Temporal lobe epilepsy with hippocampal sclerosis: relationship between the presence of facial asymmetry and clinical, electroencephalographic and image data variables

• Grant number: 21/11838-1
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2021
• End date: November 30, 2022
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Gloria Maria de Almeida Souza Tedrus
• Grantee: Daniel Ferreira Paiva
• Host Institution: Centro de Ciências da Vida. Pontifícia Universidade Católica de Campinas (PUC-CAMP). Campinas , SP, Brazil

Abstract

Temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) is the most frequent drug-resistant focal epilepsy in adults. However, there are still gaps in the knowledge of some pathophysiological aspects related to clinical variables observed in this epilepsy, such as the presence of facial asymmetry. Objective: To evaluate the occurrence of facial asymmetry in adult patients with TLE-HS. To study the relationship between the presence of facial asymmetry with clinical aspects, EEG, computed tomography, and magnetic resonance aspects, and with a personal history of central nervous system disorders in the peri-and postnatal period. Procedures: fifty consecutive patients with TLE-HS over 18 years of age treated at the Clinical Neurology outpatient clinic of the Hospital da PUC-Campinas will be included. The following procedures will be performed: clinical-neurological examination; Edinburgh inventory; mini-mental state examination and standardized facial measurements were taken using a digital caliper (with measurements of the upper third, middle third, and lower third of the face; lip filter; upper lip; lower lip; right commissure distance x corner of the right eye and the left commissure distance x corner of the left eye, as well as maximum mouth opening), EEG, computed tomography (CT) and cranial magnetic resonance (MRI). A control group (CG) will be composed of 25 individuals, of an equivalent age and without a history of neurological manifestations and genetic syndromes, who will be submitted to the same standardized facial measurements. In patients with TLE-SH, facial measurements will be related to clinical aspects and personal history. Facial measurements of patients will be compared to those of the CG with statistical tests, with a significance level of p<0.05. Expected results: The researchers of this study expect to contribute with clinical data for a better understanding of the physiopathology of facial asymmetries in patients with TLE-HS. This form of epilepsy is the most common focal epilepsy in adults, and, in a high number of cases, it is refractory to current therapeutic regimens with antiepileptic drugs, however, several aspects of its pathophysiology remain unclear or there are contradictory aspects in the literature.(AU)