Dissertations / Theses on the topic 'Epilepsy'
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Madeira, Bianca Cecchele. "Avaliação de uma ferramenta online para indicar pacientes candidatos à cirurgia da epilepsia." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/139953.
Full textBackground: Epilepsy is one of the most commons neurological conditions in practice. Its prevalence in the general population is significant (about 2%). Among these patients, there are those that are drug-resistant (those who do not achieve control of their seizures with two suitable drugs optimally), which correspond to about 20-40%. These patients have inadequate control of their chronic condition and long-term treatment becomes unsatisfactory and expensive, regardless of the reduced quality of life of patients, the psychosocial impact, disability and increased risk of death. In addition, the fact that they often need caregivers usually familiar, which, therefore, also fail to produce. It is therefore imperative that cost-effective alternative treatments are available for these patients. The epilepsy surgery is a suitable option for selected patients, since it can substantially improve the quality of life of patients, in many cases making even the patient seizure free, in addition to reducing costs in the long term. The big problem is before surgery: lies in the fact that there is some difficulty in identifying and referring these patients for proper evaluation, either by ignorance on the part of physicians in general, and the lack of formal recommendations. Objectives: Evaluate an online tool to nominate patients candidates for epilepsy surgery, thus contributing to a larger facility for the purposes of clinical decision-making with better identification of these patients. Methods: We conducted a cross-sectional study evaluating the surgical indication in patients with focal epilepsy, as testing of an online tool available for this purpose. This work was performed with consecutive outpatients attending at the Epilepsy Clinic of the Hospital de Clínicas de Porto Alegre, in the period of January-April 2014. All patients included in the study had a diagnosis of epilepsy and their information was taken from the review of their medical records using a standardized questionnaire answered by researchers. The informations who were not registered, were collected during a routine visit. In total, 211 patients were evaluated. Results: In our study, first we conducted a prevalence analysis, finding a result of 56.9% of patients referred for surgical evaluation. In addition, we conducted an evaluation of variables that contribute to the indication or not of surgical treatment. At this stage, we found the frequency of seizures, the number of tested drugs and the presence of side effects such as variables with greater statistical significance for indication for surgical treatment. Conclusion: We believe that this work has great clinical relevance because it is a tool that can help in decision making for treatment, thus benefiting patients and reducing health care costs in the medium and long term.
Räty, Lena. "Living with epilepsy : young people with uncomplicated epilepsy and adults with newly debuted epilepsy /." Linköping : Univ, 2002. http://www.bibl.liu.se/liupubl/disp/disp2003/med764s.pdf.
Full textOliveira, Elton Pallone de. "Estudo crítico dos modelos experimentais em epilepsia espontânea do tipo ausência." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-24052011-135103/.
Full textEpilepsy is a very commom neurological disorders in world population. It is a chronicle condition highly disabling that affects both genera male and female independent of your age with a soft predominance in men and is more frequent in child under 2 years old and adult above 65 years old. The morbidity and mortality consequences of this disorder have many negative repercussions at society and global economy consequently. It is estimated about 60 to 100 millions of people around the world present any epileptic condition during their lives. According some researchers the epilepsy incidence varies about 11 to 131/100 thousand habitants for year and the prevalence between 1.5 to 30/1000 habitants for year, about this statics the higher values are found in developing countries, Latin America and Africa particularly. The Idiopathic Generalized Epilepsy (IGE) are about a third of all others kinds of epilepsies and are 15 to 20% more frequent tha n others types of epilepsies. The absences IGEs are strictly related with childhood and adolescence age group and sometimes can affect patients (2.8 5.7 of cases) with age higher than 15 years old. The physiopathology as the real causes of to occur and to reoccur of absences crises in adult age are not completely enlightened and represent a important challenge to epileptlogists. The IGEs (genetic etiology) are classified in: a) typical absence seizures, b) atypical absence seizures, c) absence seizures with special factors, d) mioclonics seizures, f) tonic mioclonic seizures, g) clone seizures, h) tonic seizures and i) atonic seizures. The treatment commonly is pharmacologic and seizures are controlled in major parts of cases although about a third of patients are refratory to anticonvulsants drugs. Having as principal finality the elucidation of basic mechanisms and help of development of effectiv e therapeutical approaches to these patients, researchers around the world spend many efforts to develop experimental models able to reproduce the phenomena that want to reproduce. Among the principal experimental models of IGEs, it is possible to cite: (1) the general epilepsy model induced by penicillin in cats; (2) the models of investigation of bicuculin; (3) induction by electrical stimulation; (4) Genetic Absence Epilepsy Rats of Strasbourg (GAERS); (5) cepa WAG/Rij; (6) the model of gamma-hydroxybutyric (GHB) and (7) mutant rats. These experimental models have promoted ways to researchers can to evaluate and quantify adequately the neuronal alterations that occur during epileptigenes process both in vitro or in vivo, making possible important advances in development of new therapeutical approaches and improvement in quality of life of epilepsy carriers
Hendriks, Marc P. H. "Memory deficits in epilepsy patients referred to tertiary epilepsy centres." Maastricht : Maastricht : Universiteit Maastricht ; University Library, Maastricht University [Host], 2005. http://arno.unimaas.nl/show.cgi?fid=6293.
Full textSprissler, Ryan Steven, and Ryan Steven Sprissler. "Genetics of Epilepsy." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/625894.
Full textCourville, Aaron. "Chaosmakers for epilepsy." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0003/MQ45985.pdf.
Full textNeri, Marina Liberalesso 1980. "Avaliação neuropsicológica de crianças com epilepsia rolândica = funções executivas." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309169.
