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Enhanced limbic network excitation in the pilocarpine animal model of temporal lobe epilepsyDe Guzman, Philip Henry. January 2007 (has links)
Through the use of chronic experimental animal models, the majority of in vitro investigations of temporal lobe epilepsy have demonstrated enhanced network activity within the subdivisions of the hippocampal formation. However, clinical evidence in combination with in vivo and in vitro studies indicates that structures external to the hippocampus contribute to the genesis of seizure activity. To address the effects of limbic network excitation, I have utilized combined hippocampal---entorhinal cortex brain slices from pilocarpine-treated rats that display chronic seizures. / My investigations have focused upon three structures, the subiculum, entorhinal cortex and the insular cortex. The experiments in the pilocarpine-treated subiculum demonstrated increased network excitability that was attributed to a more positive GABAA receptor mediated inhibitory post-synaptic potential (IPSP) reversal point coupled with a reduced IPSP peak conductance. Utilizing RT-PCR analysis and immunohistochemical staining we observed a decline in K+-Cl- cotransporter mRNA expression and a reduced number of parvalbumin-positive, presumptive inhibitory interneurons. My second project assessed the network hyperexcitability in layer V of the lateral entorhinal cortex. This is the first study to report spontaneous bursting, in the absence of epileptogenic agents, in the epileptic entorhinal cortex. We attributed this level of network excitation to reduced GABAA receptor mediated inhibition and increased synaptic sprouting. In the final project, we extended our slice preparation to include the insular cortex, a structure external to the temporal lobe. Our investigations identified a mechanism of NMDA receptor dependent synaptic bursting that masked GABA A receptor mediated conductances.
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The assessment and treatment of concerns and anxiety in patients undergoing pre-surgical monitoring for epilepsy /Pniewski, Krystne. January 2006 (has links)
Thesis (M.Sc.)(Psych.)--University of Melbourne, Dept. of Behavioural Sciences, 2006. / Typescript. Includes bibliographical references (leaves 132-148).
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Enhanced limbic network excitation in the pilocarpine animal model of temporal lobe epilepsyDe Guzman, Philip Henry January 2007 (has links)
No description available.
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Neuropsychologische Untersuchung bei Frontallappenepilepsien ein Vergleich kognitiver Leistungen zwischen Patienten mit Frontal- und Temporallappenepilepsie im Rahmen der prächirurgischen Diagnostik /Kemper, Birgit. January 1995 (has links)
Thesis (doctoral)--Westfälischen Wilhelms-Universität zu Münster, 1995. / Includes bibliographical references.
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Diffusion tensor imaging and tractography in epilepsy surgery candidates /Nilsson, Daniel, January 2008 (has links)
Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2008. / Härtill 4 uppsatser.
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Vestibularapparat und hirnelektrische Aktivität : EEG- und ENG-Studien bei Gesunden und bei Epilepsiekranken /Karbowski, Kazimierz. Mumenthaler, Marco. January 1900 (has links)
Zugl.: Habil'schrift Bern.
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Discrimination between frontal and temporal lobe epilepsy in childrenClark, Jennifer Paulette Holinbaugh. January 2006 (has links) (PDF)
Thesis (M.S.) -- University of Texas Southwestern Medical Center at Dallas, 2006. / Not embargoed. Vita. Bibliography: 62-72.
