Granule Cell Dispersion and Mossy Fiber Sprouting Are Not Dependent on Epilepsy Duration in Patients with Intractable MTLE
Abstract number :
2.028
Submission category :
Year :
2001
Submission ID :
2754
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
T.R. Velasco, MD; L.V. Sales, MD; J.A. Assirati, MD; C.G. Carlotti, Jr., MD, Ph.D.; J.P. Leite, MD, Ph.D., Neurology, Univ. Sao Paulo Sch. Medicine at Ribeirao Preto, Ribeirao Preto, SP, Brazil
RATIONALE: Hippocampal sclerosis (HS) is the typical pathologic finding in patients with intractable mesial temporal lobe epilepsy (MTLE). It is characterized by severe cell loss in some hippocampal subfields and is associated to granule cell dispersion (GCD) and supragranular mossy fiber sprouting (MFS). There are some debate as to whether HS is a progressive condition or if isolated seizures contribute to the severity of the disease. The aim of the present study is to evaluate the increase of GCD and MFS in group of patients with well established intractable MTLE.
METHODS: Thirty eight MTLE patients with neuroimaging of hippocampal atrophy were evaluated at Ribeirao Preto Epilepsy Surgery Program using standardized protocols previously approved by the Ethics Committee of our Institution. Patients were divided in two groups according to the epilepsy duration 1) Short Duration (SD, n=14): patients with [lte]10 years of epilepsy and 2) Long Duration (LD, n=24): patients with [gt] 25 years of epilepsy. Fascia dentata (FD) and supragranular MFS width and MFS gray values were measured on hippocampal slices processed for Nissl and neo-Timms histochemistry using an Image Analysis system (NIH Image).
RESULTS: Epilepsy duration in SD and LD groups were 8.14 years (SEM [plusminus] 0.6) and 29.54 (SEM [plusminus] 0.71), respectively. No differences were found on FD width between groups (142.21 and 143.88 [mu]m for SD and LD , respectively). MFS width did not differ between SD and LD groups (145.99 and 188.03 [mu]m, respectively, p=0.182). MFS intensities, expressed as gray values were not different for SD and LD (164.72 and 142.28, respectively).
CONCLUSIONS: Using quantitative histological parameters, our results indicate that GCD and supragranular MFS do not progress as a consequence of epilepsy duration. These findings support the notion that after intractability is clinically established there is no evidence of progressivity. We can note exclude, however, if recently diagnosed MTLE would show some progressivity in their first years of the disease.
Support: CNPq, PRONEX and FAPESP (Proc. 99/11729-2, 00/01773-3); Brazil.