Multimodal presurgical evaluation in children with focal cortical dysplasia

WCN 2013 No: 1499 Topic: 1 — Epilepsy Pharmacologic and genetic aspects of resistant epilepsy in children in Uzbekistan N.M. Tuychibaeva, M.I. Sigatullina, A.V. Prokhorova. Tashkent Medical Academy, Uzbekistan; Tashkent Institute of Postgraduate of Medical Education, Tashkent, Uzbekistan Objectives: To develop methods of detection for the frequency and influence of polymorphism of cytochrome Р450 genes on pharmacologic and genetic action of antiepileptic drugs (AED). Identify the role of these genetic markers in individual responses to AED and development of pharmacologic resistance in epileptic patients. Material and methods: The research is based on studying the results of treatment of patients (n= 20)with resistant epilepsy. The control group included 25 volunteers of Uzbek nationality adjusted by sex and age. Results and conclusions: 1. Minimum level of gene variety of marker CYP2C9 in children was determined with not very high frequency of heterozygosis. Reduction of frequency of heterozygote genotype, absence of adverse genotype Т/Т and simultaneous increase in the share of individuals with normal homozygous С/С genotype among apparently healthy patients can be related to selective advantage of C allele. 2. Frequency of CYP2C9 polymorphism in pharmacoresistant patients considerably exceeded that in the control group indicating the association between development of resistance to AED and the genetic marker. The obtained statistically insignificant difference is most likely caused by the small amount of patients in the groups. 3. The genotypic variant distribution analysis of polymorphic marker 9896 C-G of CYP2E1 gene showed that among patients with the resistant epilepsy and the controls, the share of people with mutant genotypes had almost identical frequencies (20%). The risk of development of resistance to AED in carriers of the genotype was statistically insignificant (N0.05). doi:10.1016/j.jns.2013.07.103 Abstract — WCN 2013 No: 1513 Topic: 1 — Epilepsy Symptomatic versus idiopathic temporal lobe epilepsies: Findings from a cohort of 75 patients Y. Hizem, A. Nasri, M. Ben Djebara, Y. Sidhom, I. Abdelkefi, A. Gargouri-Berrechid, R. Gouider. Department of Neurology/Research Unit 03/UR/08-09, Research Unit 12SP21, Razi Hospital, Tunis, Tunisia Introduction: Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy. Twomain varieties have been described in TLE: mesial and lateral or neocortical temporal epilepsy. Objective: To determine clinical, electrical and radiological differences between mesial and neocortical variants of temporal lobe epilepsies in idiopathic versus symptomatic groups. Methods: Retrospective study of clinical, electrical and radiological features in four groups: mesial symptomatic (MSTLE), neocortical symptomatic (NSTLE), mesial idiopathic (MITLE) and neocortical idiopathic (NITLE). Results: Total of 75 patients: 24 MSTLE, 33 NSTLE, 14 MITLE and 4 NITLE. The mean age of onset was respectively: 11.54, 22.63, 9.78 and 15.7 years. History of febrile seizures is found in 66% inMSTLE. Themain types of seizures are automatisms and visceral sensory auras in MTLE symptomatic (75% and 58% respectively) and idiopathic (43% and 71% respectively). Psychic auras are the most frequent type in NSTLE (42%) and language alterations in NITLE (100%). spike-waves are common in mesial group. Pharmaco-resistance is more frequent in MSTLE (54%) and NITLE (50%). In the symptomatic group, brain MRI shows association of other temporal lobe abnormalities to mesial sclerosis in 46%. Conclusion: Our study shows earlier age of onset with a higher frequency of febrile seizures and pharmaco-resistance in MSTLE group. The Symptomatic group of TLE is characterized by older age and higher frequency of background EEG abnormalities. Some features are shared between the symptomatic or idiopathic variants and others depend on the mesial or neocortical localization. doi:10.1016/j.jns.2013.07.104 Abstract — WCN 2013 No: 1511 Topic: 1 — Epilepsy Multimodal presurgical evaluation in children with focal cortical dysplasia WCN 2013 No: 1511 Topic: 1 — Epilepsy Multimodal presurgical evaluation in children with focal cortical dysplasia M. Sigatullina, G. Garcia, J. Muchart, M. Rebollo, J. Aparicio, F. Sanmarti. Epilepsy Unit, University Hospital Sant Joan de Deu, Barcelona, Spain Objective: To evaluate the effectiveness of multimodal presurgical evaluation in patients with focal cortical dysplasia (FCD). Methods and subjects:We performed preand postsurgical evaluation in 20 patients withmalformations of cortical development (MCD) aged from 2 months till 17 years old. All of them underwent continuous video-EEG, MRI, 18 FDG-PET and SISCOM investigations. Results: There were operated 20 patients with MCD with preand postsurgical evaluation. Themean age at neurosurgerywas 6.5 years. 18 patients had different types FCD and 2 had hemimegalencephaly. The mean period between epilepsy onset and neurosurgery was 6 years. In 15 (75%) patients the presurgical MRI (1.5 T) detected FCD correlated with focal rhythmic epileptiform discharges during video-EEG register. In 5 patients (25%) with negative MRI, 18 FDG-PET and SISCOM were useful to complete the preoperative study. Surgical procedures included 6 temporal, 10 extratemporal, 2 multilobar resections and 2 functional hemispherotomies. Brain histological analysis confirmed the diagnosis ofMCD in all cases. The outcome after 1 year of neurosurgery, according Abstracts / Journal of the Neurological Sciences 333 (2013) e1–e64 e27