Navegando por Palavras-chave "Juvenile myoclonic epilepsy"

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    Are personality traits of juvenile myoclonic epilepsy related to frontal lobe dysfunctions? A proton MRS study
    (Wiley-Blackwell, 2009-05-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Lin, Katia [UNIFESP]; Lin, Jaime [UNIFESP]; Peruchi, Mirella M. [UNIFESP]; Caboclo, Luis Otavio S. F. [UNIFESP]; Guaranha, Mirian S. B. [UNIFESP]; Guilhoto, Laura M. F. F. [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Personality traits characterized by emotional instability and immaturity, unsteadiness, lack of discipline, hedonism, frequent and rapid mood changes, and indifference toward one's disease have been associated with patients who have juvenile myoclonic epilepsy (JME). Literature data demonstrate worse seizure control and more psychosocial dysfunctions among patients with JME who have those traits. in this controlled study we performed a correlation analysis of psychiatric scores with magnetic resonance spectroscopy (MRS) values across JME patients, aiming to verify the existence of a possible relation between frontal lobe dysfunction and the prevalence of personality disorders (PDs) in JME.Sixteen JME patients with cluster B PDs, 41 JME patients without any psychiatric disorder, and 30 healthy controls were submitted to a psychiatric evaluation and to a quantitative multivoxel MRS of thalamus; insula; cingulate gyrus; striatum; and frontal, parietal, and occipital lobes. Groups were homogeneous according to age, gender, and manual dominance. Psychiatric evaluation was performed through the Scheduled Clinical Interview for DSM-IV, Axis I and II (SCID I and II, respectively).A significant reduction of N-acetyl-aspartate over creatinine (NAA/Cr) ratio was observed mainly in the left frontal lobe in the JME and PD group. in addition, a significant increase in the glutamate-glutamine over creatinine GLX/Cr ratio was also observed in this referred region in the same group.These data support the hypothesis that PDs in JME could represent neuronal dysfunction and possibly a more severe form of this epileptic syndrome.
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    Cognitive performance in juvenile myoclonic epilepsy patients with specific endophenotypes
    (W B Saunders Co Ltd, 2016) de Carvalho, Kelly Cristina [UNIFESP]; Pedroso Uchida, Carina Goncalves [UNIFESP]; Bittar Guaranha, Mirian Salvadori [UNIFESP]; Guilhoto, Laura Maria F. F. [UNIFESP]; Wolf, Peter; Targas Yacubian, Elza Marcia [UNIFESP]
    Purpose: Juvenile myoclonic epilepsy (JME) is a heterogeneous syndrome in which seizures can be precipitated not only by non-specific factors, such as sleep deprivation and stress, but also by specific stimuli, such as photic stimuli, eye-closure, praxis, and language. The presence of these reflex traits may indicate the hyperexcitability of different cortical areas, which may be reflected in patients' neuropsychological deficit profile. The objective of our study is to investigate the possible relations between JME endophenotypes and patients' cognitive performance. Methods: 61 JME patients were divided into four groups: no reflex traits (group 1, 20 patients)
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    Epilepsia mioclônica juvenil: perfil cognitivo de pacientes com diferentes endofenótipos
    (Universidade Federal de São Paulo (UNIFESP), 2016-07-26) Carvalho, Kelly Cristina de [UNIFESP]; Yacubian, Elza Marcia Targas [UNIFESP]; http://lattes.cnpq.br/2533199994145143; http://lattes.cnpq.br/6840939110065222; Universidade Federal de São Paulo (UNIFESP)
    Purpose: Juvenile myoclonic epilepsy (JME) is a heterogeneous epileptic syndrome with seizures that are precipitated not only by general factors such as sleep deprivation and stress but also by praxis induction and language, eye-closure and photosensitivity. The aim of this study was to investigate whether the endophenotypes of JME influence on cognitive performance. Methods: Neuropsychological assessment of 61 patients with JME, being 20 patients with only general precipitating factors (group 1); 13 patients with praxis induction/language (group 2); 17 patients with eye-closure and photosensitivity (group 3) and 11 patients with the combination of reflex traits (group 4) was compared to 60 healthy controls (group 5). Neuropsychological performance was controlled by clinical variables: age of onset of epilepsy, frequency of myoclonic seizures and daily dose of total antiepileptic drugs (AED) and AEDs with sedative potential. Results: Group 1 patients had higher schooling (p=0.020). Male gender prevailed in group 2 (praxis induction) (p=0.018). In groups of patients with reflex traits there was persistence of myoclonic seizures on a daily frequency; sodium valproate in polytherapy was the most common prescription in all groups of patients and there was a higher use of clonazepam in group 2, as well as increased presence of psychiatric comorbidities. Group 4 patients had worse performance in the Trail Making Test part B when compared to those of groups 1 and 2 (p= 0.002 and 0= 0.009 for the total daily dose of medication, respectively). When controlling by daily doses of sedative AEDs, patients of group 4 had inferior performance than those of groups 1 and 2 (p 0=0.003 and 0=0.013, respectively). These results were independent of AEDs use per day, age of epilepsy onset or seizure control. Conclusion: In patients with JME the higher the expression of reflex traits, the greater the degree of executive dysfunction.
