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[PMID]:29336424
[Au] Autor:Poudyal P; Shrestha RP; Shrestha PS; Dangol S; Shrestha NC; Joshi A; Shrestha A
[Ad] Endereço:Department of Pediatrics, Dhulikhel Hospital, Kathmandu University Hospital Dhulikhel, Kavre, Nepal.
[Ti] Título:Clinical Profile and Electroencephalogram Findings in Children with Seizure Presenting to Dhulikhel Hospital.
[So] Source:Kathmandu Univ Med J (KUMJ);14(56):347-351, 2016 Oct.-Dec..
[Is] ISSN:1812-2078
[Cp] País de publicação:Nepal
[La] Idioma:eng
[Ab] Resumo:Background Seizure disorder is the most common childhood neurologic condition and a major public health concern. Identification of the underlying seizure etiology helps to identify appropriate treatment options and the prognosis for the child. Objective This study was conducted to investigate the clinical profile, causes and electroencephalogram findings in children with seizure presenting to a tertiary center in Kavre district. Method This was a hospital based prospective study carried out in the Department of Pediatrics, Dhulikhel Hospital, Kavre from 1st April 2015 to 31st March 2016. Variables collected were demographics, clinical presentations, laboratory tests, brain imaging studies, electroencephalography, diagnosis and outcome. Result Study included 120 (age 1 month to 16 years) children attending Dhulikhel Hospital. Majority of the patients were male (60.84%). Age at first seizure was less than 5 years in 75.83% of children. Seizure was generalized in 62.50%, focal in 31.67% and unclassified in 5.83%. Common causes of seizure were - Primary generalized epilepsy (26.66%), neurocysticercosis (10%) and hypoxic injury (6.6%) which was diagnosed in the perinatal period. Febrile seizure (26.66%) was the most common cause of seizure in children between 6 months to 5 years of age. Neurological examination, electroencephalography and Computed Tomography were abnormal in 71.66%, 68.92% and 58.14% cases respectively. Seizure was controlled by monotherapy in 69.16% cases and was resistant in 7.50% of the cases. Conclusion Primary generalized epilepsy and febrile seizure were the most common causes of seizures in children attending Dhulikhel Hospital. Electroencephalogram findings help to know the pattern of neuronal activity. Response to monotherapy was good and valproic acid was the most commonly used drug.
[Mh] Termos MeSH primário: Convulsões/diagnóstico
Convulsões/patologia
[Mh] Termos MeSH secundário: Adolescente
Fatores Etários
Criança
Pré-Escolar
Eletroencefalografia
Feminino
Seres Humanos
Lactente
Masculino
Prognóstico
Estudos Prospectivos
Convulsões/diagnóstico por imagem
Convulsões Febris/diagnóstico
Convulsões Febris/patologia
Fatores Sexuais
Fatores Socioeconômicos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180117
[St] Status:MEDLINE


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[PMID]:28448686
[Au] Autor:Gallentine WB; Shinnar S; Hesdorffer DC; Epstein L; Nordli DR; Lewis DV; Frank LM; Seinfeld S; Shinnar RC; Cornett K; Liu B; Moshé SL; Sun S; FEBSTAT Investigator Team
[Ad] Endereço:Department of Pediatrics (Neurology), Duke Children's Hospital, Durham, North Carolina, U.S.A.
[Ti] Título:Plasma cytokines associated with febrile status epilepticus in children: A potential biomarker for acute hippocampal injury.
[So] Source:Epilepsia;58(6):1102-1111, 2017 06.
