Expression of adenosine kinase in human mesial temporal lobe epilepsy with hippocampal sclerosis: A preliminary study

Expression of adenosine kinase in human mesial temporal lobe epilepsy with hippocampal sclerosis: A preliminary study

Abstracts / Journal of the Neurological Sciences 333 (2013) e1–e64 (TLE) but may impair memory function, typically verbal memory following left and v...

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Abstracts / Journal of the Neurological Sciences 333 (2013) e1–e64

(TLE) but may impair memory function, typically verbal memory following left and visual memory following right ATLR. Functional reorganisation can occur within the unaffected ipsilateral and contralateral hemispheres. We investigated reorganisation of memory function in TLE before and after left or right ATLR and the efficiency of postoperative memory networks. Methods: We studied 46 patients with unilateral medial TLE (26 left) on a 3T GE-MRI scanner. All subjects had neuropsychological testing and performed an fMRI memory encoding paradigm for words, pictures and faces preoperatively and four months after left or right ATLR. Results: Event-related analysis revealed that left TLE had greater activation in the left posterior medial temporal lobe (MTL) for encoding words postoperatively than preoperatively. Greater pre- than postoperative activation for encoding words in the ipsilateral posterior MTL correlated with better verbal memory outcome after left ATLR. After left ATLR greater postoperative than preoperative activation in the ipsilateral posterior MTL correlated with less good postoperative verbal memory performance, an effect that was not observed for visual memory after right ATLR. Conclusion: We found effective preoperative reorganisation of verbal memory function to the ipsilateral posterior MTL, suggesting that it is the capacity of the posterior remnant of the ipsilateral hippocampus rather than the functional reserve of the contralateral hippocampus that is important for maintaining verbal memory function after ATLR; early postoperative reorganisation to ipsilateral posterior or contralateral MTL structures are inefficient. doi:10.1016/j.jns.2013.07.208

Abstract — WCN 2013 No: 3018 Topic: 1 — Epilepsy Increased seizure frequency due to the copper deficiency in Wilson's disease H. Kaleagasi, N. Oksuz, S. Ozal, A. Yilmaz, O. Dogu. Neurology, Mersin University School of Medicine, Mersin, Turkey Background: Epileptic seizures have been reported in Wilson's disease (WD) in 6–7% of patients, mostly following the chelator therapy. Pyridoxine deficiency due to penicillamine, direct copper toxicity, pathological changes, metabolic encephalopathy and rarely copper deficiency are the attributed mechanisms for seizures. Objective: To present a patient with WD and intractable seizures, taking chelator and antiepileptic therapy with a strict copper restricted diet. Patients and methods: A-29-year old female patient admitted to emergency unit with recurrent seizures. She had been diagnosed as WD and epilepsy in another center previously with a treatment of penicillamine, zinc acetate and carbamazepine. Complex partial and less frequent secondary generalized seizures had been started after taking penicillamine and responded well to carbamazepine initially. She complained increased daily frequency of seizures ranging from 5 to 10 in recent months. Results: Although effective serum carbamazepine level and levetiracetam add-on therapy, changed chelator therapy with trientine and oral pyridoxine, daily frequency of seizures did not reduce and low serum copper [0.3 μg/dl (70–140)] has been attributed for the seizures. Zinc acetate and strict copper restricted diet were ended. As the serum copper levels increased during followup [16 μg/dl (70–140)], seizure frequency was decreased. Conclusion: Epileptic seizures respond well to antiepileptic treatment in WD. In this case, add-on antiepileptic and pyridoxine therapy did not reduce the seizure frequency. The relation between decreased seizure frequency and increased serum copper levels


shows that copper deficiency can cause intractable seizures in patients who are taking chelator therapy with a strict copper restricted diet. doi:10.1016/j.jns.2013.07.209