Full textTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A epilepsia benigna da infância com pontas centrotemporais (EBIPCT) ou rolândica (ER) é a forma mais freqüente de epilepsia na infância e é classificada como sendo focal, genética e de evolução benigna. Apesar de não haver déficit intelectual, essas crianças podem apresentar alterações cognitivas específicas. O presente estudo teve como objetivos: identificar e descrever alterações de funções executivas em crianças com ER e verificar a influência de variáveis clínicas da epilepsia nas funções executivas. Os participantes foram submetidos à aplicação de testes de funções executivas. Foram incluídas crianças com diagnóstico clínico e eletroencefalográfico de ER. A maioria dos pacientes estava controlada e muitos deles encontravam-se sem medicação. Os resultados obtidos foram comparados com os de um grupo de crianças de um grupo-controle (GC) constituído de indivíduos normais, com idade e nível sócio-educacional semelhantes ao das crianças com epilepsia. Os dados coletados nos dois grupos foram analisados e comparados através dos testes estatísticos: Mann-Whitney, teste Qui-quadrado e teste Exato de Fisher. Os resultados mostraram que quanto aos dados numéricos crianças com ER obtiveram pior desempenho em cinco das seis categorias consideradas do Wisconsin Card Sorting Test (WCST): nº de erros, nº de erros perseverativos, nº de respostas perseverativas, nº de categorias completadas e nº de fracassos em manter o set. Considerando-se resultados categóricos crianças com ER obtiveram pior desempenho no Trail Making Test (TMT) parte B, no Teste de fluência verbal FAS e em três categorias do WCST: nº de erros, nº de erros perseverativos e nº de respostas perseverativas. Em relação à variável idade de início da epilepsia, crianças com início mais precoce apresentaram pior desempenho em um dos instrumentos utilizados quando comparadas com crianças com início mais tardio da epilepsia; em relação às demais variáveis da epilepsia, não foi possível qualquer tipo de análise; quanto às variáveis das crises, não houve diferença nos resultados obtidos pelos pacientes divididos em grupos. Diante desses resultados concluímos que: as crianças com ER apresentaram déficit em funções executivas quando comparadas com o grupo-controle; a bateria utilizada mostrou-se adequada para detecção das disfunções apresentadas pelas crianças com ER; em relação à variável da epilepsia idade de início, crianças com início mais precoce apresentaram pior desempenho do que crianças com início mais tardio da epilepsia; em relação às demais variáveis da epilepsia e às variáveis das crises, não houve diferença entre os dois grupos. Assim, nosso estudo segue a linha de raciocínio de que o termo benigno deve ser usado com cautela uma vez que nossos pacientes apresentaram déficits neuropsicológicos em funções executivas, independentemente da fase ativa da epilepsia e do uso de medicações
Abstract: The benign childhood epilepsy with centrotemporal spikes (EBIPCT) or rolandic epilepsy (RE) is the most common type of childhood epilepsy and is considered to be a focal, genetic and benign epilepsy. Although there is no intellectual deficit, these children may have specific cognitive impairments. This study aimed: to identify and describe changes in executive functions in children with RE and to verify the influence of clinical variables of epilepsy in executive functions. Participants were evaluated with tests to assess executive functions. We included children with clinical and EEG features of RE. Most patients were controlled and several were without medication. The results were compared with those of a control group (CG) comprised of normal subjects with age and socioeconomic level similar to that of the RE group. The data collected from both groups were analyzed and compared using statistical tests: Mann-Whitney, Chi-square and Fisher exact tests. The results showed that concerning the numerical data, children with RE had the worst performance in five of the six categories of the WCST: number of errors, number of perseverative errors, number of perseverative answers, number of completed categories and number of failures to maintain the set. Considering categorical results, children with RE had worse performance in Trail Making Test part B, Verbal fluency test FAS and three categories of the WCST: number of errors, number of perseverative errors and number of perseverative answers. Concerning the variable age of onset of epilepsy, children with earlier onset of epilepsy had a worse performance in one of the tools when compared with children with later onset of epilepsy; the other variables of epilepsy did not allow any analysis; considering seizure variables, there was no difference between the two groups. We conclude that: children with RE showed deficits in executive functions when compared with the control group; the set of tests was adequate to detect the dysfunctions presented by children with RE; in relation to the variable age of onset of epilepsy, children with earlier onset had a worse performance than children with later onset of epilepsy; concerning other epilepsy and seizure variables, there was no difference between the two groups. Thus, our study is in keeping with the idea that the term benign should be cautiously used since our patients had neuropsychological deficits in executive functions regardless of the active phase of epilepsy and the use of medications
Doutorado
Ciencias Biomedicas
Doutor em Ciências Médicas
Rocha, Renata Pina. "Epilepsia reflexa evacuatória: revisão de literatura e descrição de caso clínico com registro de crise ao vídeo-eletroencefalograma." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17160/tde-25042018-161435/.
Full textBackground: Reflex epilepsy is a condition in which all seizures are triggered by a specific stimulus. There are many known stimulus, including defecation which has rarely been reported. In the majority of cases, it presents with refractory seizures. Objective: review the literature on reflex epilepsy, as well as identify defecation as a possible trigger and report a case of a patient with reflex seizures triggered by defecation documented by video-electroencephalogram monitoring. Methods: literature review on reflex epilepsies and review of medical records of a patient with reflex epilepsy triggered by defecation. Results: we present a 10-year-old-boy patient, left-handed, whose epilepsy onset was at the age of four. Its seizures were characterized by episodes of loss of consciousness and atonia during defecation. Video-electroencephalogram monitoring had shown a seizure triggered by defecation, characterized by right head deviation, left upper limb automatisms, associated with consciousness impairment and afterwards nose wiping with the left hand. The ictal EEG demonstrated theta rhythmic activity in the left temporal lobe. The brain magnetic resonance was normal. The interictal SPECT identified left anterior temporal lobe mild hypoperfusion. The patient became seizure free after the treatment with valproic acid and carbamazepine. Neuropsychological and quality of life assessments suggested global impairment, before and after seizure control. Conclusion: this is the third case of epilepsy induced by defecation, and the second with seizures documented by videoelectroencephalogram. Similar to this case, both had suggested lateralization and localization over the left temporal region, suggesting this region as a potential epileptogenic zone in patients with this type of reflex epilepsy. In our patient, the treatment with valproic acid and carbamazepine was effective for the seizure control and may be an option to other patients with this condition.
Kemper, Birgit. "Neuropsychologische Untersuchung bei Frontallappenepilepsien ein Vergleich kognitiver Leistungen zwischen Patienten mit Frontal- und Temporallappenepilepsie im Rahmen der prächirurgischen Diagnostik /." Münster : Universität Münster, 1995. http://catalog.hathitrust.org/api/volumes/oclc/64528329.html.
Full textSantos, Renato Oliveira dos. "Investigando o papel de genes candidatos na epilepsia do lobo temporal mesi = genes PTPRM e IL1B = Investigating candidates genes in mesial temporal lobe epilepsy : PTPRM and IL1B genes." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312709.