[Is] ISSN:1528-1167
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Our aim was to explore the association between plasma cytokines and febrile status epilepticus (FSE) in children, as well as their potential as biomarkers of acute hippocampal injury. METHODS: Analysis was performed on residual samples of children with FSE (n = 33) as part of the Consequences of Prolonged Febrile Seizures in Childhood study (FEBSTAT) and compared to children with fever (n = 17). Magnetic resonance imaging (MRI) was obtained as part of FEBSTAT within 72 h of FSE. Cytokine levels and ratios of antiinflammatory versus proinflammatory cytokines in children with and without hippocampal T2 hyperintensity were assessed as biomarkers of acute hippocampal injury after FSE. RESULTS: Levels of interleukin (IL)-8 and epidermal growth factor (EGF) were significantly elevated after FSE in comparison to controls. IL-1ß levels trended higher and IL-1RA trended lower following FSE, but did not reach statistical significance. Children with FSE were found to have significantly lower ratios of IL-1RA/IL-1ß and IL-1RA/IL-8. Specific levels of any one individual cytokine were not associated with FSE. However, lower ratios of IL-1RA/IL-1ß, IL-1RA/1L-6, and IL-1RA/ IL-8 were all associated with FSE. IL-6 and IL-8 levels were significantly higher and ratios of IL-1RA/IL-6 and IL-1RA/IL-8 were significantly lower in children with T2 hippocampal hyperintensity on MRI after FSE in comparison to those without hippocampal signal abnormalities. Neither individual cytokine levels nor ratios of IL-1RA/IL-1ß or IL-1RA/IL-8 were predictive of MRI changes. However, a lower ratio of IL-1RA/IL-6 was strongly predictive (odds ratio [OR] 21.5, 95% confidence interval [CI] 1.17-393) of hippocampal T2 hyperintensity after FSE. SIGNIFICANCE: Our data support involvement of the IL-1 cytokine system, IL-6, and IL-8 in FSE in children. The identification of the IL-1RA/IL-6 ratio as a potential biomarker of acute hippocampal injury following FSE is the most significant finding. If replicated in another study, the IL-1RA/IL-6 ratio could represent a serologic biomarker that offers rapid identification of patients at risk for ultimately developing mesial temporal lobe epilepsy (MTLE).
[Mh] Termos MeSH primário: Biomarcadores/sangue
Dano Encefálico Crônico/sangue
Citocinas/sangue
Hipocampo/diagnóstico por imagem
Hipocampo/fisiopatologia
Convulsões Febris/sangue
Estado Epiléptico/sangue
[Mh] Termos MeSH secundário: Dano Encefálico Crônico/diagnóstico por imagem
Criança
Pré-Escolar
Epilepsia do Lobo Temporal/sangue
Feminino
Seres Humanos
Lactente
Recém-Nascido
Proteína Antagonista do Receptor de Interleucina 1/sangue
Interleucina-1beta/sangue
Interleucina-6/sangue
Interleucina-8/sangue
Masculino
Fatores de Risco
Convulsões Febris/diagnóstico por imagem
Estado Epiléptico/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Biomarkers); 0 (Cytokines); 0 (Interleukin 1 Receptor Antagonist Protein); 0 (Interleukin-1beta); 0 (Interleukin-6); 0 (Interleukin-8)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180107
[Lr] Data última revisão:
180107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1111/epi.13750


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[PMID]:27771943
[Au] Autor:Reid CA; Hildebrand MS; Mullen SA; Hildebrand JM; Berkovic SF; Petrou S
[Ad] Endereço:Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.
[Ti] Título:Synaptic Zn and febrile seizure susceptibility.
[So] Source:Br J Pharmacol;174(2):119-125, 2017 01.
[Is] ISSN:1476-5381
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Zn , the second most prevalent trace element in the body, is essential for supporting a wide range of biological functions. While the majority of Zn in the brain is protein-bound, a significant proportion of free Zn is found co-localized with glutamate in synaptic vesicles and is released in an activity-dependent manner. Clinical studies have shown Zn levels are significantly lower in blood and cerebrospinal fluid of children that suffer febrile seizures. Likewise, investigations in multiple animal models demonstrate that low levels of brain Zn increase seizure susceptibility. Recent work provides human genetic evidence that disruption of brain Zn homeostasis at the level of the synapse is associated with increased seizure susceptibility. In this review, we have explored the clinical, functional and genetic data supporting the view that low synaptic Zn increases cellular excitability and febrile seizure susceptibility. Finally, the review focuses on the potential of therapeutic Zn supplementation for at risk patients.
[Mh] Termos MeSH primário: Convulsões Febris/metabolismo
Vesículas Sinápticas/metabolismo
Zinco/metabolismo
[Mh] Termos MeSH secundário: Animais
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
J41CSQ7QDS (Zinc)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1111/bph.13658


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[PMID]:28982711
[Au] Autor:Myers KA; McPherson RE; Clegg R; Buchhalter J
[Ad] Endereço:Epilepsy Research Centre, Austin Health, University of Melbourne, Melbourne, Victoria, Australia; and sfu.ken1@gmail.com.
