Navegando por Palavras-chave "epilepsia"

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    Alcohol consumption and sudden unexpected death in epilepsy: experimental approach
    (Academia Brasileira de Neurologia - ABNEURO, 2009-12-01) Scorza, Carla Alessandra [UNIFESP]; Cysneiros, Roberta Monterazzo [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Terra, Vera Cristina; Machado, Helio Rubens; Almeida, Antonio-Carlos G. de; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Presbiteriana Mackenzie Centro de Ciências Biológicas e da Saúde; Universidade de São Paulo (USP); Universidade Federal de São João Del Rei Departamento de Engenharia Biomédica
    Using the pilocarpine model of epilepsy, we investigated the effects of alcohol consumption on the frequency of seizures in animals with epilepsy as well the underlying a possible association between alcohol intake and sudden unexpected death in epilepsy (SUDEP) occurrence. Rats were divided randomly into two groups: (A) rats with epilepsy and (B) rats with epilepsy that received a daily dose of ethanol solution (350 mg kg-1, i.p.) for 30 days. The basal frequency of seizures observed in the A and B groups during the first 30 days were 3.4±1.5 and 3.2±1.9 seizures per week per animal, respectively. In B group, it was observed a significant seizure increase (11.6±5.3) during the first 2 weeks of alcohol administration and quite interesting, one rat died suddenly after a generalized tonic-clonic seizure during this period. We concluded in our experimental study that exist a possible association between alcohol abuse and SUDEP occurrence.
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    Alterações cardiovasculares e morte súbita nas epilepsias
    (Academia Brasileira de Neurologia - ABNEURO, 2007-06-01) Scorza, Fulvio Alexandre [UNIFESP]; Albuquerque, Marly de [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Mogi das Cruzes
    Epilepsy is the most common neurological disorder and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death . The cause of SUDEP is still unknown, however, the most commonly suggested mechanisms are cardiac abnormalities. Based on this, in this review the relationship between SUDEP and cardiac abnormalities has been emphasized.
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    Alterações comportamentais e cognitivas em ratos submetidos a lesão do núcleo lateral posterior do tálamo
    (Universidade Federal de São Paulo (UNIFESP), 2016-02-24) Aurora, Loredanna Cavalheiro [UNIFESP]; Scorza, Fulvio Alexandre Scorza [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Epilepsy is a chronic disease characterized by the expression of spontaneous recurrent seizures, affecting 0.5% to 2% of the world population. Experimental and clinical data indicates that the thalamic nuclei operates in the installation and propagation of seizures, as well as the consequential behavioral modifications of those seizures. Furthermore, the thalamus has extensive connections with the cortex, basal ganglia, superior colliculus, cerebellum and hippocampus, constituting an essential part of the cortical-striatal circuits. The lateral posterior thalamic nuclei (LP) has control over epileptic activity, and we observed that animals that had such damaged structure have had increased by about five times the frequency of the epileptic seizures. To considerate the value of those structures in the performance of activities such as learning, memory and social interaction, it is important to understand the possible behavioral changes that may be arising from injury in this region. Towards the understanding of such associations, male Wistar rats were subjected to electrolytic lesion of the LP core and behavioral assessment was made later in with operant chamber, sociability test, open field and elevated plus maze. In the animals of Group LP it was observed increased type anxious behavior, increased immobility, lower preference for social novelty, disabilities in learning and flexibility and, finally, evidence of stereotyped behavior type. We explain those changes based on the connections that such nuclei presentes with the cerebral cortex and superior colliculus, those last mencioned are related with visual processing as well as with the attention directed behaviour. Nevertheless, the increase of emocionality/ anxiety, which we believe are the cause of impairment in social interation tasks, may be linked to a deficit in the subcortical pathway, that includes the amigdala, meaning a dificulty in the discrimination between natural behavior threats. Thus, these data suggests that the thalamic lesions in this region cause changes in behavior and cognitive deficits which are similar to those found in epilepsy.
