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| Author(s): |
Bruno Augusto Goulart Campos
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | Campinas, SP. |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas |
| Defense date: | 2009-02-27 |
| Examining board members: |
Fernando Cendes;
Edson Amaro Júnior;
Luiz Eduardo Betting
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| Advisor: | Fernando Cendes |
| Abstract | |
Purpose: To compare relative N-acetylaspartate (NAA) measurements in temporal lobe epilepsy (TLE) patients with good response to the first trial of AED (an important prognostic factor) to TLE patients who failed the first AED trial and required further AED trials with monotherapy or polytherapy. Methods: We studied 27 individuals in control-group, 25 TLE patients who responded to the first AED (response-group) and 21 who did not (failure-group) that were regularly seen at our Epilepsy Service. They were submitted to both MRI and proton spectroscopy, and NAA/Creatine ratio calculated. Results: ANOVA of NAA/Cre demonstrated significant reduction in both ipsilateral and contralateral hippocampus related to EEG focus (p<0.001 and p=0.021), and post hoc analysis of ipsilateral and contralateral hippocampus did not reach statistic significance between response-group and control-group, but we found difference between failuregroup and the others groups. Individual analysis showed NAA/Cre ratios lower than 2 SD below the mean of controls in nine of 21 (42.8%) patients in the first AED failure group (six with unilateral and three with bilateral NAA/Cre reduction) but in none of patients who responded to first AED. Discussion: Our study demonstrated observed in refractory and mild TLE patients with HA. These results indicates that patients with TLE who respond well to first AED have significantly less evidence of neuronal and axonal damage/dysfunction compared to those who are refractory to first AED. (AU) | |