Full textTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: As epilepsias formam um grupo de doenças neurológicas crônicas caracterizadas por crises epilépticas, as quais podem ser definidas como um distúrbio intermitente do sistema nervoso causado por descarga elétrica anormal, súbita e sincronizada dos neurônios cerebrais. A epilepsia de lobo temporal (ELT) é a mais frequente, representando aproximadamente 50% dos casos em adultos e tem como manifestação típica, a crise parcial complexa. Além disso, é frequentemente refratária ao tratamento medicamentoso. Os principais sintomas gerados pela ELT são predominantemente pelo acometimento das estruturas mediais do lobo temporal, sendo a ELT mesial (ELTM), a forma mais comum de ELT. Atualmente é ainda controversa a participação de fatores genéticos contribuindo na etiologia das epilepsias, principalmente da ELTM, que não teve até hoje nenhum gene inequivocamente associado a sua predisposição. O objetivo deste trabalho foi investigar o papel de dois genes candidatos: o PTPRM e o IL1B na predisposição à ELTM. Para tanto utilizamos as seguintes modalidades de estudo em pacientes com ELTM (i) estudo de associação genética através da genotipagem de polimorfismos de nucleotídeo único (SNPs) localizados nos referidos genes candidatos (esta etapa do estudo foi realizada durante o mestrado); (ii) quantificação dos transcritos de ambos os genes, por PCR em tempo real em tecido das estruturas mediais do lobo temporal (principalmente hipocampo) que foi obtido através da realização de cirurgia para tratamento das crises refratárias. (iii) Para o PTPRM, foi também realizada a localização do transcrito pela técnica de hibridação "in situ" em tecido hipocampal de pacientes e de controle. Além disso, como existem evidências do envolvimento do PTPRM em etapas importantes do desenvolvimento cerebral, e pouco se conhece da função específica desse gene no cérebro realizamos (iv) a quantificação do transcrito de PTPRM durante o desenvolvimento em cérebro de camundongos. (v) Finalmente, com o objetivo específico de avaliar se o aumento de expressão de IL1B no tecido hipocampal se refletia também na circulação realizamos a quantificação do transcrito e proteica do IL1B no plasma de pacientes com ELTM. Nossos resultados revelaram associação genética entre SNPs localizados em ambos os genes investigados e o fenótipo estudado. No entanto, em nenhum dos estudos uma variante funcional pode ser identificada. A quantificação dos transcritos em tecido hipocampal dos pacientes com ELTM indicou que ambos os genes PTPRM e IL1B estão hiper-regulados em pacientes quando comparados ao tecido controle. Não identificamos variação significativa na expressão do transcrito de PTPRM no cérebro de camundongos nas diferentes etapas de desenvolvimento. Não identificamos variação significativa na quantificação do transcrito e proteica de IL1B no plasma dos pacientes com ELTM quando comparados aos controles. Em conclusão, nossos resultados dos estudos de associação indicam um papel de PTPRM e de IL1B na predisposição à ELTM, porém não fomos capazes de encontrar uma variante funcional associada ao fenótipo. Corroborando o papel de ambos os genes nosso estudo de expressão gênica no tecido acometido indicou um aumento de expressão de ambos os genes. No entanto, o aumento de expressão de IL-1beta no tecido hipocampal não se traduziu pelo aumento no plasma dos pacientes. Finalmente, nosso estudo do perfil de expressão de PTPRM durante o desenvolvimento cerebral não aponta para um papel desse gene em etapas específicas do desenvolvimento
Abstract: The epilepsies are a group of chronic neurological disorders characterized by seizures, which can be defined as an intermittent disorder caused by an abnormal and sudden electrical discharge of neurons in the brain. Temporal lobe epilepsy (TLE) is the most frequent form, representing approximately 50% of cases in adults, and it is often refractory to drug treatment. The main symptoms in TLE are generated by the involvement of the medial temporal lobe structures, characterizing mesial TLE (MTLE). The contribution of genetic factor to MTLE it is still controversial and to date, no gene has been unequivocally associated with the predisposition to MTLE. Therefore, the aim of this study was to investigate the role of two candidate genes: PTPRM and IL1B in the predisposition to MTLE. To achieve this we use the following type study modalities in patients with MTLE (i) genetic association study by genotyping of single nucleotide polymorphisms (SNPs) located in these two candidate genes; (ii) quantification of the transcripts of both genes by real-time PCR in hippocampal tissue obtained from epilepsy surgery for the treatment of refractory seizures. (iii) For PTPRM we also performed in situ hybridization experiments in order to localize the transcript in hippocampal tissue from patients and controls. Furthermore, since there is evidence that PTPRM could be involved in key stages of brain development and little is known about the specific role of this gene in the brain, we performed (iv) quantification of its transcript during development in mouse brain. (v) Finally, with the specific objective of assessing whether the increase of IL1B expression in hippocampal tissue was also seen outside the central nervous system we quantified IL1B transcript and protein in plasma of patients with MTLE. Our results revealed genetic association between SNPs located in both genes and the phenotype. The quantification of transcripts in hippocampal tissue of patients with MTLE indicated that both genes are hyper-regulated when compared to control tissue. We did not find any significant variation in transcript expression of PTPRM in mouse brain during developed. In addition, no difference in transcript expression and protein levels of IL1B was observed in plasma of patients with MTLE. In conclusion, our results indicate an involvement of PTPRM and IL1B in the predisposition to MTLE; however, we are unable to find a functional variant associated with the phenotype. Corroborating the role of both genes in MTLE gene expression in affected tissue (hippocampus) indicated an up-regulation of both genes. However, the increase in IL1B expression in hippocampal tissue was not reflected by an increase of transcript or protein in plasma of patients with MTLE. Finally, our expression profile of PTPRM during brain development does not point to a role for this gene in specific stages of development
Doutorado
Fisiopatologia Médica
Doutora em Ciências
Hendges, Laurize Palma. "Epilepsia e cefaleia : diferenças entre faixas etárias de início da epilepsia e aspectos neuropediátricos." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/72130.
Full textEpilepsy and headache are common neurological diseases. Epilepsy affects around 1% of the world population, while headache prevalence is much higher, occurring in 38-50% of people. Both conditions share mutual physiopathogenic mechanisms. Reports of headache in neuropediatric patients with epilepsy occur, but they are poorly studied due to the small number of patients and difficulty of headache diagnosis on this population. This study evaluated the prevalence and characteristics of headache in patients with focal epilepsy of childhood onset, adulthood and after 50 years old. We analyzed 167 patients with focal epilepsy. One hundred twenty five of those patients (74.8%) had headache. In the first group, the age at onset of epilepsy varied between 0-17 years; in the second group, from 18-50 years; and in the third group above 50 years. For each patient interviewed, a standardized survey was used to verify the occurrence of epilepsy and headache, the age at onset, frequency, intensity, classification and response to treatment. In this study, the earlier the onset of headache, the greater the chances of the patient is refractory and to present headache. All kinds of headache were more common in patients who started at a young age with epilepsy. Headache was more common in women who started until 50 years old with epilepsy. After this age, headache in epilepsy was more often observed in male patients. When epilepsy started at childhood, headache occurred more often related to the crises, being predominantly observed during post-ictal period and most commonly occurring in the occipital region. These findings may suggest that physiopathologic superposition between epilepsy and headache occurs more often at childhood. As a whole, the study demonstrated that the headache observed in epilepsy has characteristics dependent on the onset age of crises. There seems to be a superposition of disease mechanisms between headache and epilepsy when epilepsy starts during childhood. This association is less observed when epilepsy occurs after 50 years old, suggesting different physiopathogenic mechanisms for headache occurrence in epilepsy, according to the time of onset of epilepsy.
Nuttycombe, Rachael Eileen. "Parenting children with epilepsy." Thesis, University of Hull, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440230.
Full textWallace, Robyn. "Molecular genetics of epilepsy /." Title page, contents and summary only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phw193.pdf.
Full textErrata pasted onto back end-paper. Copies of author's previously published articles inserted. Includes bibliographical references (leaves 157-176).
Adjei, P. "Autonomic function in epilepsy." Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1121227/.
Full textMccagh, Jane Teresa. "Social cognition in epilepsy." Thesis, Liverpool John Moores University, 2009. http://researchonline.ljmu.ac.uk/5954/.
Full textBonnett, Laura. "Prognostic factors for epilepsy." Thesis, University of Liverpool, 2012. http://livrepository.liverpool.ac.uk/8933/.
Full textSuleiman, Jehan. "Autoimmune Epilepsy in Childhood." Thesis, The University of Sydney, 2013. http://hdl.handle.net/2123/9790.
Full textWood, David L. "Comorbidities of Pediatric Epilepsy." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5188.
Full textWood, David L. "Comorbidities of Childhood Epilepsy." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5186.
Full textDavis, Lauren Elizabeth. "Extraction : one woman's epilepsy." Thesis, University of Iowa, 2012. https://ir.uiowa.edu/etd/3281.
Full textOliveira, Ana Valeria Duarte. "Avaliação do impacto da cirurgia de epilepsia no desenvolvimento de crianças com epilepsia refratária." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17140/tde-22082017-170746/.