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    Atypical EEG pattern in children with absence seizures
    (Academia Brasileira de Neurologia - ABNEURO, 1995-06-01) Silva, Délrio F. [UNIFESP]; Lima, Márcia Marques; Anghinah, Renato; Zanoteli, Edmar [UNIFESP]; Lima, José Geraldo Camargo; Universidade Federal de São Paulo (UNIFESP)
    We studied four children with diagnosis of absence seizures (generalized primary epilepsy), and with a generalized delta activity on the EEG during clinical attacks provoked by hyperventilation. The lack of ictal generalized spike-and-wave discharges with a frequency of 3 Hz in our patients, makes this an atypical pattern. All children had complete control of their seizures and disappearance of the EEG changes with valproate. We concluded that generalized delta activity observed on EEG during the hyperventilation in children should not always be considered as a normal finding for age, since it could be an ictal event of an absence seizure.
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    Avaliação de parâmetros cardíacos em animais com epilepsia: possível causa de morte súbita?
    (Academia Brasileira de Neurologia - ABNEURO, 2005-12-01) Colugnati, Diego Basile [UNIFESP]; Gomes, Paulo Alberto Paes; Arida, Ricardo Mario [UNIFESP]; Albuquerque, Marly de [UNIFESP]; Cysneiros, Roberta Monterazzo [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade de Mogi das Cruzes Núcleo de Pesquisas Tecnológicas; Universidade Federal de São Paulo (UNIFESP); UMC NPT Laboratório de Neurociências; Centro Universitário São Camilo; UMC
    Among the causes for sudden death in epilepsy, cardiac dysfunction has been an area of interest. Based on this, the aim of our study was to evaluate the heart rate (in vivo and in vitro) and ventricular pressure in vitro of rats with epilepsy induced by pilocarpine. Adult male Wistar rats (n=6) were given pilocarpine hydrochloride to induce status epilepticus. Control rats (n=6) received saline solution instead pilocarpine. Our results showed significant differences in the mean of heart rate in vivo between the groups. In contrast, we did not find differences during in vitro experiments. Our results suggest a central nervous system modulation on the heart, which could explain the sudden unexpected death in epilepsy.
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    Avaliação do perfil metabólico, nutricional e efeitos adversos de crianças com epilepsia refratária em uso da dieta cetogênica
    (Pontifícia Universidade Católica de Campinas, 2006-10-01) Rizzutti, Sueli [UNIFESP]; Ramos, Ana Maria Figueiredo [UNIFESP]; Cintra, Isa de Pádua [UNIFESP]; Muszkat, Mauro [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: The purpose of this research was to evaluate adverse events, serum biochemistry, growth and nutritional status of children with difficult-to-control seizures who were submitted to ketogenic diet. METHODS: Twenty-three patients aging from 2 to 17 years with refractory epilepsies, where 43.5% (n=10) were males and 56.5% (n=13) females from the Sector of Neuropediatrics, Discipline of Neurology of the Universidade Federal de São Paulo (UNIFESP), were treated with the ketogenic diet and followed up for at least 1 year. Two patients were not able to achieve persistent ketosis either because they rejected the diets or their parents did not comply. RESULTS: Adverse events were all reversible and included hyperlipidemia, constipation (17.4%), nausea and vomiting (43.4%), drowsiness (47.8%), intercurrent infections (3.0%), diet refusal (13.0%) and epistaxis (4.3%). Growth was not affected in the short term and most heights remained within the normal centile lines. CONCLUSION: The ketogenic diet can be considered a safe and effective treatment for children with intractable seizures.
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    Avaliação dos hábitos de atividades físicas de adolescentes com epilepsia do município de Toledo-PR
    (Liga Brasileira de Epilepsia (LBE), 2008-12-01) Cervelini, Renato; Scorza, Fulvio Alexandre [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Universidade do Paraná; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: Although the beneficial effect of physical activity in general population and those with different types of diseases, people with epilepsy are often discouraged and excluded from physical activity participation. This usually occurs due the fear that physical activity might induce or worse epileptic seizures. Stigma and prejudice are factors which contribute to these attitudes. In spite of several studies in literature have analyzed the relationship between epilepsy and physical activity, there are no evident data evaluating the teenager population profile in relation to their physical activity habits. OBJECTIVE: Therefore, we sought to study the degree of participation in physical activities among teenagers with epilepsy of Toledo City-PR using a questionnaire. METHODS: Teenagers outpatients with epilepsy were checked by Consortium (CISCOPAR) in Toledo City-PR and invited to participate as study subject during a workaday visit at professional physician. RESULTS: All the teenagers reported opportunities of leisure time. Eighty percent of the teenagers participated physical activities, but not all of them regularly. Sixty-nine percent of the individuals (n = 20) in our study presented seizures during physical exercise and fifty-two percent (n = 14) were afraid that exercise might cause seizures. CONCLUSION: In spite of the small number of individuals analyzed in this study, our results show that epilepsy has a negative influence on physical activity habits in adolescents.
