Navegando por Palavras-chave "Hippocampal sclerosis"
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- ItemAcesso aberto (Open Access)Auras in temporal lobe epilepsy with hippocampal sclerosis: Relation to seizure focus laterality and post surgical outcome(Elsevier B.V., 2012-05-01) Ferrari-Marinho, Taissa [UNIFESP]; Caboclo, Luís Otávio Sales Ferreira [UNIFESP]; Marinho, Murilo Martinez [UNIFESP]; Centeno, Ricardo Silva [UNIFESP]; Neves, Rafael Scarpa da Costa [UNIFESP]; Santana, Maria Teresa Castilho Garcia de [UNIFESP]; Britto, Fernanda dos Santos [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)We examined the relationship between presence and frequency of different types of auras and side of lesion and post surgical outcomes in 205 patients with medically intractable mesial temporal lobe epilepsy (MTLE) with unilateral hippocampal sclerosis (HS). With respect to the number of auras, multiple auras were not associated with side of lesion (p=0.551). the side of HS was not associated with the type of auras reported. One hundred fifty-seven patients were operated. the occurrence of multiple auras was not associated with post-surgical outcome (p=0.740). the presence of extratemporal auras was significantly higher in patients with poor outcome. in conclusion, this study suggests that the presence of extratemporal auras in patients with MTLE-HS possibly reflects extratemporal epileptogenicity in these patients, who otherwise showed features suggestive of TLE. Therefore, TLE-HS patients undergoing pre-surgical evaluation and presenting clinical symptoms suggestive of extratemporal involvement should bemore extensively evaluated to avoid incomplete resection of the epileptogenic zone. (C) 2012 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosHippocampal atrophy on MRI is predictive of histopathological patterns and surgical prognosis in mesial temporal lobe epilepsy with hippocampal sclerosis(Elsevier Science Bv, 2016) Jardim, Anaclara Prada [UNIFESP]; Corso, Jeana Torres [UNIFESP]; Garcia, Maria Teresa Fernandes Castilho [UNIFESP]; Gaca, Larissa Botelho [UNIFESP]; Comper, Sandra Mara [UNIFESP]; Penteado Lancellotti, Carmen Lucia; Centeno, Ricardo Silva [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Carla Alessandra [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]Purpose: To correlate hippocampal volumes obtained from brain structural imaging with histopathological patterns of hippocampal sclerosis (HS), in order to predict surgical outcome. Methods: Patients with mesial temporal lobe epilepsy (MTLE) with HS were selected. Clinical data were assessed pre-operatively and surgical outcome in the first year post surgery. One block of mid hippocampal body was selected for HS classification according to ILAE criteria. NeuN-immunoreactive cell bodies were counted within hippocampal subfields, in four randomly visual fields, and cell densities were transformed into z-score values. FreeSurfer processing of 1.5 T brain structural images was used for subcortical and cortical volumetric estimation of the ipsilateral hippocampus. Univariate analysis of variance and Pearson's correlation test were applied for statistical analyses. Results: Sixty-two cases (31 female, 32 right HS) were included. ILAE type 1 HS was identified in 48 patients, type 2 in eight, type 3 in two, and four had no-HS. Better results regarding seizure control, i.e. ILAE 1, were achieved by patients with type 1 HS (58.3%). Patients with types 1 and 2 had smaller hippocampal volumes compared to those with no-HS (p<0.001 and p=0.004, respectively). Positive correlation was encountered between hippocampal volumes and CA1, CA3, CA4, and total estimated neuronal densities. CA2 was the only sector which did not correlate its neuronal density with hippocampal volume (p = 0.390). Conclusion: This is the first study correlating hippocampal volume on MRI submitted to FreeSurfer processing with ILAE patterns of HS and neuronal loss within each hippocampal subfield, a fundamental finding to anticipate surgical prognosis for patients with drug-resistant MTLE and HS. (C) 2016 Elsevier B.V. All rights reserved.