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Dano neuronal em pacientes com epilepsia do lombo temporal medial refrataria a tratamento clinico : estudo quantitativo por ressonancia magneticaBonilha, Leonardo Fator Gouvea 30 April 2004 (has links)
Orientadores: Li Li Min, Fernando Cendes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T03:09:51Z (GMT). No. of bitstreams: 1
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Previous issue date: 2004 / Resumo: A esclerose hipocampal (EH) é a alteração histológica mais comum em pacientes com epilepsia do lobo temporal medial (ELTM). A Ressonância Magnética (RM) de crânio possibilita a detecção in vivo de sinais associados à EH, permitindo que pacientes com EL TM reftatária à medicação sejam submetidos à ressecção cirúrgica do hipocampo para tratamento de crises epilépticas. As causas de reftatariedade à medicação e ao tratamento cirúrgico ainda são desconhecidas, porém supõe-se que um dos motivos seja a presença de lesão neuronal acometendo outras áreas cerebrais além do hipocampo. O uso da morfometria por RM permite avaliação do dano neuronal tanto no hipocampo como em outras estruturas cerebrais através da avaliação e quantificação da atrofia presente nestas estruturas. Para avaliação pormenorizada das estruturas cerebrais foi realizada a implementação e validação de um protocolo anatômico para mensuração da região mesial do lobo temporal, com uso de RM tridimensional de alta definição. Foi também definido um protocolo para volumetria automatizada baseada em voxel de todo o cérebro. Foi observado que o dano neuronal em pacientes com EL TM se estende além do hipocampo e acomete regiões que se conectam funcionalmente e anatomicamente ao hipocampo. Tál achado sugere que exista lesão abrangendo uma rede neuronal, o que pode ser responsável em conjunto pelas manifestações clínicas observadas nesses pacientes / Abstract: Hippocampal sclerosis (HS) is the most common histological finding in patients with media! temporal lobe epilepsy (MTLE). Magnetic resonance imaging (MRl) permits in vivo detection of signs that are associated to HS, permitting the surgical treatment for these patients. The causes of medical and surgical reftactoriness observed in patients with MTLE are still unknown. One possible explanation is the fact that the neuronalloss encountered in these patients spans over other brain areas beyond the hippocampus. The use of morphometric quantification of brain structures through MRI is a powerful tool to investigate the neuronalloss in the hippocampus and in other areas of the brain. In order to assess the neuronal damage in brain structures of patients with MTLE, we developed a protocol for manual MRI morphometry of the media! temporallobe structures. We also developed an automatic protocol to assess the concentration of gray matter in the whole brain of these patients through the use of Voxel Based Morphometry. We observed that patients with MTLE exhibit neuronal loss that is not restricted to the hippocampus, but affects di:fferent areas throughout the brain that are functionally and anatomica1ly connected to the hippocampus. These findings suggest that a lesion of a network of neural structures may be responsible for the clinical symptomatology exhibited by patients with MTLE / Doutorado / Neurologia / Doutor em Ciências Médicas
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Corticoamigdalohipocampectomia para o tratamento da epilepsia refratária associada à esclerose mesial temporalMeguins, Lucas Crociati 01 December 2014 (has links)
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Previous issue date: 2014-12-01 / INTRODUCTION: Mesial temporal sclerosis (MTS) is the commonest surgical pathology
associated with refractory temporal lobe epilepsy (TLE) with a percentage in series of temporal lobe resection ranging from 28% to 62%. OBJECTIVE: The aim of the present study is to describe the clinical and sociodemographic characteristics of patients with TLE-MTS submitted to cortico-amygdalohippocampectomy (CAH) and to investigate the influence of patient’s age at surgery and seizure onset on surgical outcome of TLE in a Brazilian tertiary epilepsy center. METHODS: A retrospective observational investigation was performed with data collection from a cohort of consecutive patients surgically treated in the epilepsy clinic of Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), a Brazilian tertiary referral epilepsy center, from January 2000 to March 2012. Patients were divided accordingly to their age at surgery (< or ≥50 years) and to epilepsy duration at surgery (< or > 10 years). RESULTS: Two hundred and twenty-nine patients were included. The mean age at surgery was of 39.9±11.57 years, with 105 (45.8%) male and 124 (54.2%) female. Two hundred and twenty-one (96.5%) patients were right-handed and eight (3.5%) left-handed. Thirty (13.1%) patients presented a previous history of febrile seizure during infancy and 27 (11.7%) reported head trauma before the beginning of refractory seizures. Thirty-six (16%) were taking a single anti-epileptic drug (AED) and 193 (84%) were taking two or more AEDs. Patients’ follow-up observed that 144 (62.8%) were classified as Engel I and 200 (87.5%) were classified as Engel I or II. Eleven patients (4.7%) were Engel III and 18 (7.8%) were Engel IV. At six, twelve and twenty-four months of followup, 144, 137 and 132 patients, respectively, were classified as Engel I. One-hundred and eleven of 179 patients (62%) were classified as Engel I in the group with <50 