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    Calcificação intracraniana occipital bilateral, epilepsia e doença celíaca: relato de caso
    (Academia Brasileira de Neurologia - ABNEURO, 2002-09-01) Santos, Carlos Henrique Souza [UNIFESP]; Almeida, Iara Leda Brandão de [UNIFESP]; Gomes, Maria Durce Costa [UNIFESP]; Serafim, Alexandre [UNIFESP]; Pereira, Mariana Machado [UNIFESP]; Muszkat, Mauro [UNIFESP]; Rizzutti, Sueli [UNIFESP]; Patricio, Francy Reis da Silva [UNIFESP]; Miranda, Mônica Carolina [UNIFESP]; Vilanova, Luiz Celso Pereira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    We report a case of a six-year-old girl with frequent diarrhea episodes associated with ferroprive anemia from 6 months of age, normal neuromotor development and partial seizures initiated in her 3rd year which was controlled with carbamazepine. CT scan in her 5th year of age demonstrated gyral calcifications in the occipital and posterior parietal regions bilaterally. MRI has shown low signal areas in the axial T2 sequences corresponding to the gyral calcifications evident on the CT. Blood investigation for coeliac disease with antigliadin, endomysial and transglutaminase antibodies was positive and the intestinal biopsy has showed villous atrophy associated with an increased number of intraepithelial lymphocytes and hypertrophic criptae compatible with coeliac disease.
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    Características de pacientes cirurgicamente tratados com tumores neuro-epiteliais de baixo grau do sistema nervoso central
    (Universidade Federal de São Paulo (UNIFESP), 2015-09-18) Slaviero, Felipe [UNIFESP]; Centeno, Ricardo Silva Centeno [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To define two different groups of neurosurgical patients with low-grade neuroepithelial brain tumors regarding the presence of medically refractory epilepsy (group A) or absence of medically refractory epilepsy (group B). To identify the characteristics and to define the differences between these groups in the clinical and surgical aspects. To measure the surgical impact in the control of medically refractory epilepsy. To describe the biological behavior of tumors in both groups. Methods: This paper retrospectively evaluate a cohort of patients who underwent resection or biopsy for low-grade gliomas and glioneuronal tumors in the Discipline of Neurosurgery at the Federal University of São Paulo between 2003 and 2013. The histologically proved tumors as grades I and II, according to the World Heath Organization (WHO) classification, were selected. The patients were stratified in two groups regarding the presence of medically refractory epilepsy (group A) or absence of medically refractory epilepsy (group B). The postoperative seizure control is evaluated in the group A with the Engel scale and the related factors are investigated. The biological tumor behavior is analyzed in both groups with measurement of the progression free survival, Kaplan-Meier curves for recurrence and, mortality rates. Results: A total of 76 patients with low grade tumors were selected and divided in group A (48 patients) and group B (28 patients) with a median follow-up of 4,2 years. Statistical analysis between groups A and B showed difference for the age at operation (23,5 vs 36,2 years), age at symptoms onset (15 vs 33,9 years) and duration of symptoms (8,4 vs 2,4 years),(p<0,001). In group A the temporomesial location was more common (63% vs 32%),(p=0,01) and in group B the extratemporal (24% vs 68%) and multilobar location (6% vs 54%),(p<0,001) were more prevalent. Regarding the histology, the group A was more affected by grade I tumors and glioneuronal histology (71% vs 0%), while group B had a higher prevalence of grade II gliomas (25% vs 86%)(p<0,001). There was a difference for the frequency of gross total resection (75% vs 7%),(p<0,001), mortality (0% vs 25%),(p<0,001) and recurrence (15% vs 39%),(p<0,003) between groups. In the group with refractory epilepsy, gross total resection and glioneuronal histology were predictive of longterm seizure control, (p=0,03). Conclusions: The patients with medically refractory epilepsy are younger, have longer period of symptoms and typically have !xvii temporomesial glioneuronal tumors, in which the gross total resection is usually possible. The patients without medically refractory epilepsy usually comprises grade II gliomas with more extratemporal and multilobar locations. The recurrences are earlier and the mortality rate is higher in this group. Gross total resection and glioneuronal histology are predictive of long-term seizure control in medically refractory epilepsy patients.