Abstract — WCN 2013 No: 3019 Topic: 1 — Epilepsy Attentional deficit in childhood benign epilepsy with centrotemporal spikes (bects) and absence seizure epilepsy P. Conde-Guzóna, M.T. Bartolomé-Albisteguib, R. Cancho-Candelac, C. Rodríguezd, M.J. Conde-Guzóna. aNeuropsychology, Universidad de León, Spain; bNeurology, Obra Hospitalaria Nuestra Señora de Regla, Leon, Spain; cNeuropediatrics, Hospital Pio del Rio Hortega, Valladolid, Spain; dNeuropediatrics, Complejo Hospitalario de León, Leon, Spain Objective: There is controversy regarding the neuropsychological profile of children with epilepsy. The aim of this study is to analyze the attentional profile of children with benign epilepsy with centrotemporal spikes (BECTS) compared with children with absence seizures. Methods: Sample: 34 children from 7 to 12 years (18 with BECTS and 16 with absence seizures). We get the attentional profile by applying the WISC-IV (Wechsler Intelligence Scale for Children-IV), Battery Luria-DNI (Manga and Ramos, 1991) and Attention Test d2 (Brickenkamp, 2002). Results: A) We haven't found any differences in IQ between children with BECTS and absence seizures. B) We haven't found any differences in attentional profile when we use WISC-IV. C) Nevertheless, when we use specific Attentional Test d2, we have found a significant (p b 0.05) deficit in children with BECTS compared with absence seizure children in attentional control, inhibitory control, working capacity, concentration, and selective and sustained attention. Conclusions: We must consider, in children with this diagnosis, the neuropsychological profile described to strengthen deficient neuropsychological and psychoeducational areas. In addition, we must continue research in future studies on the role of the attention in children with epilepsy. doi:10.1016/j.jns.2013.07.210

Abstract — WCN 2013 No: 2953 Topic: 1 — Epilepsy Expression of adenosine kinase in human mesial temporal lobe epilepsy with hippocampal sclerosis: A preliminary study B. Leala, R. Rangelb, J. Chavesb, C. Carvalhoa, A. Bettencourta, L. Zenattia, A. Santosc, T. Magalhãesc, A. Martins da Silvab, P. Correia-de-Sáa, B. Martins da Silvaa, P.P. Costaa,d. aUMIB — ICBAS-UP, Portugal; bCentro Hospitalar do Porto — Hospital de Santo António, Portugal; cInstituto Nacional de Medicina Legal — Delegação Porto, Portugal; dInstituto Nacional de Saude Dr. Ricardo Jorge (INSA), Porto, Portugal Background: Adenosine is a ubiquitous homeostatic molecule that acts as an “endogenous neuromodulator”. Adenosine attenuates neuronal activity either presynaptically by inhibiting neurotransmitter release or by controlling neurotransmitter responsiveness at post-synaptic sites. Unbalanced adenosine metabolism has been


Abstracts / Journal of the Neurological Sciences 333 (2013) e1–e64

implicated in pathological conditions such as epilepsy. Adenosine kinase (ADK), synthetized by astrocytes, is the key regulator of extracellular adenosine levels in the brain. Evidences from experimental studies support a role for ADK in brain injury associated with astrogliosis, a morphological hallmark of Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis (MTLE-HS). In fact, expression of astrocytic ADK was found to be increased in the hippocampus and temporal cortex of MTLE-HS patients. Overexpression of ADK decreases extracellular adenosine and consequently may cause seizures. The aim of this study was to characterize ADK gene expression in MTLE-HS patients. Methods: Previous studies used immunohistochemistry and Western blot analysis to investigate ADK expression. Here we quantified the expression levels of ADK by Real-Time PCR in the hippocampus (lesional and peri-lesional cortical area) of 10 MTLE-HS patients submitted to surgery as compared with 9 autopsy controls with no history of neurological disorders. Results: Our results showed that ADK expression levels were similar in the hippocampus and temporal cortex of MTLE-HS patients when compared to healthy controls. Conclusion: Our preliminary data demonstrate that ADK expression levels are not altered in MTLE-HS. These results do not preclude post-transcriptional ADK abnormalities at both protein and functional levels. Our results should be confirmed in a larger cohort as well as with complementary methodologies. doi:10.1016/j.jns.2013.07.211