Full textEpilepsy is a disease of the brain defined by at least two unprovoked seizures occurring 24 h apart, one unprovoked seizure and a probability of further seizures like the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years or diagnosis of an epilepsy syndrome. After epilepsy diagnosis, there are situations where patients do not respond to drug treatment, developing one seizure per month for a minimum of 2 years. If during this period two or three antiepileptic drugs different used as monotherapy or in combination, a condition known as drug-resistant epilepsy. Epilepsy surgery is an option for children with drug-resistant epilepsy acting on the seizure control seizures and, potentially on neuropsychomotor development. In this study, we evaluated clinical variables such as epilepsy age of onset, epilepsy duration, seizure frequency, etiology and adaptive behavior scale of Vineland to characterize aspects related to age equivalence through the domains of communication, socialization, daily skills and motor skills pre- and post-surgical period. Our intention was to determine the impact of epilepsy surgery on the performance of patients in these areas evaluated by Vineland. Thus, we found that the seizure free group participants showed better cognitive performance in the second evaluation, compared to the group that not seizure controlled. The clinical variable duration of epilepsy influenced the age equivalence and standard Vineland scores in the preoperative period, being considered determinant for the neuropsychomotor delay of patients submitted to epilepsy surgery. Regarding the predictive factors of improvement of postoperative crises, it was observed that Engel and surgery were the variables considered significant. The majority of the patients (63.9%) in the second postoperative evaluation still had seizures or did not improve. The findings of the research on the impact of crises on neuropsychomotor were that in the first evaluation 21.3 months after surgery there was a below-expected gain of only 4.4 months of age equivalence, not showing improvement in the short term after surgery, independent of control crisis. After 41.3 months of the surgical procedure, the patients presenting with seizure control had significant adaptive gains of 15 months when compared to those without seizure control. In the latter patients, the age equivalence remained practically stable with an increase of o preoperative only 3 months, analyzing the phases pre and postoperative evaluation
Pniewski, Krystne. "The assessment and treatment of concerns and anxiety in patients undergoing pre-surgical monitoring for epilepsy /." Connect to thesis, 2006. http://eprints.unimelb.edu.au/archive/00002908.
Full textPetty, Karen Hammack. "Pediatric temporal lobe epilepsy versus frontal lobe epilepsy : how does cognitive performance differ ? /." Full text available from ProQuest UM Digital Dissertations, 2007. http://0-proquest.umi.com.umiss.lib.olemiss.edu/pqdweb?index=0&did=1414130851&SrchMode=1&sid=2&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1221160824&clientId=22256.
Full textGaler, Sophie. "Impact de l'activité épileptique interictale sur le traitement cognitif: approche neurophysiologique et comportementale." Doctoral thesis, Universite Libre de Bruxelles, 2013. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/241299.
Full textBarbosa, Patricia Horn 1980. "Associação entre alterações eletroencefalográficas interictais, ressonância magnética e resultado cirúrgico de pacientes com epilepsia de lobo temporal." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312639.
Full textTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Epilepsia de lobo temporal resulta com freqüência em refratariedade ao tratamento medicamentoso. Alguns fatores prognósticos da epilepsia focal e seu tratamento já foram descritos, mas outros ainda estão por ser melhor conhecidos. Nosso objetivo foi investigar associação entre alterações no EEG pré e pós-operatório e na ressonância de crânio pré-operatória com o resultado cirúrgico de pacientes com epilepsia de lobo temporal. Pacientes com epilepsia focal refratária submetidos a cirurgia após investigação não invasiva foram reavaliados. Calculamos o período livre de crises até a recorrência. Realizamos análise visual da RM crânio pré-operatória buscando sinais de atrofia hipocampal e alterações sutis no hipocampo contralateral. Revisamos exames de EEG pré e pós-operatórios buscando inicialmente a presença ou ausência de descargas epileptiformes. Posteriormente, quantificamos atividade epileptiforme interictal e buscamos associação com recorrência de crises. Utilizamos os testes estatísticos qui-quadrado e Fisher, quando adequados, e construímos curvas de sobrevivência de Kaplan-Meier, considerando recorrência de crises como desfecho, com comparação pelo método de Mantel. Na primeira parte do estudo foram incluídos 86 pacientes com atrofia hipocampal. EEG pré-operatório unilateral não se associou a resultado cirúrgico favorável; EEG pós-operatório com presença de atividade epileptiforme interictal não se associou a resultado cirúrgico desfavorável; RM cranio com hipocampo contralateral alterado se associou tanto a resultado cirúrgico desfavorável, quanto com bilateralidade nos EEGs pré-operatórios. Na segunda parte do estudo, com 129 pacientes incluídos, não encontramos associação significativa entre presença de atividade epileptiforme interictal no EEG pós-operatório e resultado cirúrgico. As curvas de sobrevivência dos grupos com descargas epileptiformes presentes versus ausentes não foram estatisticamente diferentes (p=0,09), porem observamos uma tendência, o que motivou a terceira parte. Desta forma, demonstramos, através da quantificação da atividade epileptiforme, associação entre descargas pouco frequentes no EEG pós-operatório com resultado cirúrgico favorável. Finalmente, na tentativa de estabelecer o EEG pós-operatório como preditor de recorrência de crises, não encontramos, com a amostra disponível, associação entre EEG pós-operatório com atividade epileptiforme pouco frequente e resultado cirúrgico favorável. Estes resultados demonstram que é importante valorizar alterações sutis no volume, conformação, eixo e sinal do hipocampo menos afetado na indicação de cirurgia de pacientes com epilepsia de lobo temporal e atrofia hipocampal. O resultado cirúrgico dos pacientes com hipocampo contralateral normal é mais favorável. Alteração eletrográfica bitemporal no EEG pré-operatório, em geral, está associada a alteração estrutural sutil no hipocampo contralateral, que muitas vezes não é valorizada. Tal achado corrobora evidências previamente descritas de que pacientes com EEG pré-operatório bitemporal tem prognóstico cirúrgico menos favorável. Os dados relacionados à análise quantitativa de descargas epileptiformes no EEG pós-operatório mostraram associação entre atividade epileptiforme e resultado cirúrgico. Tal achado sugere que o EEG pode ser uma ferramenta útil no seguimento clínico pós-operatório. Em conclusão, nossos resultados indicaram dois fatores importantes no prognóstico de controle de crises após cirurgia em ELT: presença de alteração hipocampal contralateral mesmo que sutil, e espículas em uma frequência maior que 4 por um período de 15 minutos
Abstract: Temporal lobe epilepsy is frequently linked to medical refractoriness. Many clinical prognostic data on focal epilepsy have repeatedly been described, while surgical outcome factors are yet to be fully known. We presently look into an association between interictal epileptiform discharges in pre and postoperative EEG, as well as preoperative brain magnetic resonance imaging, and surgical outcome of temporal lobe epilepsy. Patients with medically refractory focal epilepsy submitted to surgery following non invasive investigation were reassessed. We calculated time until seizure recurrence. We visually analysed preoperative MRI searching for signs of hipoccampal atrophy, as well as subtle contralateral hipoccampal changes. We reviewed pre and postoperative EEGs concerning presence or absence of interictal epileptiform discharges. Later on, we quantified interictal discharges and tested association with seizure freedom. We used chi square or Fisher¿s exact test, when most adequate. We also built Kaplan-Meier¿s survival curves setting seizure recurrence as endpoint, and compared curves by Mantel method. We initially included 86 patients with hipoccampal atrophy. Preoperative unilateral EEG was not associated with favorable surgical outcome; presence of IED in postoperative EEG was not associated with unfavorable outcome; contralateral hipoccampal changes on preoperative MRI was strongly associated with unfavorable surgical outcome, as well as with bilateral preoperative EEGs. We then studied postoperative EEGs of 129 individuals. There was not a significant association between postoperative EEG and surgical outcome. Survival curves of group of patients with interictal discharges present and absent were not statistically different (p=0.09), but we observed a tendency in that direction. Therefore, we were able to demonstrate through manual quantification of epileptiform discharges that postoperative EEG direct association with surgical outcome. Our ultimate goal was to establish postoperative EEG as predictor of seizure recurrence. Unfortunately we were not able to demonstrate it with data available on our sample. These results highlight importance of assessing subtle changes in volume, form, axis and signal intensity on contralateral hipoccampus prior to indication of surgery in patients with temporal lobe epilepsy with hipoccampal atrophy. Surgical outcome is more favorable when contralateral hipoccampus is normal. Bilateral discharges over temporal electrodes in pre-operative EEG are associated with subtle structural changes on contralateral hipoccampus, which may be underestimated. Such findings is in agreement with previously described evidence of bitemporal preoperative EEG associated with less favorable surgical outcome. Quantification data on postoperative EEG sets forth direct association with epileptiform discharges and surgical outcome. Such finding suggests EEG may be a useful tool in postoperative followup. In conclusion, our results indicate two important prognostic factors for seizure control in surgically treated temporal lobe epilepsy patients: presence of contralateral signs of hipoccampal sclerosis, even if subtle, and interictal epileptiform discharges occuring in a frequency higher than 4 at 15 minutes period
Doutorado
Neurociencias
Fisiopatologia Médica
Monnerat, Bruno Zanotelli. "Uso do padrão ictal na epilepsia da região mesial do lobo temporal associada à esclerose hipocampal como marcador prognóstico pós-cirúrgico: uma coorte retrospectiva." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/17/17140/tde-31032012-090652/.