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    Carbamazepine does not alter the intrinsic cardiac function in rats with epilepsy
    (Academia Brasileira de Neurologia - ABNEURO, 2010-08-01) Colugnati, Diego Basile [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Cysneiros, Roberta Monterazzo [UNIFESP]; Terra, Vera Cristina; Sonoda, Eliza Yumi de Freitas [UNIFESP]; Pansani, Aline Priscila [UNIFESP]; Scorza, Carla Alessandra [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Presbiterian Mackenzie University Center of Biological Sciences and Health Program Graduate Development Disorders; University of São Paulo Ribeirão Preto Medicine School Department of Neurosciences and Behavior Sciences
    Among the causes for sudden unexpected death (SUDEP) in epilepsy, the effects of antiepileptic drugs on the heart have been poorly explored. Based on this, the aim of our study was to evaluate the heart rate (in vivo and isolated ex vivo) and ventricular pressure (isolated ex vivo) of rats with and without epilepsy treated with carbamazepine. Four groups of adult, male Wistar rats (200-250 g) were studied: [A] control rats (n=8), received neither pilocarpine nor carbamazepine [B] carbamazepine-treated rats (n=8), received a daily dose of 120 mg/Kg, i.p. of carbamazepine for two weeks; [C] rats with epilepsy that received just saline solution (n=8); [D] rats with epilepsy that received a daily dose of 120 mg/Kg, i.p. of carbamazepine for two weeks (n=8). Our results showed significant increase in heart rate in animals with epilepsy (with and without the use of carbamazepine) when compared to the control groups in vivo. In contrast, we did not find differences during isolated ex vivo experiments comparing animals with and without epilepsy and despite the use of carbamazepine. Our results suggest that, in isolation, carbamazepine may not be a potential risk factor for sudden unexpected death in epilepsy.
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    Clinical features and surgical outcome of patients with indolent brain tumors and epilepsy
    (Liga Brasileira de Epilepsia (LBE), 2007-06-01) Melo, Julieta G. S. P. [UNIFESP]; Centeno, Ricardo Silva [UNIFESP]; Malheiros, Suzana Maria Fleury [UNIFESP]; Ferraz, Fernando Antonio Patriani [UNIFESP]; Stávale, João Norberto [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Sakamoto, Américo Ceiki [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: In this study the authors review the outcomes of 22 patients with medically refractory epilepsy and slow growth brain tumors. OBJECTIVES: Evaluate the clinical, electrophysiological, operative, and histopathological features. PATIENTS AND RESULTS: The majority of the tumors were located in the temporal lobe (n = 20) and involved the cortical gray matter. The most frequent tumors were gangliogliomas (n = 9), astrocytomas grade I and II (n = 6), dysembryoplastic neuroepithelial tumors (n = 5) and ganglioneuroma (n = 2). The biological behavior of the tumors was strikingly indolent, as indicated by a long preoperative history of chronic seizures (mean, 14 years). Mean follow-up time after resection was 27 months, and according to Engel s classification, 85% were seizure-free, 10% showed a reduction of seizure frequency of at least 90%, and 5% had reduction in seizure frequency at least 75%. CONCLUSION: The data indicate that neoplasms associated with pharmacoresistent epilepsy constitute a distinct clinicopathological group of tumors that arise in young patients, involve the cortex, and exhibit indolent biological behavior for many years. Complete surgical removal of these tumors, including the epileptogenic area, can achieve excellent seizure control.
