Busca avançada
Ano de início
Entree
(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

MRI and EEG as long-term seizure outcome predictors in familial mesial temporal lobe epilepsy

Texto completo
Autor(es):
Mostrar menos -
Morita, Marcia E. [1, 2] ; Yasuda, Clarissa Lin [2, 1] ; Betting, Luiz E. [2, 1] ; Pacagnella, Denise [2] ; Conz, Livia [3] ; Barbosa, Patricia Horn [2, 1] ; Maurer-Morelli, Claudia Vianna [4] ; Costa, Andre Luiz F. [2] ; Kobayashi, Eliane [1, 2] ; Lopes-Cendes, Iscia [4] ; Cendes, Fernando [1, 2]
Número total de Autores: 11
Afiliação do(s) autor(es):
[1] Univ Estadual Campinas, UNICAMP, Dept Neurol, Campinas, SP - Brazil
[2] Univ Estadual Campinas, UNICAMP, Neuroimaging Lab, Campinas, SP - Brazil
[3] Univ Estadual Campinas, UNICAMP, Fac Med Sci, Campinas, SP - Brazil
[4] Univ Estadual Campinas, UNICAMP, Dept Med Genet, Campinas, SP - Brazil
Número total de Afiliações: 4
Tipo de documento: Artigo Científico
Fonte: Neurology; v. 79, n. 24, p. 2349-2354, DEC 2012.
Citações Web of Science: 15
Resumo

Objective: To evaluate the natural history and outcome predictors in familial mesial temporal lobe epilepsy (FMTLE). Methods: We conducted a longitudinal study of 103 individuals from 17 FMTLE families (mean follow-up: 7.6 years). We divided subjects into 3 groups: FMTLE (n = 53), unclassified seizure (n = 18), and asymptomatics (n 5 32). We divided FMTLE patients into 3 subgroups: seizure-free (n = 19), infrequent (n = 17) seizures, and frequent (n = 17) seizures and further reclassified them into favorable and poor outcome. We defined hippocampal atrophy (HA) by visual MRI analysis and performed volumetry in those who had 2 MRIs. Results: FMTLE patients with infrequent seizures evolved to either frequent seizures (17.6%) or seizure freedom (23.5%). In the seizure-free group, most remained seizure-free and 21% developed infrequent seizures. All patients with frequent seizures remained in the same status or underwent surgery. Twelve percent of the asymptomatics and 22% of the unclassified-seizure group evolved to FMTLE with infrequent seizures. Predictive factors of poor outcome were presence of HA (p = 0.0192) and interictal epileptiform discharges (p = 0.0174). The relationship between initial precipitating incidents and clinical outcome was not significant although a tendency was observed (p = 0.055). Use of antiepileptic drugs and secondary generalized seizures during the patient's lifetime did not predict poor outcome. We observed progression of HA only in the group with frequent seizures. Conclusion: Most patients with FMTLE continued in the same clinical status. However, patients with frequent seizures had progression of HA and none improved except those who underwent surgery. Interictal epileptiform discharges and HA predicted poorer outcome in FMTLE, and there was a tendency in favor of initial precipitating incidents as outcome predictors. Neurology (R) 2012;79:2349-2354 (AU)

Processo FAPESP: 06/59101-7 - Epilepsia de lobo temporal familial: caracterização da evolução natural, progressão da atrofia hipocampal e resposta ao tratamento
Beneficiário:Marcia Elisabete Morita
Linha de fomento: Bolsas no Brasil - Doutorado Direto
Processo FAPESP: 05/56578-4 - Centro multimodal de neuroimagens para estudos em epilepsia
Beneficiário:Fernando Cendes
Linha de fomento: Auxílio à Pesquisa - Programa CINAPCE - Temático