Full textPatients with drug-resistant temporal lobe epilepsy usually have hippocampal sclerosis as an epileptogenic lesion. Most of the times, these patients are benefited from temporal lobectomy for seizure relief. For this procedure to occur, a long-term videoelectroencephalogram is necessary for the accurate delineation of the epileptogenic zone. Despite the developments in the diagnostic methods on this area, the quest continues for an instrument that allows a clear evaluation of the chance to obtain a seizure-free life after epilepsy surgery. In the present study, the electroencephalographic ictal patterns were evaluated, and the relationship between its occurrence and permanence in one cerebral hemisphere and the possibility of a seizure-free outcome after surgery were compared. The ictal electroencephalografic and medical records of 284 patients were analyzed. A classification of ictal patterns, whether unilateral or bilateral, was issued, and the seizure outcome after one, two, and five years after surgery annotated. Unilateral ictal patterns occurred in 132 patients, and bilateral ictal patterns in 152. Seizure-free status was obtained in 236 patients, and 48 still persisted with seizures. There was no association between a unilateral ictal status and a seizure-free outcome after surgery (difference of 7.5%, p=0.092; chi-square). So, the electroencephalographic ictal pattern is not a valuable tool for predictions regarding seizure outcome in patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis that are submitted to temporal lobectomy.
Jimenez, Jimenez Diego Mauricio. "Pathophysiology of seizure onset in human focal epilepsy and its relevance to epilepsy surgery." Thesis, King's College London (University of London), 2016. https://kclpure.kcl.ac.uk/portal/en/theses/pathophysiology-of-seizure-onset-in-human-focal-epilepsy-and-its-relevance-to-epilepsy-surgery(d062586c-22be-4351-84f2-0acc594c9460).html.
Full textJohnson, Adrienne L. "The Role of Cigarette Smoking in Epilepsy-Related Quality of Life and Epilepsy Severity." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1530266095820498.
Full textMcLaughlin, Deirdre P. "Ageing and epilepsy : psychosocial impact /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19068.pdf.
Full textRibenis, Aksels. "Epilepsy surgery around language cortex." Diss., lmu, 2009. http://nbn-resolving.de/urn:nbn:de:bvb:19-98318.
Full textCormack, Karl Frederick Magnus. "Children's cognitive representations of epilepsy." Thesis, University of Southampton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396777.
Full textMcGinnity, Colm Joseph. "Quantitative imaging in epilepsy (PET)." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/40095.
Full textJolin, Paula. "Epilepsy in medieval Islamic history." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0025/MQ50527.pdf.
Full textLoukas, Andrew. "Sodium channel mutations causing epilepsy." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=80321.
Full textThe C121W mutation causes a 100 fold reduction in efficacy of current modulation as well as a reduction of current amplitude. This may cause increased sodium currents via a negative shift of the steady-state inactivation curve. alpha-D188V channels recover faster from the inactivated state which causes a resistance to frequency-dependent cumulative inactivation of current amplitude. This may contribute to cellular hyperexcitability resulting in ictal events in the epileptic patient.
Farrow, Tom F. D. "Hippocampus, cognitive function and epilepsy." Thesis, University of Sheffield, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.322874.
Full textHammers, Alexander. "PET investigations in focal epilepsy." Thesis, University College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396330.
Full textNovy, J. "Somatic co-morbidities in epilepsy." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1458552/.
Full textElwes, R. D. C. "The early prognosis of epilepsy." Thesis, University of Edinburgh, 1988. http://hdl.handle.net/1842/18865.
Full textCorrell, Cynthia Marie. "Seizure awareness among epilepsy patients." [New Haven, Conn. : s.n.], 2008. http://ymtdl.med.yale.edu/theses/available/etd-12022008-101323/.
Full textScott, Amelia Jane. "Anxiety in People with Epilepsy." Thesis, The University of Sydney, 2019. https://hdl.handle.net/2123/21333.
Full textCATTANEO, STEFANO. "Combinatorial gene therapy for epilepsy." Doctoral thesis, Università Vita-Salute San Raffaele, 2022. http://hdl.handle.net/20.500.11768/128275.
