Navegando por Palavras-chave "mesial temporal lobe epilepsy"
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- ItemAcesso aberto (Open Access)Employment and quality of life in mesial temporal lobe epilepsy with hippocampal sclerosis: is there a change after surgical treatment?(Liga Brasileira de Epilepsia (LBE), 2009-06-01) Alonso, Neide Barreira [UNIFESP]; Azevedo, Auro Mauro [UNIFESP]; Centeno, Ricardo Silva [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: The aim of this study was to evaluate in patients with mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS): (1) employment patterns before and three years after epilepsy surgery and their impact in Quality of Life (QOL); (2) demographic and clinical variables associated with employment. METHODS: Data from 58 patients with diagnosis of refractory MTLE with HS who had corticoamygdalo-hippocampectomy were analyzed. The subjects answered to Brazilian validated version of the Epilepsy Surgery Inventory (ESI-55) before, and three years after surgery. In a semi-structured interview, sociodemographic and clinical characteristics were obtained. Changes in employment after surgery were classified in one of the three categories: (i) improvement status: those who were unemployed, no-formal employed, students, housewives and subjects who have never worked to employed category; (ii) unchanged status: no change in occupation; this category included subjects who were employed before and after the surgery, housewives, students, and the group who remained unemployed, receiving ill-health benefits or retired after the surgical treatment; and (iii) worsened status: loss of employment. RESULTS: Employment status did not show any significant change after surgery: in 51(87.9%) it remained unchanged, in six (10.3%) it improved, and one patient (1.7%), who was employed before the surgery, retired after that. In a subgroup of 22 patients employed after surgery, ten (45.5%) were seizure-free, seven (31.8%) had only rare auras, and five (22.7%) had seizures. In the group of improvement, 12 patients (70.5%) had no-formal employment and five (29.5%) had a formal job before surgery. After three years, 14 (63.6%) of 22 subjects were formally employed. Our data suggested that the employability was strongly correlated (p<0.05) with a positive perception of health-related quality of life measured by ESI-55, before and after surgical evaluation. CONCLUSION: Our study demonstrated in a homogeneous group of MTLE with HS, a modest, but positive relationship between surgical outcome and work gain, and that QOL had strong correlation with the fact of being employed.
- ItemSomente MetadadadosFacial paresis in patients with mesial temporal sclerosis: Clinical and quantitative MRI-based evidence of widespread disease(Blackwell Publishing, 2007-08-01) Lin, Katia [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Lin, Jaime [UNIFESP]; Leite de Oliveira, Pedro Alessandro; Caboclo, Luis Otávio Sales Ferreira [UNIFESP]; Sakamoto, Américo Ceiki [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: To assess the frequency and significance of facial paresis (FP) in a well-defined cohort of mesial temporal lobe epilepsy (MTLE) patients.Methods: One hundred consecutive patients with MRI findings consistent with mesial temporal sclerosis (NITS) and concordant electroclinical data underwent facial motor examination at rest, with voluntary expression, and with spontaneous smiling. Hippocampal, amygdaloid, and temporopolar (TP) volumetric measures were acquired. Thirty healthy subjects, matched according to age and sex, were taken as controls.Results: Central-type FP was found in 46 patients. in 41 (89%) of 46, it was visualized at rest, with voluntary and emotional expression characterizing true facial motor paresis. in 33 (72%) of 46 patients, FP was contralateral to the side of NITS. By using a 2-SD cutoff from tile mean of normal controls, we found reduction in TP volume ipsilateral to MTS in 61% of patients with FP and in 33% of those without (p = 0.01). Febrile seizures as initial precipitating injury (IPI) were observed in 34% of the patients and were classified as complex in 12 (26%) of 46 of those with FP and in five (9%) of 54 of those without (p = 0.02). the presence of FP was significantly associated with a shorter latent period and younger age at onset of habitual seizures, in particular, with secondarily generalized tonic-clonic seizures.Conclusions: Facial paresis is a reliable lateralizing sign in MTLE and was associated with history of complex febrile seizures as IPI, younger age at onset of disease, and atrophy of temporal pole ipsilateral to NITS, indicating more widespread disease.
- ItemSomente MetadadadosGranule cell dispersion is not a predictor of surgical outcome in temporal lobe epilepsy with mesial temporal sclerosis(Dustri-verlag Dr Karl Feistle, 2013-01-01) Costa Neves, Rafael Scarpa da [UNIFESP]; Jardim, Anaclara Prada [UNIFESP]; Caboclo, Luis Otavio [UNIFESP]; Lancellotti, Carmen; Marinho, Taissa Ferrari [UNIFESP]; Hamad, Ana Paula [UNIFESP]; Marinho, Murilo [UNIFESP]; Centeno, Ricardo [UNIFESP]; Cavalheiro, Esper Abrao [UNIFESP]; Scorza, Carla Alessandra [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Santa Casa São Paulo; AFIPThe aim of this retrospective study of a series of patients with mesial temporal lobe epilepsy (MTLE) and mesial temporal sclerosis (MTS) was to analyze the association of granule cell dispersion (GCD) with surgical prognosis, patterns of MTS and clinical data. Hippocampal specimens from 66 patients with MTLE and unilateral MTS and from 13 controls were studied. Quantitative neuropathological evaluation was performed on NeuN-stained hippocampal sections. Patients' clinical data, types of MTS and surgical outcome were reviewed. GCD occurred in 45.5% of cases and was not correlated with clinical variable. More severe neuronal loss was observed in patients with GCD. Except for MTS Type 2 observed only in four no-GCD patients groups did not differ with respect to the types of MTS. Surgical outcome was similar in both groups. in conclusion, GCD was associated with the degree of hippocampal cell loss, but was not a predictor of surgical outcome.