- ItemSomente MetadadadosImpact of hippocampal subfield histopathology in episodic memory impairment in mesial temporal lobe epilepsy and hippocampal sclerosis(Academic Press Inc Elsevier Science, 2017) Comper, Sandra Mara [UNIFESP]; Jardim, Anaclara Prada [UNIFESP]; Corso, Jeana Torres [UNIFESP]; Gaca, Larissa Botelho [UNIFESP]; Silva Noffs, Maria Helena [UNIFESP]; Penteado Lancellotti, Carmen Lucia; Cavalheiro, Esper Abrao [UNIFESP]; Centeno, Ricardo Silva [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]Objective: The objective of the study was to analyze preoperative visual and verbal episodic memories in a homogeneous series of patients with mesial temporal lobe epilepsy (MTLE) and unilateral hippocampal sclerosis (HS) submitted to corticoamygdalohippocampectomy and its association with neuronal cell density of each hippocampal subfield. Methods: The hippocampi of 72 right-handed patients were collected and prepared for histopathological examination. Hippocampal sclerosis patterns were determined, and neuronal cell density was calculated. Preoperatively, two verbal and two visual memory tests (immediate and delayed recalls) were applied, and patients were divided into two groups, left and right MTLE (36/36). Results: There were no statistical differences between groups regarding demographic and clinical data. Cornu Ammonis 4 (CA4) neuronal density was significantly lower in the right hippocampus compared with the left (p = 0.048). The groups with HS presented different memory performance the right HS were worse in visual memory test [Complex Rey Figure, immediate (p = 0.001) and delayed (p = 0.009)], but better in one verbal task [RAVLT delayed (p = 0.005)]. Multiple regression analysis suggested that the verbal memory performance of the group with left HS was explained by CA1 neuronal density since both tasks were significantly influenced by CA1 [Logical Memory immediate recall (p = 0.050) and Logical Memory and RAVLT delayed recalls (p = 0.004 and p = 0.001, respectively)]. For patients with right HS, both CA1 subfield integrity (p = 0.006) and epilepsy duration (p = 0.012) explained Complex Rey Figure immediate recall performance. Ultimately, epilepsy duration also explained the performance in the Complex Rey Figure delayed recall (p < 0.001). Significance: Cornu Ammonis 1 (CA1) hippocampal subfield was related to immediate and delayed recalls of verbal memory tests in left HS, while CAl and epilepsy duration were associated with visual memory performance in patients with right HS. (C) 2017 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosMorphological variations of hippocampal formation in epilepsy: Image, clinical and electrophysiological data(Elsevier B.V., 2013-01-01) Andrade Hamad, Ana Paula [UNIFESP]; Carrete, Henrique [UNIFESP]; Bianchin, Marino Muxfeldt; Ferrari-Marinho, Taissa [UNIFESP]; Lin, Katia [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Pereira Vilanova, Luiz Celso [UNIFESP]; Garzon, Eliana [UNIFESP]; Caboclo, Luis Otavio [UNIFESP]; Sakamoto, Americo Ceiki [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Morphological variations of hippocampal formation (MVHF) are observed in patients with epilepsy but also in asymptomatic individuals. the precise role of these findings in epilepsy is not yet fully understood. This study analyzes the hippocampal formation (HF) morphology of asymptomatic individuals (n = 30) and of patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS) (n = 68), patients with malformations of cortical development (MCD) (n = 34), or patients with pure morphological variations of hippocampal formation (pure MVHF) (n = 12). Main clinical and electrophysiological data of patients with MVHF were also analyzed. Morphological variations of hippocampal formation are more frequently observed in patients with MCD than in patients with MTLE-HS or in asymptomatic individuals. Patients with pure morphological variations of hippocampal formation showed higher incidence of extratemporal seizure onset. Refractoriness seems to be more associated with other abnormalities, like HS or MCD, than with the HF variation itself. Thus, although morphological HF