Full textL'epilessia è una malattia neurologica caratterizzata da una persistente predisposizione a generare crisi, che colpisce circa l'1% della popolazione mondiale. Circa il 30% dei pazienti epilettici sono resistenti ai farmaci, quindi refrattari ai farmaci antiepilettici attualmente disponibili (AED). Meno del 10% di questi pazienti resistenti ai farmaci sono eleggibili per la chirurgia, spesso a causa di foci epilettici generalizzati o multipli, o a causa della vicinanza del focus epilettico alle aree cerebrali eloquenti. Pertanto, la terapia genica può rappresentare un approccio fattibile. Il neuropeptide Y (NPY) può agire come un anticonvulsivo endogeno. L'espressione di NPY è aumentata sia nelle sezioni ippocampali di roditori che in quelle di campioni chirurgici umani di epilessia del lobo temporale, nonostante la forte perdita di interneuroni GABAergici a livello dell’ilo. Pertanto, la terapia genica basata su NPY può rappresentare un nuovo approccio per il trattamento delle epilessie focali. Idealmente, tuttavia, tali vettori dovrebbero contenere più elementi (almeno NPY e Y2R guidati da promotori appropriati). In passato, il nostro laboratorio ha fatto grandi progressi nel campo dei vettori virali basati su HSV-1. Abbiamo quindi mirato a combinare il potenziale dei vettori HSV di ospitare DNA di grandi dimensioni, e la complessità del sistema NPY, per creare una cassetta terapeutica combinatoria "ideale". Tuttavia, le preoccupazioni residue in merito alla sicurezza della nostra nuova generazione di vettori basati su HSV-1 (chiamati J∆NI8) ci hanno spinto a valutare i profili di sicurezza ed efficacia in vitro per valutare l’effetto dell’infezione sulle proprietà elettrofisiologiche in neuroni primari. Sorprendentemente e in maniera deludente, abbiamo dimostrato che mutazioni nella glicoproteina B dell'involucro (gB), che è responsabile dell'entrata virale e della fusione cellulare, potrebbero sorgere durante la produzione del vettore virale. A livello elettrofisiologico, abbiamo inoltre visto che la gB mutata può aumentare la frequenza di potenziali d’azione e contemporaneamente ridurre sia la resistenza di ingresso che il potenziale di riposo neuroni trasdotti. Complessivamente, questi dati suggeriscono che un'attenta valutazione delle glicoproteine dell'involucro è necessaria per sviluppare vettori sicuri non replicativi basati su HSV-1 per il trattamento dei disturbi del SNC. Abbiamo quindi deciso di passare ai vettori Lentivirali (LV), una piattaforma più robusta e caratterizzata nonostante una capacità di carico più limitata rispetto ai vettori HSV. Per potenziare l'effetto protettivo di NPY, abbiamo sviluppato un approccio combinatorio di terapia genica basato sull'espressione di NPY insieme al suo recettore (Y2). Poiché i recettori Y2 agiscono principalmente a livello pre-sinaptico per diminuire il rilascio di glutammato riducendo l’ingresso di Ca2+, l'espressione dei transgeni è stata guidata dal promotore minimal CamKII, orientando così la loro espressione selettivamente nei neuroni eccitatori. Abbiamo successivamente caratterizzato la capacità dei nostri vettori LV di esprimere NPY e il suo recettore funzionale Y2 nei neuroni ippocampali e nel cervello dei topi. In seguito, abbiamo utilizzato un sistema di monitoraggio video-EEG mediante telemetria per valutare l'effetto dei geni terapeutici sul fenotipo epilettico in un modello genetico di epilessia. Abbiamo scoperto che l'espressione combinata di NPY e Y2 è sufficiente a ridurre sia la frequenza che la durata delle crisi nel modello di epilessia Synapsin triple-KO. Questi dati rafforzano ulteriormente l'ipotesi che le strategie mirate all’utilizzo di NPY e Y2 possono avere successo per il trattamento dell'epilessia, in particolare per le forme resistenti ai farmaci ma anche per forme genetiche della malattia.
Matos, Alexandre Hilário Berenguer de 1986. "Expressão gênica em larga escala em modelos genéticos de epilepsia." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309736.
Full textDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Wistar audiogenic rat (WAR) é um modelo genético de epilepsia de crises audiogênicas desencadeadas após alta intensidade de estimulação sonora. Outro modelo genético recentemente identificado é o da epilepsia generalizada com crises de ausência (GEAS). O objetivo do presente estudo foi caracterizar o perfil de expressão gênica destas duas cepas através de uma análise em larga escala. Para os estudos de expressão foi utilizada inicialmente a tecnologia de microarranjos seguida da validação dos resultados por técnica quantitativa de PCR em tempo real. Os resultados foram analisados em ambiente R, utilizando os pacotes AFFY e RankProd do bioconductor, utilizando o algoritmo MAS 5 os array foram normalizados e calculou-se a intensidade do sinal e a detecção (presença ou ausência de expressão). Após a detecção, os transcritos que estavam ausentes foram removidos. Para a análise estatística foi utilizado o teste RankProd, que é biologicamente projetado para testar e detectar genes diferencialmente expressos em experimentos de microarranjos. Foi utilizado um valor de p ? 0,01 e pfp ? 0,05, a fim de considerar os transcritos diferencialmente expressos. No geral, nossos resultados mostram uma assinatura molecular similar nos dois modelos de ratos genéticos analisados. Houve uma sobreposição na lista de genes diferencialmente expressos encontrados em ambos os modelos, quando comparado com controles. Além disso, descobrimos que duas importantes vias moleculares para epileptogênese: neurotransmissão GABAérgica e potencialização de longo prazo pós-sináptica NMDA-dependente, foram encontrados em ambos os modelos, quando combinamos os dados dos animais WAR e GEAS. No entanto, algumas diferenças nas vias de sinalização expressas nos dois modelos também foram identificadas. Portando os resultados mostram claramente a natureza heterogênea e complexa dos mecanismos moleculares envolvidos na epileptogênese
Abstract: Wistar audiogenic rat (WAR) is a genetic epilepsy model susceptible to audiogenic seizures, after high-intensity sound stimulation. Another genetic model we have recently identified is the generalized epilepsy with absence seizures (GEAS) rat. The aim of the present study was to characterize and compare the genetic profile of these two strains using gene expression analysis. Experiments were performed initially using microarray technology followed by quantitative real-time PCR. Results were analyzed in R environment using the Affy and RankProd packages from Bioconductor, using the algorithm MAS 5 we normalized the arrays and calculated the signal intensity and the detection (presence or absence of expression), after the detection, transcripts which were absent in all samples were removed. For statistical analysis we used the Rank Product test, which is biologically motivated and designed to test and detect differentially expressed genes in replicated microarray experiments. This is a simple non-parametric statistical method based on ranks of fold changes. We used a p-value ? 0.01 and a pfp ? 0.05 in order to consider a given transcript to be differentially expressed Overall, the results show a different molecular signature in the two genetic rat models analyzed, since different enriched gene ontology categories were found. However, there was some overlap in the list of genes differentially expressed found in both models when comparing to controls. In addition, we found that two important molecular pathways for epileptogenesis: GABAergic neurotransmission and: Neurophysiological process NMDA-dependent postsynaptic long-term potentiation in CA1 hippocampal neurons, were found to be present in both models when combining data from WAR and GEAS animals. In conclusion, our results clearly show the heterogeneous and intricate nature of the molecular mechanisms involved in epileptogenesis as well as the importance of studies looking at different regulatory pathways at once, in order to better appreciate this complexity
Mestrado
Neurociencias
Mestre em Ciências
Svensson, Emma, and Sofie Månsson. "Copingstrategier hos vuxna personer med diagnosen epilepsi : En litteraturstudie." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-30910.
Full textThe number of people who are diagnosed with epilepsy increases each year and what is more each person stricken by the disease also experiences different issues all related to the illness. To be able handle the problems generated from epilepsy they can use different coping strategies. The aim of this study was to examine coping strategies among adults diagnosed with epilepsy and it was made as a literary study where article search, examination and selection was done according to a structural and methodical approach. The result was based upon eight scholarly articles. After an analysis of the articles three main categories emerged: Internalized coping strategy, external coping strategy and allocation and use of coping strategies. Internalized coping strategy gave rise to two additional lower categories: situation-focused coping and emotion-focused coping. The result shows that the most common coping strategies are adaption, denial and religion. Furthermore it is also shown that similar strategies are used among many countries, whereas there is a difference between men and women. Additional research is needed within this field to increase the knowledge about coping strategies among people with epilepsy. The effect of this knowledge is that it will be easier for nurses to guide and understand people diagnosed with epilepsy.
Stroink, Hans. "Diagnosis and prognosis of seizures and epilepsy in childhood (Dutch study of epilepsy in childhood)." [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2008. http://hdl.handle.net/1765/13133.
Full textBeresford, Bryony. "Coping with epilepsy in childhood : an examination into factors mediating adjustment in children with epilepsy." Thesis, University of Exeter, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316379.