years old, whereas 33 of 50 (66%) as Engel I in the group with ≥50 years old group (p=0.82). From the total of patients seizure free (Engel I), 88 (61%) reported epilepsy duration inferior to 10 years and 56 (39%) superior to 10 years (p<0.01). From the total of patients not seizure free (Engel II, III and IV), 36 (42%) reported epilepsy duration inferior to 10 years and 49 (58%) superior to 10 years (p<0.01). There were no surgery-related significant neurological deficits or deaths. CONCLUSION: In the present study, we demonstrated that CAH is a safe and feasible surgical modality to effectively treat patients with refractory TLE-MTS. Additionally, it was observed that a shorter epilepsy duration at surgery is an important risk factor that must be considered before surgical management of MTS. Early recognition and surgical treatment of patients with refractory TLE-MTS may improve seizure outcome. / INTRODUÇÃO: A esclerose mesial temporal (EMT) representa a doença cirúrgica mais
comumente associada à epilepsia do lobo temporal (ELT) atingindo uma porcentagem de 28%
a 62% nas séries de ressecção do lobo temporal. OBJETIVOS: O objetivo do presente estudo
é descrever as características sócio-demográficas e clínicas de pacientes com ELT-EMT
submetidos à corticoamigdalohipocampectomia (CAH) e investigar a influência da idade do
paciente no momento da cirurgia e a duração da doença antes do tratamento cirúrgico no
resultado clínico da ELT em um centro terciário para tratamento da epilepsia. MÉTODOS:
Uma investigação observacional retrospectiva com coleta de dados de uma coorte de pacientes
consecutivos, tratados cirurgicamente no Hospital de Base da Faculdade de Medicina de São
José do Rio Preto (FAMERP), um centro terciário brasileiro para o tratamento de epilepsia, a
partir de janeiro de 2000 a março de 2012. Os pacientes foram divididos de acordo com sua
idade no momento da cirurgia (<ou ≥50 anos) e duração da epilepsia antes do tratamento
cirúrgico (<ou> 10 anos). RESULTADOS: Duzentos e vinte e nove pacientes foram incluídos
no presente estudo. A idade média no momento da cirurgia foi de 39,9 ± 11,57 anos, com 105
(45,8%) do sexo masculino e 124 (54,2%) do sexo feminino. Duzentos e vinte e um (96,5%)
pacientes eram destros e oito (3,5%) canhotos. Trinta (13,1%) pacientes apresentavam história
prévia de convulsão febril na infância e 27 (11,7%) relataram traumatismo craniano antes do
início das crises refratárias. Trinta e seis (16%) usavam um único drogas anti-epiléptico (DAE)
e 193 (84%) estavam tomando dois ou mais DAE. No acompanhamento pós-operatório dos
pacientes observou-se que 144 (62,8%) foram classificados como Engel I e 200 (87,5%) foram
classificados como Engel I ou II. Onze pacientes (4,7%) foram Engel III e 18 (7,8%) foram Engel IV. Aos seis, doze e vinte quatro meses de seguimento, 144, 137 e 132 pacientes,
respectivamente, foram classificados como Engel I. Cento e onze de 179 pacientes (62%) foram
classificados como Engel I no grupo com <50 anos de idade, ao passo que 33 de 50 (66%) como
Engel I no grupo com ≥50 anos grupo de idade (p = 0,82). Do total de pacientes livres de crises
(Engel I), 88 (61%) relataram a duração da epilepsia inferior a 10 anos e 56 (39%) superiores a
10 anos (p <0,01). Do total de pacientes não livres de crises (Engel II, III e IV), 36 (42%)
relataram a duração da epilepsia inferior a 10 anos e 49 (58%) superiores a 10 anos (p <0,01).
Não houve deficit neurológico significativos relacionadas à cirurgia ou mortes.
CONCLUSÕES: No presente estudo, demonstramos que CAH é uma modalidade cirúrgica
segura e viável para tratar eficazmente pacientes com ELT-EMT. Além disso, observou-se que
a menor duração da epilepsia no momento da cirurgia é um importante fator de risco que deve
ser considerado antes de tratamento cirúrgico. O reconhecimento precoce e tratamento adequado
de pacientes com ELT-EMT podem melhorar o resultado do controle das crises.
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"Esclerose mesial temporal em crianças" / Mesial temporal sclerosis in childrenBrandão, Eliana Maria Domingues 13 December 2005 (has links)
Esclerose mesial temporal é causa freqüente de epilepsia de difícil controle em adultos. Avaliamos em crianças o espectro clínico, eletrográfico e radiológico desta patologia. Para tanto foi realizada revisão bibliográfica e estudo retrospectivo de 44 crianças no Hospital das Clínicas de São Paulo. Em ambos observou-se: predomínio das crises epilépticas com parada da movimentação, automatismo oroalimentar e gestual, e fenômeno motor; freqüente antecedente de crise febril e de estado de mal epiléptico. Na casuística verificou-se ainda que a lesão foi mais freqüente à esquerda em pacientes: com primeira crise entre seis meses e cinco anos de idade, com crise febril complicada e com dificuldade escolar / Mesial temporal sclerosis is frequent cause of intractable epilepsy in adults. We evaluate the clinical , electrographic and radiological spectrum this pathology in children. Was realized bibliographic revision and retrospective study in 44 children of the Clinic Hospital of São Paulo. Was observed: predominance of seizures with decreased responsiveness, oroalimentary and gestural automatism, and motor phenomenon; febrile seizures and epileptic status like frequent antecedents. The casuistry revealed lesion more frequent at left side in patients: with first seizure between six month and five years old, with febrile seizures complex and with school difficulty
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