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    Comparação da qualidade de vida e sobrecarga dos cuidadores de pacientes com epilepsia por esclerose mesial temporal e epilepsia mioclônica juvenil
    (Liga Brasileira de Epilepsia (LBE), 2005-01-01) Westphal, Ana Carolina [UNIFESP]; Alonso, Neide Barreira [UNIFESP]; Silva, Tatiana Indelicato Da [UNIFESP]; Azevedo, Auro Mauro [UNIFESP]; Caboclo, Luís Otávio Sales Ferreira [UNIFESP]; Garzon, Eliana [UNIFESP]; Sakamoto, Américo Ceiki [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: The relationship pattern between patient and caregiver can influence in quality of life (QOL) and growth of both. OBJECTIVE: To compare QOL and burden over the caregivers of patients with refractory temporal lobe epilepsy (TLE) due to mesial temporal sclerosis and juvenile myoclonic epilepsy (JME). CASUISTIC AND METHODS: 20 caregivers of patients with TLE and 20 of patients with JME were evaluated. The QOL Inventory SF-36 and the Caregiver Burden Questionnaire Burden Interview - Zarit - were applied. RESULTS: When QOL of both groups was compared, no relation statistically significant was observed between caregivers for JME and TLE, as well as burden on them. There was a correlation for burden on the caregivers of JME patients and the following domains of SF-36: General Health Status (p = 0.011), Emotional Limitation Aspects (p = 0.037) e Mental Health (p = 0.002). CONCLUSION: The burden on the caregivers of both groups was similar and did not interfere in QOL in most of SF-36 domains. However, caregivers of patients with JME suffered greater impact in domains related to physical and emotional health. In spite of more adequate seizure control in JME patients this burden might be heavier due to greater exposure to daily activities.
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    Complex partial seizures and aphasia as initial manifestations of non-ketotic hyperglycemia: case report
    (Academia Brasileira de Neurologia - ABNEURO, 1998-06-01) Batista, Marcus Sabry Azar [UNIFESP]; Silva, DÉlrio FaÇanha [UNIFESP]; Ferraz, Henrique Ballalai [UNIFESP]; Andrade, Luiz Augusto Franco de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    We describe a case of non-ketotic hyperglycemia (NKH), heralded by complex partial seizures and aphasia of epileptic origin, besides versive and partial motor seizures. This clinical picture was accompanied by left fronto-temporal spikes in the EEG. The seizures were controlled by carbamazepine only after the control of the diabetes. A month later, carbamazepine was discontinued. The patient remained without seizures, with normal language, using only glybenclamide. Complex partial seizures, opposed to simple partial seizures, are rarely described in association to NKH. Epileptic activity localized over language regions can manifest as aphasia.
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    Composição celular absoluta do cérebro de animais com epilepsia em diferentes fases da vida adulta
    (Universidade Federal de São Paulo (UNIFESP), 2014-06-30) Lopim, Glauber Menezes [UNIFESP]; Arida, Ricardo Mario Arida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Epilepsy is a chronic neurological disorder characterized by permanent brain predisposition to generate epileptic seizures, reaching approximately 50 million people around the world. Temporal lobe epilepsy is the most common form of human epilepsy, being reported extensive loss of pyramidal neurons from hippocampal region, hilar neurons from the dentate gyrus and gliosis. Many features of temporal lobe epilepsy are reproduced in animals by the pilocarpine model. This study investigated the frequency of epileptic seizures in animals throughout adulthood and subsequently quantified the number of cells in different brain regions (cortex, hippocampus, cerebellum and remaining regions) of these animals. Sixty Wistar rats were divided into control and epilepsy groups (9 animals per group). Seizures were video-monitored during 360 days, 24 hours a day. The number of cells was quantified by the technique of isotropic fractionation on the 30th, 180th and 360th day after the first spontaneous seizure. Our results showed a progressive increase in the frequency of spontaneous seizures in the early months, followed by a reduction from the seventh month, and later a stabilization from the tenth to the twelfth month. Statistical analysis (ANOVA for repeated measures) showed higher number of seizures in the fourth and sixth months compared to the first (p=0.001, p=0.006), second (p=0.006, p=0.005) and eleventh (p=0.012, p=0.002) months. The total number of brain cells was lower in rats with epilepsy compared to control animals (p<0.005). Animals with epilepsy had fewer cortical and cerebellar cells at 30, 180 and 360° (p<0.005, p<0.005). In the hippocampal for mation, this reduction occurred in 180° (p<0.001) and 360° days (p=0.01). In the re maining regions, the reduction occurred at 30° and 180° days (p<0.001). A correlat ion between the frequency of recurrent seizures and the number of cells in the hippocampal formation was noted. Animals presenting more seizures showed less cell number at the 30° (r=-0.828, p=0.006) and 360° days (r=-0.729 , p = 0.017). Our findings demonstrate that there is an relation between frequency of spontaneous seizures and number of brain cells throughout the life of animals with epilepsy, and this depends on investigated area and age of animals.