Full textRushe, Helen. "Living with a sibling with refractory epilepsy children's experience of having a sibling with epilepsy." Thesis, University of Essex, 2011. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.549276.
Full textVeronez, Djanira Aparecida da Luz. "Estudo morfologico e morfometrico do corpo amigdaloide para definição topografica nas amigdalo-hipocampectomias." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308848.
Full textTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: A epilepsia do lobo temporal (ELT) apresenta-se em um percentual elevado de pacientes que são refTatários ao tratamento clínico. Fato este que faz da ELT a epilepsia que melhor responde ao tratamento cirúrgico baseado na lobectomia do lobo temporal e na amígdalo-hipocampectomia. Esta última técnica cirúrgica consiste na ressecção parcial do corpo amigdalóide, do hipocampo e do giro para-hipocampal; estruturas consideradas epileptogênicas. Destas estruturas, o corpo amigdalóide é o único ainda com volume morfológico e morfométrico indeterminado. Com base nestes fatos, este trabalho apresenta como objetivos, determinar em cérebros de cadáveres humanos, parâmetros quantitativos e tridimensionais do corpo amigdalóide a partir da análise de cortes bidimensionais; definir os limites topográficos macroscópicos do corpo amigdalóide; estabelecer as distâncias entre o como temporal do ventrículo lateral e as superficies utilizadas nos acessos cirúrgicos; expressar os resultados em escalas métricas, da análise morfométrica e estereológica e sugerir o uso destas nas amígdalo-hipocampectomias. Para isto realizamos análise de cortes seriados, coronais e parassagitais do corpo amigdalóide, que foram avaliados através de um sistema de processamento e análise de imagem. O método de Cavalieri foi utilizado para estabelecer o volume absoluto do corpo amigdalóide. Por último, foram feitas análises estatísticas e apresentação gráfica dos resultados. Os hemisférios cerebrais, direitos e esquerdos foram analisados separadamente, para verificar a morfometria do corpo amigdalóide. Foram observadas diferenças inter-hemisféricas na volumetria do corpo amigdalóide. Nos cortes coronais a média do volume absoluto do corpo amigdalóide direito foi de 1.870mm3 e do corpo amigdalóide esquerdo foi de 1.807mm3, com índice de assimetria de 3,4%. Nos cortes parassagitais a média do volume absoluto do corpo amigdalóide direito foi de 1.927mm3 e do corpo amigdalóide esquerdo foi de 1.878mm3, com índice de assimetria de 2,6%. Não foi identificada variabilidade anatômica significativa na topografia dos ventrículos laterais e do corpo amigdalóide. Nossos resultados demonstram que a análise morfométrica e estereológica aplicada ao corpo amigdalóide e as medidas obtidas na topografia do lobo temporal constitui instrumento confiável, que pode auxiliar nas cirurgias de amígdalo-hipocampectomias
Abstract: The temporallobe epilepsy (TLE) has a high percentage of patients who are reffactory to a clinical treatment. This fact makes TLE the epilepsy that best responds to a surgi cal treatment. It is based on lobectomy of temporallobe and on amygdalohippocampectomy. This surgi cal technique consists of a partial resection of the amygdaloid complex, hippocampus, and gyrus parahippocampal. These structures are considered as epileptogenics. Among these structures, the amygdaloid complex is the only with undetermined morphological and morphometric volume. Based on these facts, this study will have the following objectives: to determine in brains of human corpses the quantitative and three-dimensional parameters of the amygdaloid complex obtained ITom analyses of two-dimensional slices; to define the topographic macroscopic limits of the amygdaloid complex; to establish the distances between the temporal hom of the lateral ventricles and the surfaces used for the surgi cal approaches; to express the results in metrical scales of morphometric and estereological analysis of the amygdaloid complex, and to suggest the use of them in an amygdalohippocampectomy. In order to do this, we have accomplished analysis of serial, coronary and parasagital slices of the amygdaloid complex, which were evaluated through a processing system and an image analysis. The Cavalieri Method was used to establish the absolute volume of the amygdaloid complexo Finally, estatistics analyses and a graphical presentation of the results were done. Right and left brain hemispheres were analyzed separately in order to verify the morphometry of the amygdaloid complexo The inter-hemispherical differences in the volumetry of the amygdaloid complex were observed. In the coronal slices the absolute medium volume of the right amygdaloid complex was 1.894mm3, and the left was 1.837mm3 with an index of asymmetry of 3,4%. In the parassagital si ices the absolute medium volume of the right amygdaloid complex was of 1.927mm3 and the left amygdaloid complex was 1.878mm3 with an index of asymmetry of 2,6%. We have verified that there was no significant anatomical variation in the topography of lateral ventricles and the amygdaloid complexo Our results demonstrate that a morphometric and estereological analysis applied to the amygdaloid complex and measurements obtained in the topography of the temporallobe is a reliable instrument, which can help in surgeries ofthe amygdalohippocampectomy
Doutorado
Ciencias Biomedicas
Doutor em Ciências Médicas
Amorim, Barbara Juarez. "Analise estatistica baseada em voxel do SPECT cerebral em pacientes com epilepsia de lobo temporal." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313716.
Full textTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: O statistical parametric mapping (SPM) é uma ferramenta de quantificação que tem sido usada no SPECT de perfusão cerebral (SPECT), mas apenas poucos trabalhos na literatura comparam a sua sensibilidade com a da análise visual em pacientes com epilepsia de lobo temporal (ELT) OBJETIVO: Avaliar a capacidade da análise com SPM no SPECT em detectar o foco epileptogênico e alterações perfusionais em regiões extra-temporais em pacientes com epilepsia de lobo temporal mesial (ELTM), comparando os seus achados com os da análise visual MÉTODOS: Foram realizados SPECTs ictal e interictal em 22 pacientes com ELTM refratários ao tratamento clínico. O lado do foco epileptogênico foi definido com base na história clínica, ressonância magnética, eletroencefaiogramas seriados e telemetria. Os SPECTs foram submetidos à análise visual sendo que os SPECTs interictal e ictal foram analisados em conjunto pelos observadores (SPECT-visual-inter e SPECT-visual-ictal). Foi aplicado o SPM2 que comparou os pacientes com um grupo controle de 50 indivíduos normais. No SPM foram realizadas as seguintes comparações: grupo de SPECT interictal com o grupo controle (SPM-grupo-inter); SPECT interictal de cada paciente com o grupo controle (SPM-indiv-inter); grupo de SPECT ictal com o grupo controle (SPM-grupo-ictal); SPECT ictal de cada paciente com o grupo controle (SPM-indiv-ictal). Foram também comparadas as intensidades das alterações perfusionais nos lobos temporais procurando-se por um aumento da perfusão no SPECT ictal em relação ao interictal (SPM-indiv-ictal/inter). RESULTADOS: Não foi observada nenhuma alteração perfusional significativa no SPM-grupo-inter Já no SPM-grupo-ictal o foco epileptogênico foi a região de hiperperfusão mais significativa No SPM-indiv-inter a sensibilidade na localização do foco foi de 45% e no SPM-indiv-ictal a sensibilidade foi de 64%. O SPM-indiv-ictal/inter apresentou a maior sensibilidade para detectar o foco dentre as análises realizadas no SPM (77%) A sensibilidade do SPECT-visual-inter foi de 68% e para o SPECT-visuai-ictal foi de 100%. Por outro lado, diversas áreas de hiperperfusão e hipoperfusão à distância no SPECT ictal foram detectadas principalmente com o SPM CONCLUSÃO: O SPM é uma ferramenta que não depende do operador e é capaz de demonstrar mais áreas de alteração perfusional à distância do foco epileptogênico do que a análise visual. Ele pode ajudar a entender melhor a patofisiologia das crises epilépticas em pacientes com ELTM estudando a relação das diferentes regiões corticais e subcorticais na gênese e na propagação das crises parciais. Entretanto, essa ferramenta não acrescentou um aumento na sensibilidade na localização do foco epileptogênico em relação á análise visual, tanto do SPECT interictal quanto do SPECT ictal
