DIFFERENTIAL PATTERNS OF MOSSY FIBER SPROUTING IN CHILDREN AND ADULTS WITH INTRACTABLE MESIAL TEMPORAL LOBE EPILEPSY
Abstract number :
3.061
Submission category :
Year :
2002
Submission ID :
1625
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Leticia V. Sales, Tonicarlo R. Velasco, Luciana P.A. Andrade-Valen[ccedil]a, Marcelo M. Valen[ccedil]a, Luciana T. Ribeiro, Carlos G. Carlotti, Jo[atilde]o A. Assirati, Jo[atilde]o P. Leite. Departament of Neurology, University of S[atilde]o Paulo School
RATIONALE: Patients with mesial temporal lobe epilepsy (MTLE) characteristically present a history of IPI and onset of complex partial seizures by the end of first or second decade of life. In the present study we evaluate if hippocampal structural changes in pediatric temporal lobe epilepsy (TLE) are progressive and differ from those in adult patients. Hippocampi from children and adolescents with intractable TLE were compared with those from adult patients for granule cell dispersion (GCD) and intensity of mossy fiber sprouting (MFS).
METHODS: Pediatric patients with less than 12 years of epilepsy were evaluated at Ribeir[atilde]o Preto Epilepsy Surgery Program using protocols previously published and approved by Ethics Committee. Cases for this study were selected from temporal lobectomies between 1996 and 2000. Evaluation included a detailed history and neurologic examination, interictal/ictal video-EEG monitoring, neuropsychological test, MRI and SPECT. Preoperative data localized the focus to the anterior temporal region and patients were referred for a standardized en bloc resection including 2-3 cm of the hippocampus. At surgery, hippocampi specimens were cut transverse to the long axis and processed for Nissl and neo-Timm stainings. Pediatric patients with short epilepsy duration (SD [lte] 10 years, n =11) were compared to adults with long duration (LD [gte] 22 years, n =10). Fascia dentata (FD) width and MFS gray values were measured on hippocampi slices using an Image Analysis System (NIH Image).
RESULTS: Hippocampi from pediatric group (n = 11) had less intense mossy fiber staining in the inner molecular layer (Mean 109.70, SE [plusminus] 8.17) than adults (Mean 140.56, SE [plusminus] 9.96; p = 0.026). No differences in granular cell dispersion were found between groups.
CONCLUSIONS: Our results suggest that GCD does not progress as a consequence of epilepsy duration but supragranular MFS increases with age.
This finding supports the notion that there may exist some progressivity after intractability is established in children.
[Supported by: CNPq, PRONEX and FAPESP ( Proc. 99/11729-2, 00/01773-3); Brazil.]