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    Could sudden cardiac death in epilepsy be related to the occurrence of thalamic dysfunction or anatomic change?
    (Academia Brasileira de Neurologia - ABNEURO, 2009-03-01) Scorza, Fulvio Alexandre [UNIFESP]; Calderazzo, Lineu [UNIFESP]; Albuquerque, Marly de [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Almeida, Antonio-Carlos G. de; Cavalheiro, Esper Abrão [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de São João Del Rei Departamento de Engenharia Biomédica
    Sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death in people with chronic epilepsy. Its physiopathology is still unknown; however, the most commonly suggested potential mechanisms involve cardiac or respiratory abnormalities. As the anatomical substrate of epileptic activity in the central nervous system (CNS) shows a direct relationship with cardiovascular alterations, this may suggests that patients with epilepsy associated with focal CNS lesions may be at particular risk of SUDEP. Currently, experimental and clinical data support an important role for thalamic nuclei in the behavioural manifestations, initiation and propagation of seizures. In view of the above findings, we purpose that SUDEP, at least in some cases, could be related to the occurrence of thalamic dysfunction or anatomic change.
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    Distribuição e expressão dos receptores de melatonina no hipocampo de ratos submetidos ao modelo de epilepsia induzida por pilocarpina
    (Universidade Federal de São Paulo (UNIFESP), 2014-10-31) Rocha, Anna Karynna Alves de Alencar [UNIFESP]; Scerni, Debora Amado Scerni [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Studies from our laboratory have shown a neuroprotective effect of melatonin on pilocarpine-induced epilepsy. The pinealectomy is able to facilitate the epileptogenesis while the melatonin exerted a neuroprotection in the epilepsy model induced by pilocarpine, indicating a major role of melatonin in this condition. However, no consistent data are published about the dynamic changes of melatonergic system in the natural course of temporal lobe epilepsy. Dysfunctions in the melatonin signaling pathway may be primarily based on changes in the density of their receptors. Moreover, altered receptor expression may be a consequence of neurodegenerative processes. Therefore, our study aimed to verify if status epilepticus-induced by pilocarpine cause alterations in the distribution and gene expression of melatonin receptors, MT1, MT2 and ROR? in rat hippocampus. For this, we compared the differences in mRNA expression of MT1, MT2 and ROR? receptors in acute, silent and chronic phases of the model compared to controls within a period of 24 hours by RT-PCR in real time as well as the difference in the location and intensity of immunostaining of these receptors in the same phase by immunohistochemistry.Therefore, our study found that the pilocarpine-induced status epilepticus caused short and long-term changes in the distribution and gene expression of melatonin receptors, MT1, MT2 and ROR? in rat hippocampus. There is an increase in the expression of MT1 and MT2 receptor in the initial hours of the status epilepticus. During the following phases of the model (silent and chronic) there is a reduction in the expression of these receptors in various hippocampal subregions. In contrast to membrane receptors, the expression of nuclear receptor ROR? presented a drastically reduction during the acute phase and the silent phase. In the chronic phase, the presence of these nuclear receptors returns to levels similar of controls. Therefore, we can suggest that the increase in the expression of MT1 and MT2 receptors may be a compensatory mechanism due to the loss of receptors during injury, as the attempt to ?capture? more melatonin. Also, we hypothesized that these receptors might be involved in mechanisms of neuroprotection. Moreover, taking into account the beneficial effect of melatonin via ROR? by modulating of the inflammation and excitotoxicity, we suggest that the reduction of these receptors in the early stages of the pilocarpine model of epilepsy may negatively influence the development of epilepsy, facilitating the epileptogenesis. The correct mechanism related to the decrease and later increase in the expression of this receptors are unknown and needs further investigations.
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    Does sudden unexpected death in children with epilepsy occur more frequently in those with high seizure frequency?