Abstract: Statistical parametric mapping (SPM) is a quantitative tool which has been used in the brain perfusion SPECT (SPECT) However, few works in literature compare its sensitivity with the visual analysis in patients with temporal lobe epilepsy (TLE). PURPOSE: To investigate the capability of SPM analysis in SPECT to detect the epileptogenic focus and distant perfusion abnormalities in patients with mesial temporal lobe epilepsy (MTLE) and to compare these findings to the visual analysis. METHODS: Interictal and ictal SPECTs of 22 patients with refractory MTLE were performed. Epileptic foci were determined based on clinical history, magnetic resonance, electroencephalograms (EEG) and ictal video-EEG. SPECTs were submitted to visual analysis. Ictal and interictal SPECTs were analyzed together by the nuclear physicians (SPECT-visual-inter and SPECT-visual-ictal). It was also performed the SPM2 analysis which used a control group composed of 50 volunteers. The following comparisons were performed in SPM: interictal SPECT group with control group (SPM-group-inter); interictal SPECT from each patient with control group (SPM-indiv-inter); ictal SPECT group with control group (SPM-group-ictal), ictal SPECT from each patient with control group (SPM-indiv-ictal). It was also compared the perfusion intensity in temporal lobes looking for an increase in perfusion on ictal SPECT in relation to interictal SPECT (SPM-indiv-ictal/inter). RESULTS: No significant perfusion alterations were observed on SPM-group-inter. On the other hand, the epileptogenic temporal lobe was the region with most significant hypoperfusion on SPM-group-ictal. The sensitivity to localize the focus on SPM-indiv-inter was 45% and on SPM-indiv-ictal was 64%. The SPM-indiv ictal/inter revealed the highest sensitivity among the SPM analysis to detect the focus (77%). The sensitivity of SPECT-visual-inter was 68% and to SPECT-visual-ictal was 100%. On the other hand, several areas of distant hypoperfusion and hypoperfusion were detected mainly with SPM. CONCLUSION: SPM is a tool which does not depend on the operator and can detect more distant perfusion abnormalities than the visual analysis. It can improve the understanding of pathophysiology in seizures of patients with MTLE by studying the relation among different cortical and subcortical areas in the genesis and propagation of partial seizures. However, this tool did not increase the visual analysis sensitivity to localize the epileptogenic focus in interictal SPECT as well as in ictal SPECT
Doutorado
Neurologia
Doutor em Ciências Médicas
Mory, Susana Barretto. "Alteração morfofuncional talamica em epilepsia mioclonica juvenil." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/310347.
Full textTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A epilepsia mioclônica juvenil é o subtipo mais frequente entre as epilepsias generalizadas idiopáticas. Apresenta bom prognóstico e fácil controle em relação às crises epilépticas. O nosso objetivo foi a análise do tálamo combinada com métodos funcional e estruturais de neuroimagem. Estudamos vinte e um pacientes (treze do sexo feminino com média de idade 30 ± 9 anos) com epilepsia mioclônica juvenil do ambulatório de epilepsia dos Hospital das Clínicas da UNICAMP em Campinas. O grupo controle foi constitúído de dezoito voluntários hígidos (onze do sexo feminino) com média de idade 35 ± 16 anos. Todos foram submetidos ao protocolo de pesquisa incluindo ressonância magnética. Além da ressonância diagnóstica, foi realizada uma sequência em 3D para investigação estrutural e a colocação de um voxel único de (2x2x2cm3) em tálamo direito para a ressonância por espectroscopia de prótons. A morfometria baseada em voxel e análise da forma demonstraram as anormalidades talâmicas restritas em porção anterior e inferior. A espectroscopia evidenciou uma redução da relação de N-acetil aspartato e creatina. Existe alteração morfofuncional do tálamo e este padrão de comprometimento estrutural e funcional do tálamo é sugestivo da participação desta estrutura em uma rede neural na epilepsia mioclônica juvenil
Abstract: Juvenile myoclonic epilepsy is a common disease found among the group of all idiopathic generalized epilepsies. It shows a good prognosis, and seizures can be controlled easily. The objective of the present study was to make a comparison between thalamic analysis and functional and structural neuroimaging. We selected twenty-one patients (thirteen females) with mean age 30 ± 9 years old from our clinic in Hospital das Clinicas da UNICAMP, in (Campinas). Eighteen healthy volunteers (eleven females) with mean age 35 ± 6 years old were selected for the control group,. All subjects were submitted to a structured protocol of research including magnetic resonance. A 3D sequence with a single voxel (2x2x2cm3) on right thalamus was also performed for spectroscopy. Voxel based morphometry and shape analysis demonstrated thalamic abnormalities in anterior and inferior portions. Brain spectroscopy showed a decrease in NAA/Cr ratio. There is a dysfunction of the thalamus, and this pattern of structural abnormality suggests that the thalamus is involved in the neural network associated with myoclonic epilepsy
Doutorado
Neurociencias
Doutor em Fisiopatologia Medica
Chaddad, Neto Feres Eduardo Aparecido. "Estudo do posicionamento nas craniotomias pterionais, pre-temporais e orbitozigomaticas e suas variações nas cirurgias vasculares e de epilepsia." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309215.
Full textTese (doutorado) - Universidade Estadual de Campinas. Faculdade de Ciencias Medicas
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Resumo: A craniotomia pterional é o acesso cirúrgico mais utilizado na prática neurocirúrgica atual. É utilizada para abordar a maior parte dos aneurismas da circulação anterior e lesões tumorais envolvendo a região supra-selar e parte das estruturas da fossa anterior e média. No entanto, se caracteriza como sendo um acesso limitado para as lesões que envolvem a maior parte do lobo temporal, o assoalho da fossa média do crânio e o complexo da artéria basilar. Para tanto, foram desenvolvidas as craniotomias pré-temporal e orbitozigomática. No entanto a literatura é ainda relativamente carente quanto ao estudo do posicionamento exato da cabeça para a melhor abordagem de cada patologia, em particular. Esse trabalho tem por objetivo estudar o melhor posicionamento da cabeça para a realização das craniotomias mencionadas, visando a melhor exposição de cada lesão em particular
Abstract: The pterional approach is the most applied neurosurgical access in the customized practice nowadays. It is used for approaching most of the anterior circulation aneurysms and tumors involving the anterior and the middle cranial space. However, it is considered a limited approach to some pathologies involving the temporal lobe, the middle cranial space floor and the basilar artery complex region. As a result, the orbitozygomatic and the pretemporal craniotomies developed since it was necessary to enlarge such access to the temporal area. However, there is not a systematic evaluation of head positioning study about the best approach to each specific pathology. This study aims to demonstrate the best way to position the head according to each specific pathology, in order to offer a better surgical visualization by using the most appropriated craniotomy
Doutorado
Neurologia
Doutor em Ciências Médicas