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| Author(s): |
Ana Carolina Nunes Bovi
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: | 2011-01-02 |
| Examining board members: |
Fernando Cendes;
Marcondes Cavalcante Franca Junior;
Ricardo Mario Arida
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| Advisor: | Fernando Cendes |
| Abstract | |
Temporal Lobe Epilepsy (TLE) is a condition that is associated to atrophy of the mesial temporal structures as a result of mesial temporal sclerosis (MTS), present in 60 to 70% of patients who undergo surgery. The MTLE associated with MTS has a high degree of resistance to antiepileptic drugs, as a small proportion of individuals can achieve seizure control. Many studies show that the atrophy of the hippocampus contralateral to the epileptogenic focus also undergoes changes. The MR imaging has been a fundamental tool for the diagnosis and quantification of these changes. Thus the study investigate 60 patients, being 30 individuals in drug treatment and 30 in surgical treatment, with the objective of assessing and quantifying these morphological changes found in structures involved in MTLE by means of a software which enables the tracing of the structure; and the association of these volumes with the clinical findings, in order to elucidate on the different responses to medical and surgical treatments. The results shown that the control group had no progression of atrophy of either hippocampus (p > 0.05) or corpus callosum (p = 0.260). The analysis of clinical group identified a reduction in the volume of the hippocampi, both the ipsilateral (affected) and the contralateral in both subgroups, resistant and benign. In relation to the hippocampus ipsilateral there was significant volumetric reduction in the benign group (p = 0.001) and also in the refractory group (p = 0.003). The hippocampus contralateral to the epileptogenic focus in the CLR group presented a significant atrophy (p = 0.001) and the same occurred to CLB (p = 0.011). In the surgery group (SG), the contralateral hippocampus (healthy remnant) showed a progression of atrophy that was pronounced in both the subgroup who continued with seizures after surgery (p = 0.001) and the subgroup who became seizure-free after surgery (p = 0.002). The paired analysis between the subgroups revealed a significant decrease in volume of the corpus callosum for the 4 subgroups (AU) | |