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    Espectroscopia por ressonância magnética de prótons em epilepsia mioclônica juvenil sugere o comprometimento de uma rede neuronal específica
    (Liga Brasileira de Epilepsia (LBE), 2008-09-01) Lin, Katia [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Lin, Jaime [UNIFESP]; Peruchi, M.m. [UNIFESP]; Araujo Filho, Gerardo Maria de [UNIFESP]; Pascalicchio, T.f. [UNIFESP]; Guaranha, Mirian Salvadori Bittar [UNIFESP]; Guilhoto, Laura Maria de Figueiredo Ferreira [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: The neuroanatomical basis and the neurochemical abnormalities that underlay juvenile myoclonic epilepsy (JME) are not fully defined. While the thalamus plays a central role in synchronization of widespread regions of the cerebral cortex during a seizure, emerging evidence suggests that all cortical neurons may not be homogeneously involved. The purpose of this study was to investigate the cerebral metabolic differences between patients with JME and normal controls. METHODS: All patients had a JME diagnosis based on seizure history and semiology, EEG recording, normal magnetic resonance neuroimaging (MRI) and video-EEG. Forty JME patients (JME-P) were submitted to 1.5 T MRI proton spectroscopy (1H-MRS), multi-voxel with PRESS sequence (TR/TE = 1500/30 ms) over the following locations: prefrontal cortex (PC), frontal cortex (FC), thalamus, basal nuclei, posterior cingulate gyrus (PCG), insular, parietal and occipital cortices. We determined ratios for integral values of N-acetyl aspartate (NAA) and glutamine-glutamate (GLX) over creatine-phosphocreatine (Cr). The control group (CTL) consisted of 20 age and sex-matched healthy volunteers. RESULTS: Group analysis demonstrated a tendency for lower NAA/Cr ratio of JME-P compared to CTL predominantly on FC, PC, thalamus and occipital cortex. When compared to CTL, JME-P had a statistically significant difference in GLX/Cr on FC, PC, insula, basal nuclei, PCG and on thalamus. When evaluating the relationship among the various components of this epileptic network among JME-P, the strongest correlation occurred between thalamus and PC. Also, we found a significant negative correlation between NAA/Cr and duration of epilepsy. CONCLUSION: Reductions in NAA may represent loss or injury of neurons and/or axons, as well as metabolic dysfunction while glutamate is considered to be an excitatory neurotransmitter in the brain which is involved in the pathogenesis of epileptogenic seizures.