    (Academia Brasileira de Neurologia - ABNEURO, 2009-12-01) Terra, Vera Cristina; Scorza, Fulvio Alexandre [UNIFESP]; Sakamoto, Américo Ceiki [UNIFESP]; Pinto, Kylvia Giselle Fernades Dantas; Fernandes, Regina Maria França; Arida, Ricardo Mario [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Machado, Helio Rubens; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    People with epilepsy are more likely to die prematurely and the most common epilepsy-related category of death is sudden unexpected death in epilepsy (SUDEP). Several studies have reported a moderate or high seizure frequency among SUDEP cases and SUDEP is considered rare in patients in remission. METHOD: We reviewed the occurrence of SUDEP in our epilepsy unit over an 8-year period to identify a potential association between seizure frequency and SUDEP occurrence in children with epilepsy. RESULTS: From 835 patients evaluated, 12 had suffered SUDEP and nearly all of the SUDEP cases in our children are related to chronic uncontrolled epilepsy (daily - 50.0%, two to four/week - 41.7%, monthly - 8.3%). CONCLUSION: SUDEP is not a rare event in children and increased mortality was recorded in those individuals who had not responded to pharmacologic treatment. Improved seizure control seems to be one of the most important measures to prevent SUDEP.
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    Dostoyevsky and epilepsy: between science and mystique
    (Academia Brasileira de Neurologia - ABNEURO, 2010-02-01) Lima, Antenilson Franklyn Rodrigues [UNIFESP]; Gallian, Dante Marcello Claramonte [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This article, the result of a research project presented as a Master's degree dissertation in the graduate program of Teaching of Health Education at UNIFESP, seeks to highlight the pertinence of analyzing epilepsy and especially, the paradoxical experience of the epileptic individual through literary narrative. Using as its object the novel, The Idiot, by Fyodor Dostoyevsky, it seeks to discuss the relationship between epilepsy and the mystic experience, bearing in mind the context of the scientific and humanistic perspectives of the 19th century and today.
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    Early destructive lesions in the developing brain: clinical and electrographic correlates
    (Academia Brasileira de Neurologia - ABNEURO, 2007-06-01) Low, Cristiane [UNIFESP]; Garzon, Eliana [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Vilanova, Luiz Celso Pereira [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Sakamoto, Américo Ceiki [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    OBJECTIVE: Early brain insults can cause cavitary lesions including porencephaly (POR) and multicystic encephalopathy (MCE). The objective of this study was to investigate clinical and electrographic correlates associated to these types of destructive brain lesions. METHOD: Patients with POR and MCE were selected and submitted to clinical and Video-EEG monitoring. The following variables were analyzed: demographic data, type of lesion, presence of gliosis, perinatal complications, epilepsy, brain atrophy, and presence and frequency of epileptiform discharges. RESULTS: Twenty patients were included, 65% males, 35% females, ages ranging from 1 to 40 years, 14 with MCE and 6 with POR. Eighteen patients had hemiparesis, 19 had epilepsy (current or in the past), seven of them had refractory seizures, and 16 had epileptiform discharges. All patients with MCE had gliosis while only 2 with POR had it. CONCLUSIONS: No correlation was observed between type of lesion and clinical and electrographical outcome. However, a positive correlation was observed between frequency of discharges and presence of brain atrophy, and between MCE and gliosis.
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    Efeito de um programa de treinamento de força em animais com epilepsia do lobo temporal induzido pela pilocarpina
    (Universidade Federal de São Paulo (UNIFESP), 2013-06-26) Pena, Luiz Fernando Peixinho [UNIFESP]; Arida, Ricardo Mario Arida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The beneficial effects of physical exercise on epilepsy, such as a decreased seizure frequency, have been observed following aerobic exercise programs in both clinical and experimental studies. However, it is not well clarified whether other types of exercise, including strength exercise, can provide similar benefits for epilepsy. Forty four animals with epilepsy were continuously monitored 24 h a day for 60 days and divided into two periods of 30 days. The first period was used to determine the number of seizures before beginning the physical exercise program, and the second period was utilized to determine the number of seizures during the strength training. The mean frequency of seizures in the control and SHAM groups increased significantly from period 1 to period 2. Although the frequency of seizures did not change significantly between the two periods of 30 days of observation in the strength exercise group, a significant reduction in the seizure frequency was observed compared with the control and SHAM groups in period 2. Our study demonstrated that a strength exercise program exerted a significant influence on the seizure frequency in animals with epilepsy and strengthens the observed beneficial effect of exercise on epilepsy that has been demonstrated in animal studies. The finding of this nonclinical study can open a new window to verify the beneficial contribution of strength exercise in epilepsy. Further experimental and clinical investigations are necessary to explore the extent to which strength exercise interferes with the epileptic condition.