖（葡萄糖）進入靜脈導管。靜脈輸液是開始她補充水分，並注射可的松給予幫助提高她的血糖水平。她開始好轉了一些，就足以警示喝一些液體葡萄糖。

Unfortunately her blood glucose level was still lower than normal, and she began having seizures again. This time she had a “screaming fit” with a very high-pitched vocalization. Some more dextrose was injected into the IV catheter, and some dextrose was added to the IV fluids. This time her glucose level rose above the normal range. This stimulated the insulinoma to release more insulin, and her glucose quickly became too low again. It was hard to get her seizure to stop this time.
不幸的是她的血糖水平仍低於正常，她又開始有癲癇發作。這一次，她有一個“尖叫適合”具有非常高亢發聲。一些更葡萄糖注射到靜脈導管，和一些葡萄糖加入到靜脈輸液。這一次，她的血糖水平上升高於正常範圍。這刺激的胰島素釋放更多的胰島素，而她的血糖很快就太低了。這是很難讓她發作停止這個時候。

When a ferret remains in a seizure that does not respond to correcting the glucose level, additional anti-seizure medications need to be used. In this case, I used some valium, but she continued to have seizure activity. Phenobarbital, propofol or general anesthesia (with a gas such as Sevo or Iso) is the next thing to try. For this ferret, I put her under general anesthesia with Sevo to stop the seizure. It was hard to maintain her glucose in the normal range over the next 24 hours, but she eventually recovered.鼬保持在癲癇發作，不糾正的葡萄糖水平做出反應，另外的抗驚厥藥物需要被使用。在這種情況下，我用一些安定，但她還是繼續有癲癇發作。苯巴比妥，丙泊酚麻醉或全身麻醉（用氣體如瑟沃或ISO）是未來的事情來嘗試。對於這個鼬，我把她帶之下瑟沃全身麻醉停止發作。這是很難維持她在正常範圍在接下來的24小時血糖，但她最終被收回。

Ferrets are not the only species to suffer from insulinomas. Insulinomas have been reported in dogs, cats, guinea pigs, cattle and people. Fortunately insulinomas are rare in most species.

雪貂是不是唯一的物種胰島素之苦。胰島素瘤的報導在狗，貓，豚鼠，牛和人。幸運的胰島素瘤是罕見的種類最多