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    Hippocampal atrophy and memory dysfunction in patients with juvenile myoclonic epilepsy
    (Elsevier B.V., 2013-10-01) Lin, Katia [UNIFESP]; Araujo Filho, Gerardo Maria de [UNIFESP]; Pascalicchio, Tatiana Frascareli [UNIFESP]; Silva, Ivaldo [UNIFESP]; Silva Tudesco, Ivanda Souza [UNIFESP]; Bittar Guaranha, Mirian Salvadori [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); HGCR; Universidade de São Paulo (USP)
    Juvenile myoclonic epilepsy (JME) is a well-defined idiopathic generalized epilepsy (IGE) syndrome, being the most common IGE in adults and accounting for 5-11% of patients with epilepsy. While neuropsychological and neuroimaging studies have discussed the thalamofrontal dysfunction as the major pathophysiologic mechanism of JME, investigation on memory is scarce in patients with JME, with lack of objective assessments addressing common complaints and daily difficulties such as recalling telephone numbers, messages to pass on, and taking antiepileptic drugs regularly. the aim of this study was to objectively assess memory deficits in a group of patients with JME using neuropsychological examination combined with structural MRI of the hippocampi. After informed consent, a cohort of 56 consecutive patients with JME (29 males; mean age +/- SD = 26.5 +/- 9.01 years; range = 14.0-55.0 years) was included. the control group consisted of 42 healthy volunteers (18 males; mean age +/- SD = 31.0 +/- 8.54 years; range = 20.0-56.0 years) without a family history of neuropsychiatric disorders. Patients and controls were submitted to a MRI and to a neuropsychological assessment, and comparisons between groups were performed, as well as a correlation study between hippocampal atrophy and neuropsychological performance in a group of patients with JME. the level of statistical significance was set at p < 0.05. Significant hippocampal atrophy among patients with JME was observed, which was correlated with memory dysfunctions. the present findings reinforce the existence of functional-anatomic ictogenic networks that are not limited to frontal lobes, providing further support towards the concept of 'system epilepsies' in JME. (C) 2013 Elsevier Inc. All rights reserved.
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    The integrity of corpus callosum and cluster B personality disorders: A quantitative MRI study in juvenile myoclonic epilepsy
    (Elsevier B.V., 2010-04-16) Araujo Filho, Gerardo Maria de [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]; Lin, Katia [UNIFESP]; Silva, Ivaldo [UNIFESP]; Guaranha, Mirian S. B. [UNIFESP]; Guilhoto, Laura M. F. F. [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Evidence suggests increased prevalence of cluster B personality disorders (PD) among patients with juvenile myoclonic epilepsy (JME), which has been associated with worse seizure control and more psychosocial dysfunctions. A preliminary voxel-based morphometry study demonstrated corpus callosum (CC) volume reduction in patients with JME and cluster B PD, particularly in the posterior midbody and isthmus. in this study we aimed to follow up these results with region of interest analysis. Sixteen JME patients with cluster B PD, 38 JME patients without any psychiatric disorder, and 30 demographically matched healthy controls submitted to a psychiatric evaluation and a magnetic resonance imaging scan. the total and regional callosal areas were obtained from the midsagittal slice using a semi-automated program. Psychiatric evaluation was performed through SCID-I and -II. Significant reductions in the posterior region of the CC were observed in the JME with PD group relative to the other groups. These data support previous findings of callosal reductions in cluster B PD, as well as a possible involvement of CC in patients with JME and such personality characteristics. (C) 2010 Elsevier Inc. All rights reserved.
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    Juvenile myoclonic epilepsy: Challenges on its 60th anniversary
    (W B Saunders Co Ltd, 2017) Yacubian, Elza Márcia Targas [UNIFESP]
    Purpose: Since its initial 1957 description, juvenile myoclonic epilepsy (JME) has been recognized as a common epileptic syndrome worldwide. Methods: We reviewed a series of articles on JME to clarify challenges in clinical and pathophysiological findings, treatment and outcome. Results: Typical JME characteristics include: 1) the age at seizure onset between 10 and 25 years
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    Juvenile myoclonic epilepsy: Psychiatric comorbidity and impact on outcome
    (Elsevier B.V., 2013-07-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Juvenile myoclonic epilepsy (JME) is a well-defined age-related idiopathic epilepsy syndrome. Past studies have emphasized the difficulties in the treatment of patients with JME, which have been attributed to some specific psychiatric, psychological, and psychosocial characteristics. These aspects have aroused a significant amount of interest in the last two decades. in this article, the available studies that investigated the prevalence of psychiatric disorders (PDs) in JME and its impact on seizure outcome were reviewed in order to provide an update to clinicians about these two important aspects associated with this common epilepsy syndrome. the review disclosed a high prevalence of PDs in patients with JME, particularly mood, anxiety, and personality disorders. in addition, most recent studies have also observed that overall prevalence of PDs in JME has not shown statistically significant differences when compared with TLE, an epilepsy syndrome where the psychiatric aspects are most frequently studied. Taken together, data regarding the prevalence of PDs and their possible consequences on seizure outcome on JME indicate that special attention should be directed to psychological disturbances and psychiatric symptoms in this epilepsy syndrome. the early recognition and treatment of psychiatric symptoms, as well as psychological disturbances and psychosocial difficulties, should be considered fundamental to JME prognosis.This article is part of a supplemental special issue entitled Juvenile Myoclonic Epilepsy: What is it Really? (C) 2013 Elsevier Inc. All rights reserved.
