Characteristics of mesial temporal lobe epilepsy associated with hippocampal sclerosis plus neurocysticercosis

被引:37
作者
Bianchin, Marino M. [1 ,2 ]
Velasco, Tonicarlo R. [1 ,3 ]
Wichert-Ana, Lauro [1 ,3 ]
Alexandre, Veriano, Jr. [1 ,3 ]
Araujo, David, Jr. [1 ,4 ]
dos Santos, Antonio Carlos [1 ,4 ]
Carlotti, Carlos G., Jr. [1 ,5 ]
Takayanagui, Osvaldo M. [3 ]
Sakamoto, Americo C. [1 ,3 ]
机构
[1] Univ Sao Paulo, Hosp Clin Ribeirao Preto, Ribeirao Preto Sch Med, Ctr Epilepsy Surg CIREP,Dept Neurol, BR-14049 Ribeirao Preto, Brazil
[2] Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil
[3] Univ Sao Paulo, Ribeirao Preto Sch Med, Dept Neurosci & Behav, BR-14049 Ribeirao Preto, Brazil
[4] Univ Sao Paulo, Ribeirao Preto Sch Med, Dept Radiol, BR-14049 Ribeirao Preto, Brazil
[5] Univ Sao Paulo, Ribeirao Preto Sch Med, Dept Surg & Anat, Div Neurosurg, BR-14049 Ribeirao Preto, Brazil
关键词
Hippocampal sclerosis; Focal epilepsy; Epileptogenesis; Cysticercosis; Initial precipitating injury; CALCIFIED NEUROCYSTICERCOSIS; LESIONS; SEIZURES;
D O I
10.1016/j.eplepsyres.2014.09.018
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Recent observations suggest that neurocysticercosis (NCC) might act as an initial precipitating injury (IPI) causing mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS). A total of 191 patients from Brazil, a country in which NCC is endemic, were surgically treated for MTLE-HS, and subsequent findings for patients with MTLE-HS were compared with those of patients with MTLE-HS plus NCC. Seventy-one patients (37,2%) presented chronic findings of NCC (cNCC). MTLE-HS plus cNCC was significantly more common in women (O.R. = 2.45; 95%Cl = 1.30-4.60; p= 0.005), in patients with no history of classical forms of IPI (O.R. =2.67; 95%Cl = 1.37-5.18; p= 0.004), and in those with bi-temporal interictal spikes on video-EEG (O.R. =2.00; 95%Cl = 1.07-3.73; p= 0.03). Single cNCC lesions were observed to occur significantly more often on the same side as hippocampal sclerosis, a finding suggesting an anatomical relationship between NCC and MTLE-HS. Taken together, our results suggest that NCC may be a marker, or contributes to or even causes MTLE-HS. Based on our findings, we propose two distinct, non-excluding, and potentially synergistic mechanisms involved in the development of MTLE-HS in NCC, one of them being inflammatory-mediated, while the other is electrogenicmediated. Taken together, our observations may provide further evidence suggesting a role of NCC in the genesis or development of MTLE-HS. (C) 2014 Elsevier B.V. All rights reserved.
引用
收藏
页码:1889 / 1895
页数:7
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