- ItemSomente MetadadadosStimulus and potassium-induced epileptiform activity in the human dentate gyrus from patients with and without hippocampal sclerosis(Soc Neuroscience, 2004-11-17) Gabriel, Siegrun; Njunting, Marleisje; Pomper, Joem K.; Merschhemke, Martin; Sanabria, Emidio RG; Eilers, Alexander.; Kivi, Anatol; Zeller, Melanie; Meencke, Heinz-Joachim; Cavalheiro, Esper Abrão [UNIFESP]; Heinemann, Uwe; Lehmann, Thomas-Nicolas; Johannes Mueller Inst Physiol; Charite Univ Med Berlin; Evangel Krankenhaus Konigin Elisabeth Herzberge; Universidade Federal de São Paulo (UNIFESP)Hippocampal specimens resected to cure medically intractable temporal lobe epilepsy (TLE) provide a unique possibility to study functional consequences of morphological alterations. One intriguing alteration predominantly observed in cases of hippocampal sclerosis is an uncommon network of granule cells monosynaptically interconnected via aberrant supragranular mossy fibers. We investigated whether granule cell populations in slices from sclerotic and nonsclerotic hippocampi would develop ictaform activity when challenged by low-frequency hilar stimulation in the presence of elevated extracellular potassium concentration (10 and 12 mM) and whether the experimental activity differs according to the presence of aberrant mossy fibers.We found that ictaform activity could be evoked in slices from sclerotic and nonsclerotic hippocampi (27 of 40 slices, 14 of 20 patients; and 11 of 22 slices, 6 of 12 patients, respectively). However, the two patient groups differed with respect to the pattern of ictaform discharges and the potassium concentration mandatory for its induction. Seizure-like events were already induced with 10 mM K+. They exclusively occurred in slices from sclerotic hippocampi, of which 80% displayed stimulus-induced oscillatory population responses (250-300 Hz). in slices from nonsclerotic hippocampi, atypical negative field potential shifts were predominantly evoked with 12 mM K+. in both groups, the ictaform activity was sensitive to ionotropic glutamate receptor antagonists and lowering of [Ca2+](o).Our results show that, in granule cell populations of hippocampal slices from TLE patients, high K+-induced seizure-like activity and ictal spiking coincide with basic electrophysiological abnormalities, hippocampal sclerosis, and mossy fiber sprouting, suggesting that network reorganization could play a crucial role in determining type and threshold of such activity.
- ItemSomente MetadadadosTexture analysis of high resolution MRI allows discrimination between febrile and afebrile initial precipitating injury in mesial temporal sclerosis(Wiley-Blackwell, 2012-11-01) Alegro, Maryana de Carvalho; Silva, Alexandre Valotta [UNIFESP]; Bando, Silvia Yumi; Lopes, Roseli de Deus; Martins de Castro, Luiz Henrique; HungTsu, Wen; Moreira-Filho, Carlos Alberto; Amaro, Edson; Hosp Israelita Albert Einstein; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)A computational pipeline combining texture analysis and pattern classification algorithms was developed for investigating associations between high-resolution MRI features and histological data. This methodology was tested in the study of dentate gyrus images of sclerotic hippocampi resected from refractory epilepsy patients. Images were acquired using a simple surface coil in a 3.0T MRI scanner. All specimens were subsequently submitted to histological semiquantitative evaluation. the computational pipeline was applied for classifying pixels according to: a) dentate gyrus histological parameters and b) patients' febrile or afebrile initial precipitating insult history. the pipeline results for febrile and afebrile patients achieved 70% classification accuracy, with 78% sensitivity and 80% specificity [area under the reader observer characteristics (ROC) curve: 0.89]. the analysis of the histological data alone was not sufficient to achieve significant power to separate febrile and afebrile groups. Interesting enough, the results from our approach did not show significant correlation with histological parameters (which per se were not enough to classify patient groups). These results showed the potential of adding computational texture analysis together with classification methods for detecting subtle MRI signal differences, a method sufficient to provide good clinical classification. A wide range of applications of this pipeline can also be used in other areas of medical imaging. Magn Reson Med, 2012. (c) 2012 Wiley Periodicals, Inc.