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    Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traits
    (Wiley-Blackwell, 2012-05-01) Beniczky, Sandor; Bittar Guaranha, Mirian Salvadori [UNIFESP]; Conradsen, Isa; Singh, Mamta Bhushan; Rutar, Veronika; Lorber, Bogdan; Braga, Patricia; Bogacz Fressola, Alicia; Inoue, Yushi; Targas Yacubian, Elza Marcia [UNIFESP]; Wolf, Peter; Danish Epilepsy Ctr; Univ Aarhus; Universidade Federal de São Paulo (UNIFESP); Tech Univ Denmark; All India Inst Med Sci; Univ Med Ctr Ljubljana; Inst Neurol; Natl Epilepsy Ctr
    Purpose: Previous studies have suggested that cognitive tasks modulate (provoke or inhibit) the epileptiform electroencephalography (EEG) discharges (EDs) in patients with juvenile myoclonic epilepsy (JME). Their inhibitory effect was found to be especially frequent (6490%). These studies arbitrarily defined modulation as a >100% increase or >50% decrease of the EDs compared with baseline, which may not sufficiently distinguish from spontaneous fluctuations. the aim of our study was to assess the modulation of EDs and the precipitation of myoclonic seizures by cognitive tasks and by conventional provocation methods, taking into account also the spontaneous fluctuation of EDs. Method: Sixty patients with JME underwent video-EEG recordings including 50-min baseline, sleep, hyperventilation, intermittent photic stimulation (IPS), and cognitive tasks. To account for spontaneous fluctuations of the EDs we divided the baseline period into 5-min epochs and calculated the 95% confidence interval for the baseline EDs in each patient. Modulation was assumed when the number of EDs during any 5-min test period was outside the 95% confidence interval. Key Findings: Using the arbitrary method, our results were similar to previous publications: Cognitive tasks seemed to inhibit the EDs in 94% of the patients, and to provoke them in 22%. However, when the spontaneous fluctuations were accounted for, inhibition was found in only 29% of the patients and provocation in 18%. A nonspecific effect of any cognitive task seemed to account for the observed significant inhibition in two-thirds of the cases, but was observed in only one of the patients with significant provocation. Photoparoxysmal response was observed in 23% of the patients. When accounting for the spontaneous occurrence of EDs, IPS had provocative effect in 10% of the patients. Hyperventilation and sleep had provocative effect on EDs to an extent similar to the cognitive tasks (hyperventilation: 22%; sleep: 18%). the conventional provocation methods tended to be more efficient in patients who were not seizure free. Myoclonia were recorded most often during the cognitive tasks (10 patients). Significance: Spontaneous fluctuations of EDs account for most of the previously described inhibitory effect of the cognitive tasks. the provocative effect of the cognitive tasks is task-specific, whereas the inhibitory effect seems to be related to cognitive activation in general.
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    Neuropsychology and behavior in juvenile myoclonic epilepsy
    (Elsevier B.V., 2013-07-01) Schmitz, Bettina; Yacubian, Elza Márcia Targas [UNIFESP]; Feucht, Martha; Hermann, Bruce; Trimble, Michael; Vivantes Humboldt Klinikum Berlin; Ctr Epilepsy; Universidade Federal de São Paulo (UNIFESP); Med Univ Wien AKH; Univ Wisconsin Hosp & Clin; Natl Hosp Neurol & Neurosurg
    Following decades of neglect, there has been an increasing interest in the behavioral aspects of juvenile myoclonic epilepsy (JME) in the recent literature. A number of authors have investigated psychiatric comorbidity, cognitive profiles, and related behavioral features associated with JME. Although these findings are not entirely uniform, most studies suggest an increased incidence in psychiatric comorbidity and specific cognitive deficits that explain some of the clinical observations of poor compliance and other unhealthy behaviors in people suffering from JME. Neuropsychological profiles in JME are suggestive of subtle frontal dysfunctions, and some of the observations have been linked with sophisticated structural and functional imaging findings. Taken together, there is evidence that JME is associated with dysfunctions in networks linking motor and cognitive neuronal centers. Interestingly, there is evidence from family studies that the behavioral abnormalities in JME are genetically determined, suggesting an underlying developmental disorder.This article is part of a supplemental special issue entitled Juvenile Myoclonic Epilepsy: What is it Really? (C) 2013 Elsevier Inc. All rights reserved.