Abstract — WCN 2013 No: 3057 Topic: 1 — Epilepsy Proposal of a staging system for risk stratification and cross sectional reporting of status epilepticus M. Leitinger, G. Kalss, D. Huber, A. Rohracher, J. Höfler, J. Dobesberger, E. Trinka. Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria Background: Definitions for status epilepticus (SE) vary regarding their time points and -windows of treatment options. Clinical phenomena are highly dynamic and symptoms may gradually disappear, as status advances (electromechanical dissociation). Pragmatically, this may cause problems, when transferring a patient in SE from one to another unit (e.g. emergency department to ICU). To date no standardized system exists for acquisition, documentation and communication of clinical core parameters to stage SE. Such a system would make research results better comparable for metaanalyses and serve as a tool for risk stratification. Methods: Fifty consecutive patients with various types of status epilepticus of any cause were classified according to a proposed staging system for status epilepticus (SSSE) in a tertiary neurological university clinic in Salzburg, Austria. A data sheet was designed and explained to responsible physicians in charge. The SSSE uses a letter code comparable to the pTNM-system in tumors. A “D” denotes the definition based on clinical grounds, “S” for semiology, “N” for level of neurophysiological evidence, “L” for laboratory changes and “I” for results of neuroimaging. Results: SSSE was easily applicable and well accepted by physicians, did not interfere with patient management and was suitable for communication in medical records. Conclusion: The SSSE is applicable to various forms of SE in any clinical setting with low time consumption and no interference with acute patient management. Larger prospective studies are needed to perform risk stratification and to determine test characteristics such as inter-rater reliability. doi:10.1016/j.jns.2013.07.212

Abstract — WCN 2013 No: 2951 Topic: 1 — Epilepsy Clinical and CT-scan aspects of neurocysticercosis (NCC) at teaching hospital Yalgado Ouédraogo concerning 35 cases A.A. Savadogoa, J. Kaboréb, R. Cisséc. aClinique Neurologique/Fann Teaching Hospital, Cheikh Anta DIOP University, Dakar, Senegal; b Department of Neurology/Yalgado Ouédraogo Teaching Hospital, Burkina Faso; cDepartement of Radiology and Radiodiagnostic/Yalgado Ouédraogo Teaching Hospital, University of Ouagadougou, Ouagadougou, Burkina Faso Background: The clinical and the CT-scan features of NCC are poorly studied in sub-saharian Africa. This study aims to emphasize the clinical and CT-scan characteristics of NCC at teaching hospital Yalgado Ouédraogo. Patients and methods: We conducted a transversal prospective study from February 2001 to April 2006. The diagnosis has been established on the basis of clinical and cerebral CT scan examinations. All the patients received an antihelmenthic drug. Objective: This study focused on the clinical and CT features of NCC at Teaching Hospital Yalgado Ouédraogo, Ouagadougou, Burkina Faso. Results: The most common clinical event in our study was seizure (94.3%) and generalized seizure was the most found type. Seizures were followed by headache with or without ICP (62.9%) and by focal deficit (17.1%).All the patients had a parenchymal location associated to extraparenchymal locations in the rate of 20%. There were 85.7% of isolated supratentorial lesions. The number of lesions among patients ranged from 1 to 67. The calcification and the vesicle were the most frequent lesions. Two solitary cerebral cysticercus granuloma and two giant cysts have been brought out. 94.6% of the patients with parenchymal location had seizures. NCC lesions were associated to cerebral infarction in two patients. Conclusion: The diagnosis of NCC has been revolutionized by CT scan. MRI and immunologic tests which are unavailable in Burkina Faso will help in the diagnosis and the management of this infection. doi:10.1016/j.jns.2013.07.213

Abstract — WCN 2013 No: 3088 Topic: 1 — Epilepsy Views of young people toward epilepsy in Novi Sad V. Ivetic, K. Ivosevic, D. Karaba Jakovljevic, N. Naumovic. Department of Physiology, Medical Faculty, Novi Sad, Serbia Epilepsy is a significant health problem especially prominent in underdeveloped countries. Quality of life in epilepsy is affected not only by the subjective experience of the illness it manifests, and long-lasting therapy, but also by the inappropriate attitude of the society that is mostly uniformed about the real nature of epilepsy. In this investigation it was analyzed how well young people are informed about epilepsy and its characteristics as well as first aid to epileptic. A special questionnaire for investigation was used. The first part of the questionnaire was used to determine the sociodemographic characteristics of the study participants, and the second part dealt with student knowledge of epilepsy. In this study 432 students were included from different schools of University in Novi Sad (excluding students from medical schools), ages 20–24, both sex. The results show that the young people are familiar with epilepsy, and they have a basic knowledge regarding nature of the disease, but due to different subjective attitudes towards epilepsy and epileptic patients, it can be said that the attitude of the young population