Do Gender and Age of the Initial Precipitant Injury (IPI) Influence the Side of the Hippocampal Lesion in Patients with Mesial Temporal Lobe Epilepsy?
Abstract number :
2.161
Submission category :
Year :
2001
Submission ID :
2842
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
M.M. Valenca, MD, PhD, Neuropsychiatry, Federal University of Pernambuco, Recife, PE, Brazil; L.P.A. Andrade-Valenca, MD,, Brazil; T.R. Velasco, MD,, Brazil; V.C. Terra-Bustamante, MD,, Brazil; C.G. Carlotti, Jr., MD, PhD,, Brazil; J.A. Assirati, MD,, Bra
RATIONALE: Previous study indicated that the development of partial epilepsy in children, after brain trauma, depend on the gender and injury side. Latent intervals are shorter in girls or when the lesion is in the left side of the brain. It is widely known that in many patients with mesial temporal lobe epilepsy (MTLE) there is an initial precipitating injury (IPI), which occurs in a critical period of brain development and that the hippocampal lesion is usually asymmetric. The pathophysiologic mechanisms involved in this intriguing lateralization of the lesion, however, remain unresolved. The present study was performed in order to address the questions of whether the side of the MTLE would be influenced by the gender and age of the individual at the time of IPI. Further, we evaluated if the latent interval would be modified by age that takes place the IPI or by gender.
METHODS: Forty three patients (22 women) were evaluated at Ribeirao Preto Epilepsy Surgery Program, University of Sao Paulo, using standardized protocols previously approved by the Ethics Committee of our Institution. Neuroimaging workup included high resolution MRI with special protocols to visualize the hippocampus. To analyze the relationship between gender, age, and IPI, patients were divided in other two groups: a) patients with IPI happened at *12 months of age (earlier-IPI) or b) IPI occurred at [gt] 12 months of age (later-IPI). Similar division was done in relation to the age of the first usual epilepsy seizure (FES): a) as earlier-FES when it occurred at the age * 10-year-old or b) later-FES with an age [gt]10-year-old.
RESULTS: Men had an age of IPI significantly earlier than women (p[lt]0.05). Five out 22 women (22.7%) and 9 out 21 men (42.9%) presented IPI ages * 12-month-old (mean [plusminus] SEM; 30.0 [plusminus] 3.7 vs. 23.2 [plusminus] 3.5 months, respectively). For IPI ages [gt] 12 months the FES occurred at older age (mean [plusminus] SEM, earlier-IPI = 8.4 [plusminus] 1.0 vs. later-IPI = 11.4 [plusminus] 0.7 years of age; p[lt]0.05). Although gender did not correlated with the side of MTLE, women in the later-IPI group had a higher involvement of the left temporal lobe [right = 5/17 patients (29.4 %) vs. left = 12/17 patients (70.6 %); p[lt]0.05]. For men and women the age of FES was similar in both sides (left = 10.4 [plusminus] 1.0 vs. right 9.7 [plusminus] 0.9 years of age; p[gt]0.05).
CONCLUSIONS: Our results suggest that either gender or age of IPI can influence the lateralization of the hippocampal lesion in patients with MTLE. Such findings support other studies which indicate that brain development is influenced by steroid sexual hormones.
Support: CNPq, PRONEX and FAPESP (Proc. 99/11729-2, 00/12376-5); Brazil.