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    Personality traits in juvenile myoclonic epilepsy: Evidence of cortical abnormalities from a surface morphometry study
    (Elsevier B.V., 2013-05-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Araujo, Thabata Bueno de [UNIFESP]; Sato, Joao Ricardo [UNIFESP]; Silva, Ivaldo da [UNIFESP]; Lin, Katia [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do ABC (UFABC)
    Cluster B personality disorders (PD), characterized as emotional instability, immaturity, lack of discipline, and rapid mood changes, have been observed among patients with juvenile myoclonic epilepsy (JME) and have been associated with a worse seizure outcome. Proper understanding of the neurobiology of PD associated with JME could contribute to understanding the basis for earlier and more effective interventions. in the present study, volumetric and geometric features of cortical structure were assessed through an automated cortical surface reconstruction method aiming to verify possible structural cortical alterations among patients with JME. Twenty-two patients with JME with cluster B PD, 44 patients with JME without psychiatric disorders, and 23 healthy controls were submitted to a psychiatric evaluation through SCID I and SCID II and to an MRI scan. Significant cortical alterations in mesiofrontal and frontobasal regions, as well as in other limbic and paralimbic regions, were observed mainly in patients with JME with PD. the present study adds evidence to the hypothesis of frontal and limbic involvement in the pathophysiology of cluster B PD in JME, regions linked to mood and affective regulation, as well as to impulsivity and social behavior. Moreover, a multidimensional pattern of frontal, limbic, and paralimbic changes was observed through a method of structural analysis which offers different and simultaneous geometric features, allowing the elaboration of important pathophysiologic insights about cluster B PD in JME. (C) 2013 Elsevier Inc. All rights reserved.
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    Personality traits related to juvenile myoclonic epilepsy: MRI reveals prefrontal abnormalities through a voxel-based morphometry study
    (Elsevier B.V., 2009-06-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]; Lin, Katia [UNIFESP]; Guaranha, Mirian S. B. [UNIFESP]; Guilhoto, Laura M. F. F. [UNIFESP]; Silva, Henrique Hattori da [UNIFESP]; Sales Ferreira Caboclo, Luis Otavio [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Studies involving juvenile myoclonic epilepsy (JME) patients have demonstrated an elevated prevalence of cluster B personality disorders (PD) characterized as emotional instability, immaturity, unsteadiness, lack of discipline, and rapid mood changes. We aimed to verify a possible correlation between structural brain abnormalities in magnetic resonance image (MRI) and the PD in JME using voxel-based morphometry (VBM). Sixteen JME patients with cluster B PD, 38 JME patients without psychiatric disorders, and 30 healthy controls were Submitted to a psychiatric evaluation through SCID I and II and to a MRI scan. Significant reduction in thalami and increase in mesiofrontal and frontobasal regions' volumes were observed mainly in JME patients with PD. Structural alterations of the orbitofrontal cortex (OFC), involved in regulation of mood reactivity, impulsivity, and social behavior, were also observed. This study supports the hypothesis of frontobasal involvement in the pathophysiology of cluster B PD related to JME. (C) 2009 Elsevier Inc. All rights reserved.
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    Praxis induction. Definition, relation to epilepsy syndromes, nosological and prognostic significance. A focused review
    (W B Saunders Co Ltd, 2014-04-01) Yacubian, Elza Márcia Targas [UNIFESP]; Wolf, Peter; Universidade Federal de São Paulo (UNIFESP); Danish Epilepsy Ctr
    Purpose: There is increasing awareness that reflex epileptic mechanisms provide unique insight into ictogenesis in human epilepsies. Several of the described triggers have in common that they imply complex visuomotor coordination and decision-making; they are today regarded as variations of one principle, i.e. praxis induction (PI). This focused review considers PI from the aspects of history and delineation, clinical and electroencephalographic presentation, syndromatic relations, prevalence, mechanisms of ictogenesis and nosological implications, treatment and prognosis.Methods: We reviewed a series of published articles and case reports on PI in order to clarify clinical and electroencephalographic findings, treatment and outcome.Results: Findings of both induction and inhibition by the same stimuli suggest widening the reflex epilepsy concept into a broader one of epilepsies with exogenous modification of ictogenesis. PI is closely related to juvenile myoclonic epilepsy (JME) where hyperexcitability and hyperconnectivity of the entire network of visuomotor coordination seem to provide the precondition for eliciting reflex myocloni in the musculature active in the precipitating task.Conclusion: the conclusions on ictogenesis derived from PI support the concept of JME as a system disorder of the brain. (C) 2014 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.
