Document Detail

Mesial temporal lobe epilepsy: clinical and neuropathologic findings of familial and sporadic forms.
MedLine Citation:
PMID:  18294201     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To evaluate the clinical and hippocampal histological features of patients with mesial temporal lobe epilepsy (MTLE) in both familial (FMTLE) and sporadic (SMTLE) forms. METHODS: Patients with FMTLE (n = 20) and SMTLE (n = 39) who underwent surgical treatment for refractory seizures were studied at the University of São Paulo School of Medicine at Ribeirão Preto. FMTLE was defined when at least two individuals in a family had clinical diagnosis of MTLE. Hippocampi from all patients were processed for Nissl/HE and Timm's stainings. Both groups were compared for clinical variables, hippocampal cell densities, and intensity of supragranular mossy fiber staining. RESULTS: There were no significant differences between FMTLE and SMTLE groups in the following: age at the surgery, age of first usual epileptic seizure, history of initial precipitating injury (IPI), age of IPI, latent period, ictal and interictal video-EEG patterns, presence of hippocampal atrophy and signal changes at MRI, and postoperative outcome. In addition, no differences were found in cell densities in hippocampal cornu ammonis subfields (CA1, CA2, CA3, CA4), fascia dentata, polymorphic region, subiculum, prosubiculum, and presubiculum. However, patients with SMTLE had greater intensity of mossy fiber Timm's staining in the fascia dentata-inner molecular layer (p< 0.05). DISCUSSION: Patients with intractable FMTLE present a clinical profile and most histological findings comparable to patients with SMTLE. Interestingly, mossy fiber sprouting was less pronounced in patients with FMTLE, suggesting that, when compared to SMTLE, patients with FMTLE respond differently to plastic changes plausibly induced by cell loss, neuronal deafferentation, or epileptic seizures.
Luciana Patrízia A Andrade-Valença; Marcelo Moraes Valença; Tonicarlo Rodrigues Velasco; Carlos Gilberto Carlotti; João Alberto Assirati; Orfa Yineth Galvis-Alonso; Luciano Neder; Fernando Cendes; João Pereira Leite
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-20
Journal Detail:
Title:  Epilepsia     Volume:  49     ISSN:  1528-1167     ISO Abbreviation:  Epilepsia     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-16     Completed Date:  2008-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1046-54     Citation Subset:  IM    
Department of Neurology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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MeSH Terms
Anterior Temporal Lobectomy
Epilepsy, Temporal Lobe / diagnosis,  genetics*,  pathology,  surgery
Follow-Up Studies
Hippocampus / pathology*,  surgery
Magnetic Resonance Imaging
Middle Aged
Mossy Fibers, Hippocampal / pathology
Neuronal Plasticity / genetics
Neurons / pathology

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