[Ti] Título:Sudden Death After Febrile Seizure Case Report: Cerebral Suppression Precedes Severe Bradycardia.
[So] Source:Pediatrics;140(5), 2017 Nov.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 20-month-old girl with a complex chromosomal disorder had first presentation of febrile status epilepticus and was admitted to the hospital. Two days after her initial seizure, she died suddenly and unexpectedly during a video EEG monitoring study. An advanced analysis of the physiologic changes in the hours and minutes leading up to death was undertaken. The electrocardiography over the last 19 minutes of life was reviewed, and the R-R intervals were manually measured. Heart rate variability was assessed through calculation of the SD of the R-R intervals and the root mean square of successive differences over successive 100 beat periods. Instantaneous heart rate, SD of the R-R intervals, the root mean square of successive differences, and oxygen saturation were plotted against time over the last 19 minutes of life. Diffuse cerebral suppression on EEG was observed 10 minutes before death, followed minutes later by severe bradycardia and increased heart rate variability. Although the child did not meet criteria for a diagnosis of epilepsy, the sequence of physiologic changes leading up to death suggests a pathophysiology similar to sudden unexplained death in epilepsy. A comparable pattern of diffuse cerebral suppression preceding parasympathetic overactivity has been suggested in some rare cases of adults who have experienced sudden unexplained death in epilepsy during video EEG monitoring.
[Mh] Termos MeSH primário: Bradicardia/fisiopatologia
Encéfalo/fisiopatologia
Morte Súbita
Eletroencefalografia
Convulsões Febris/fisiopatologia
Índice de Gravidade de Doença
[Mh] Termos MeSH secundário: Bradicardia/complicações
Bradicardia/diagnóstico
Eletroencefalografia/tendências
Feminino
Seres Humanos
Convulsões Febris/complicações
Convulsões Febris/diagnóstico
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171007
[St] Status:MEDLINE


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[PMID]:28842445
[Au] Autor:Zhang YH; Burgess R; Malone JP; Glubb GC; Helbig KL; Vadlamudi L; Kivity S; Afawi Z; Bleasel A; Grattan-Smith P; Grinton BE; Bellows ST; Vears DF; Damiano JA; Goldberg-Stern H; Korczyn AD; Dibbens LM; Ruzzo EK; Hildebrand MS; Berkovic SF; Scheffer IE
[Ad] Endereço:From the Epilepsy Research Centre, Department of Medicine (Y.-H.Z., R.B., J.P.M., G.C.G., K.L.H., L.V., B.E.G., S.T.B., D.F.V., J.A.D., M.S.H., S.F.B., I.E.S.), The University of Melbourne, Austin Health, Australia; Department of Pediatrics (Y.-H.Z.), Peking University First Hospital, Beijing, China
[Ti] Título:Genetic epilepsy with febrile seizures plus: Refining the spectrum.
[So] Source:Neurology;89(12):1210-1219, 2017 Sep 19.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Following our original description of generalized epilepsy with febrile seizures plus (GEFS+) in 1997, we analyze the phenotypic spectrum in 409 affected individuals in 60 families (31 new families) and expand the GEFS+ spectrum. METHODS: We performed detailed electroclinical phenotyping on all available affected family members. Genetic analysis of known GEFS+ genes was carried out where possible. We compared our phenotypic and genetic data to those published in the literature over the last 19 years. RESULTS: We identified new phenotypes within the GEFS+ spectrum: focal seizures without preceding febrile seizures (16/409 [4%]), classic genetic generalized epilepsies (22/409 [5%]), and afebrile generalized tonic-clonic seizures (9/409 [2%]). Febrile seizures remains the most frequent phenotype in GEFS+ (178/409 [44%]), followed by febrile seizures plus (111/409 [27%]). One third (50/163 [31%]) of GEFS+ families tested have a pathogenic variant in a known GEFS+ gene. CONCLUSION: As 37/409 (9%) affected individuals have focal epilepsies, we suggest that GEFS+ be renamed genetic epilepsy with febrile seizures plus rather than generalized epilepsy with febrile seizures plus. The phenotypic overlap between GEFS+ and the classic generalized epilepsies is considerably greater than first thought. The clinical and molecular data suggest that the 2 major groups of generalized epilepsies share genetic determinants.