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    Prognosis of juvenile myoclonic epilepsy is related to endophenotypes
    (W B Saunders Co Ltd, 2011-01-01) Guaranha, Mirian Salvadori Bittar [UNIFESP]; Araujo Filho, Gerardo Maria de [UNIFESP]; Lin, Katia [UNIFESP]; Guilhoto, Laura Maria de Figueiredo Ferreira [UNIFESP]; Caboclo, Luís Otávio Sales Ferreira [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To investigate if phenotypic variations have prognostic implications in juvenile myoclonic epilepsy (JME).Methods: Sixty-five consecutive JME patients had video-EEG recording and were followed for at least three years. Reflex traits were defined as seizures and/or EEG discharges induction by eye-closure, photic stimulation, language, praxis or calculation. Patients had psychiatric evaluation and answered to STAI (State-Trait Anxiety Inventory). Seizure control was classified according to Prasad et al. (2003).(24) Patients were divided into Group 1: good seizure control and Group 2: moderate or poor seizure control. Video-EEG/EEG evaluation was repeated in 21 patients.Results: Forty of 65 (61.5%) patients reached good seizure control, 25(38.5%) of whom became seizure free. Group 2 patients had longer epilepsy duration (13.9 +/- 9.0 vs. 8.7 +/- 8.2; p = 0.019); higher prevalence of the combination of all three seizure types (72.0% vs. 30.0%; p = 0.003); discharges in baseline EEG (56.0% vs. 22.5%; p = 0.008); seizure recording (68% vs. 20%; p < 0.001) and sensitivity to praxis (63.6% vs. 29.6%; p = 0.023). Compared to seizure-free patients, those with persistent seizures presented younger age at epilepsy onset (12.6 +/- 3.33 years vs. 15.4 +/- 5.47 years; p = 0.015); higher prevalence of personality disorders (25% vs. 4%; p = 0.029); higher scores in STAI-T (45.9 +/- 11.31 vs. 36.6 +/- 11.43; p = 0.011) and higher incidence of sensitivity to praxis (58.6% vs. 25.0%; p = 0.04) and to language (53.8 vs. 16.7%; p = 0.026) tasks. Repetition of EEG/video-EEG revealed a parallel evolution of reflex traits disappearance and seizure control.Discussion: Clinical features and reflex traits have prognosis implications in JME. (C) 2010 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.
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    Psychiatric comorbidity in patients with two prototypes of focal versus generalized epilepsy syndromes
    (W B Saunders Co Ltd, 2011-06-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Mazetto, Lenon [UNIFESP]; Silva, Joyce Macedo da [UNIFESP]; Caboclo, Luís Otávio Sales Ferreira [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The frequency of psychiatric disorders (PD) in a homogeneous series of patients with temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS) compared to patients with juvenile myoclonic epilepsy (JME) was evaluated, aiming to determine the frequency of PD and possible differences in psychiatric diagnoses between these two epileptic syndromes. Data from 248 patients with refractory TLE-MTS and from 124 JME patients were reviewed and compared. There was a high prevalence of PD in both groups of epilepsy patients, present in 100 TLE-MTS (41%) and in 58 JME patients (46.7%). Mood (23.7%), anxiety (13.7%) and psychotic (11.6%) disorders were the most frequent diagnoses in TLE-MTS group, while mood and anxiety disorders (25% and 21%, respectively) were the most common PD among JME. Psychoses were significantly associated with TLE-MTS (p = 0.01). These observations are concordant with our previous study, reforcing the existence of a possible anatomic correlation of PD and brain structures involved in both epilepsy syndromes. (C) 2011 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.