abnormalities might play a role in epileptogenicity, they seem to contribute less to refractoriness. (C) 2012 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosMorphometric MRI features and surgical outcome in patients with epilepsy related to hippocampal sclerosis and low intellectual quotient(Academic Press Inc Elsevier Science, 2018) Gaça, Larissa Botelho [UNIFESP]; Garcia, Maria Teresa Fernandes Castilho [UNIFESP]; Sandim, Gabriel Barbosa [UNIFESP]; Leme, Idaiane Batista Assumption; Noffs, Maria Helena Silva [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Centeno, Ricardo Silva [UNIFESP]; Sato, Joao Ricardo [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]Objective: The objectives of this study were to verify in a series of patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) if those with low intellectual quotient (IQ) levels have more extended areas of atrophy compared with those with higher IQ levels and to analyze whether IQ could be a variable implicated on a surgical outcome. Material and methods: Patients (n = 106) with refractory MTLE-HS submitted to corticoamygdalohippocampectomy (CAH) (57 left mesial temporal lobe epilepsy (MILE): 45 males) were enrolled. To determine if the IQ was a predictor of seizure outcome, totally seizure-free (SF) versus nonseizure-free (NSF) patients were evaluated. FreeSurfer was used for cortical thickness and volume estimation, comparing groups with lower (<80) and higher IQ (90-109) levels. Results: In the whole series, 42.45% of patients were SF (Engel Class la
- ItemSomente MetadadadosMorphometric MRI features are associated with surgical outcome in mesial temporal lobe epilepsy with hippocampal sclerosis(Elsevier Science Bv, 2017) Fernandes Castilho Garcia, Maria Teresa [UNIFESP]; Gaca, Larissa Botelho [UNIFESP]; Sandim, Gabriel Barbosa [UNIFESP]; Assuncao Leme, Idaiane Batista; Carrete Junior, Henrique [UNIFESP]; Centeno, Ricardo Silva [UNIFESP]; Sato, Joao Ricardo; Targas Yacubian, Elza Marcia [UNIFESP]Purpose: Corticoamygdalohippocampectomy (CAH) improves seizure control, quality of life, and decreases mortality for refractory mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). One-third of patients continue having seizures, and it is pivotal to determine structural abnormalities that might influence the postoperative outcome. Studies indicate that nonhippocampal regions may play a role in the epileptogenic network in MTLE-HS and could generate seizures postoperatively. The aim of this study is to analyze areas of atrophy, not always detected on routine MRI, comparing patients who became seizure free (SF) with those non seizure free (NSF) after CAH, in an attempt to establish possible predictors of surgical outcome. Methods:105 patients with refractory MTLE-HS submitted to CAH (59 left MTLE
- ItemSomente MetadadadosSign of the Cross (Signum Crucis): Observation of an uncommon ictal manifestation of mesial temporal lobe epilepsy(Elsevier B.V., 2009-02-01) Lin, Katia [UNIFESP]; Marx, Catherine [UNIFESP]; Caboclo, Luis O. S. F. [UNIFESP]; Centeno, Rical'do S. [UNIFESP]; Sakamoto, Americo C. [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The objective of the study was to describe the clinical characteristics and determine the lateralizing value of ictal Sign of the Cross (SC) as a complex hand automatism (CHA) in patients evaluated by video/EEG monitoring in a comprehensive epilepsy unit. We reviewed video/EEG data of 530 patients with epilepsy recorded in a tertiary epilepsy center from 2002 to 2008. Four patients were found to have manifested a CHA similar to the SC at least once during their complex partial seizures. All patients had unilateral right mesial temporal lobe epilepsy (TLE) refractory to medical treatment. the limbic system is often Suggested as the critical site of religious experience. Moreover, it may be localized predominantly to the temporal regions of the right hemisphere. However, this rare and peculiar ictal manifestation may be related not only to the neural Substrate and personality characteristics of TLE, but also to the general religious convictions of Brazilians. (C) 2008 Elsevier Inc. All rights reserved.