[Mh] Termos MeSH primário: Epilepsias Parciais/fisiopatologia
Epilepsia Generalizada/fisiopatologia
Convulsões Febris/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idade de Início
Criança
Pré-Escolar
Epilepsias Parciais/genética
Epilepsia Generalizada/genética
Feminino
Seres Humanos
Lactente
Masculino
Meia-Idade
Linhagem
Fenótipo
Convulsões Febris/genética
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170827
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004384


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[PMID]:28806450
[Au] Autor:Macartney K; Gidding HF; Trinh L; Wang H; Dey A; Hull B; Orr K; McRae J; Richmond P; Gold M; Crawford N; Kynaston JA; McIntyre P; Wood N; Paediatric Active Enhanced Disease Surveillance Network
[Ad] Endereço:National Centre for Immunisation Research and Surveillance, Sydney, Australia.
[Ti] Título:Evaluation of Combination Measles-Mumps-Rubella-Varicella Vaccine Introduction in Australia.
[So] Source:JAMA Pediatr;171(10):992-998, 2017 Oct 01.
[Is] ISSN:2168-6211
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Incorporating combination vaccines, such as the measles-mumps-rubella-varicella (MMRV) vaccine, into immunization schedules should be evaluated from a benefit-risk perspective. Use of MMRV vaccine poses challenges due to a recognized increased risk of febrile seizures (FSs) when used as the first dose in the second year of life. Conversely, completion by age 2 years of measles, mumps, rubella, and varicella immunization may offer improved disease control. Objective: To evaluate the effect on safety and coverage of earlier (age 18 months) scheduling of MMRV vaccine as the second dose of measles-containing vaccine (MCV) in Australia. Design, Setting, and Participants: Prospective active sentinel safety surveillance comparing the relative incidence (RI) of FSs in toddlers given MMRV and measles-mumps-rubella (MMR) and a national cohort study of vaccine coverage rates and timeliness before and after MMRV vaccine introduction were conducted. All Australian children aged 11 to 72 months were included in the coverage analysis, and 1471 Australian children aged 11 to 59 months were included in the FS analysis, with a focus on those aged 11 to 23 months. Main Outcomes and Measures: MMRV vaccine safety, specifically, the RI of FSs after MMRV vaccine at age 18 months, compared with risk following MMR vaccine and vaccine uptake for 2-dose MCV and single-dose varicella vaccine, focusing on timeliness. Results: Of the 1471 children, the median age at first FS was 21 months (interquartile range [IQR], 14-31 months). Three hundred ninety-one children were aged 11 to 23 months and had at least 1 FS included in the analysis; of these, 207 (52.9%) were male. A total of 278 children (71.1%) had received MMR followed by MMRV vaccine, 97 (24.8%) had received MMR vaccine only, and 16 (4.1%) had received neither vaccine. There was no increased risk of FSs (RI, 1.08; 95% CI, 0.55-2.13) in the 5 to 12 days following MMRV vaccine given as the second MCV to toddlers. Febrile seizures occurred after dose 1 of MMR vaccine at a known low increased risk (RI, 2.71; 95% CI, 1.71- 4.29). Following program implementation, 2-dose MCV coverage at age 36 months exceeded that obtained at age 60 months in historical cohorts recommended to receive MMR vaccine before school entry, and on-time vaccination increased by 13.5% (from 58.9% to 72.4%). Despite no change in the scheduled age of varicella vaccine, use of MMRV vaccine was associated with a 4.0% increase in 1-dose varicella vaccine coverage. Conclusions and Relevance: To our knowledge, this is the first study to provide evidence of the absence of an association between use of MMRV vaccine as the second dose of MCV in toddlers and an increased risk of FSs. Incorporation of MMRV vaccine has facilitated improvements in vaccine coverage that will potentially improve disease control.