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    Psychoses of epilepsy: A study comparing the clinical features of patients with focal versus generalized epilepsies
    (Elsevier B.V., 2011-04-01) Araujo Filho, Gerardo Maria de [UNIFESP]; Silva, Joyce Macedo da [UNIFESP]; Mazetto, Lenon [UNIFESP]; Marchetti, Renato Luis; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    In the literature, psychosis of epilepsy (POE) has been described as one of the most frequent psychiatric comorbidities of epilepsy, occurring particularly in association with temporal lobe epilepsy. However, the presence of such psychiatric disorders among patients with idiopathic generalized epilepsies has also been mentioned. in this study, we evaluated the clinical features of psychotic disorders in a series of patients with temporal lobe epilepsy related to mesial temporal sclerosis (TLE-MTS) and juvenile myoclonic epilepsy with the aim of describing and comparing the clinical patterns of the psychotic symptoms in such frequent and important epilepsy syndromes. POE occurred most frequently in patients with TLE-MTS (P=0.01), but no differences were observed between the groups with respect to the subtypes and core symptoms of psychoses. the clinical implications of POE in both epilepsy syndromes are discussed. (C) 2011 Elsevier Inc. All rights reserved.
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    Validity and reliability of the Portuguese-Brazilian version of the Quality of Life in Epilepsy Inventory-89
    (Elsevier B.V., 2009-03-01) Azevedo, Auro Mauro [UNIFESP]; Alonso, Neide Barreira [UNIFESP]; Vidal-Dourado, Marcos [UNIFESP]; Silva Noffs, Maria Helena da [UNIFESP]; Pascalicchio, Tatiana Frascarelli [UNIFESP]; Sales Ferreira Caboclo, Luis Otavio [UNIFESP]; Ciconelli, Rozana Mesquita [UNIFESP]; Sakamoto, Americo Ceiki [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: the purpose of this article was to report the translation of the Quality of Life in Epilepsy Inventory-89 (QOLIE-89) into a Portuguese-Brazilian version and evaluate its reliability and validity.Methods: This study involved 105 Outpatients: 54 patients with refractory temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) and 51 with juvenile myoclonic epilepsy (JME). Reliability and test-retest reliability were assessed. Relationships between QOLIE-89 domains and other questionnaires (Nottingham Health Profile, Beck Depression Inventory, Adverse Event Profile, Neuropsychological Evaluation), and external measures such as demographic and clinical variables were analyzed to examine construct validity.Results: Internal consistency (Cronbach's alpha = 0.73-0.92) and test-retest reliability (intraclass correlation coefficient = 0.60-0.84) for individual domains were acceptable. for construct validity, we verified high correlations between the QOLIE-89 and the Nottingham Health Profile, Beck Depression Inventory, Adverse Event Profile, and Neuropsychological Evaluation. for clinical characteristics, the patients with juvenile myoclonic epilepsy had better quality-of-life scores on 11 of 17 QOLIE-89 subscales compared with patients with temporal lobe epilepsy (P < 0.05).Conclusion: These results Support the reliability and validity of the Portuguese-Brazilian translation of QOLIE-89. (C) 2009 Published by Elsevier Inc.
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    Voxel-based morphometry evaluation of patients with photosensitive juvenile myoclonic epilepsy
    (Elsevier B.V., 2009-10-01) Lin, Katia [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Araujo Filho, Gerardo Maria de [UNIFESP]; Silva, Henrique Hattori [UNIFESP]; Bittar Guaranha, Mirian Salvadori [UNIFESP]; Figueiredo Ferreira Guilhoto, Laura Maria [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    We aim to investigate structural brain abnormalities in juvenile myoclonic epilepsy (JME) patients with photosensitivity (PS). Sixty JME patients, 19 (32%) of whom were photosensitive, were submitted to 1.5 T magnetic resonance voxel-based morphometry (VBM). the control group (CTL) consisted of 30 sex-matched healthy volunteers. JME patients with (JME-PS) and without (JME-NPS) PS did not differ in their duration of disease, treatment or seizure control. VBM revealed significantly reduced bilateral gray matter volume (GMV) in thalami, insula cortices and cerebellar hemispheres; while significantly increased GMV was observed in the right superior frontal, orbitofrontal and medial. frontal gyri of the JME group compared to CTL. JME-PS had reduced bilateral GMV of visual cortices when compared with CTL; white it was not seen among JME-NPS patients. Reduced left hippocampus and left inferior frontal gyrus volume was observed among JME-PS compared with JME-NPS. This study demonstrates structural abnormalities beyond the limits of the frontal lobes and provides evidence for the role of the occipital cortex in human PS, reinforcing the existence of functional-anatomic ictogenic networks in JME and the concept of 'system epitepsies'. (C) 2009 Elsevier B.V. All rights reserved.