[Mh] Termos MeSH primário: Vacina contra Varicela/administração & dosagem
Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem
Convulsões Febris/etiologia
[Mh] Termos MeSH secundário: Austrália
Vacina contra Varicela/efeitos adversos
Criança
Pré-Escolar
Feminino
Seres Humanos
Esquemas de Imunização
Incidência
Lactente
Masculino
Vacina contra Sarampo-Caxumba-Rubéola/efeitos adversos
Estudos Prospectivos
Convulsões Febris/epidemiologia
Vacinas Combinadas/administração & dosagem
Vacinas Combinadas/efeitos adversos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chickenpox Vaccine); 0 (Measles-Mumps-Rubella Vaccine); 0 (Vaccines, Combined); 0 (measles, mumps, rubella, varicella vaccine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE
[do] DOI:10.1001/jamapediatrics.2017.1965


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[PMID]:28759416
[Au] Autor:McCarthy PL
[Ad] Endereço:Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut paul.mccarthy@yale.edu.
[Ti] Título:Observational Assessment in the Febrile Infant.
[So] Source:Pediatrics;140(1), 2017 07.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Bacteriemia
Febre
[Mh] Termos MeSH secundário: Seres Humanos
Lactente
Convulsões Febris
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170801
[St] Status:MEDLINE


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[PMID]:28719301
[Au] Autor:Waggoner J; Heath CJ; Ndenga B; Mutuku F; Sahoo MK; Mohamed-Hadley A; Vulule J; Mukoko D; Desiree LaBeaud A; Pinsky BA
[Ad] Endereço:Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
[Ti] Título:Development of a Real-Time Reverse Transcription Polymerase Chain Reaction for O'nyong-nyong Virus and Evaluation with Clinical and Mosquito Specimens from Kenya.
[So] Source:Am J Trop Med Hyg;97(1):121-124, 2017 Jul.
[Is] ISSN:1476-1645
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:O'nyong-nyong virus (ONNV), an alphavirus closely related to chikungunya virus (CHIKV), has been the documented cause of two large outbreaks in east Africa; however, little is known about the contribution of ONNV to cases of acute febrile illness during interepidemic periods. An ONNV real-time reverse transcription polymerase chain reaction (rRT-PCR) was developed and evaluated using clinical and mosquito pool samples. The ONNV rRT-PCR linear range extended from 8.0 to 2.0 log copies/µL, and the lower limit of 95% detection was 22.4 copies/µL. No cases of ONNV infection were identified in serum from 385 Kenyan children who presented with an acute febrile illness. Additionally, ONNV was not detected in 120 mosquito pools collected in coastal and western Kenya. The ONNV rRT-PCR demonstrated good analytical sensitivity when performed in monoplex or as a component of an ONNV-CHIKV duplex assay. This assay should provide a useful diagnostic for the detection of ONNV in surveillance studies.
[Mh] Termos MeSH primário: Infecções por Alphavirus/genética
Anopheles/virologia
Vírus O´nyong-nyong/genética
Vírus O´nyong-nyong/isolamento & purificação
Convulsões Febris/virologia
[Mh] Termos MeSH secundário: Adolescente
África Oriental
Infecções por Alphavirus/virologia
Animais
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Masculino
Reação em Cadeia da Polimerase em Tempo Real
Reação em Cadeia da Polimerase Via Transcriptase Reversa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE
[do] DOI:10.4269/ajtmh.17-0027


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[PMID]:28675560
[Au] Autor:Koepp MJ; Årstad E; Bankstahl JP; Dedeurwaerdere S; Friedman A; Potschka H; Ravizza T; Theodore WH; Baram TZ
[Ad] Endereço:Institute of Neurology, University College London, London, United Kingdom.
[Ti] Título:Neuroinflammation imaging markers for epileptogenesis.
[So] Source:Epilepsia;58 Suppl 3:11-19, 2017 Jul.
[Is] ISSN:1528-1167
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Epilepsy can be a devastating disorder. In addition to debilitating seizures, epilepsy can cause cognitive and emotional problems with reduced quality of life. Therefore, the major aim is to prevent the disorder in the first place: identify, detect, and reverse the processes responsible for its onset, and monitor and treat its progression. Epilepsy often occurs following a latent period of months to years (epileptogenesis) as a consequence of a brain insult, such as head trauma, stroke, or status epilepticus. Although this latent period clearly represents a therapeutic window, we are not able to stratify patients at risk for long-term epilepsy, which is prerequisite for preventative clinical trials. Moreover, because of the length of the latent period, an early biomarker for treatment response would be of high value. Finally, mechanistic biomarkers of epileptogenesis may provide more profound insight in the process of disease development.
[Mh] Termos MeSH primário: Biomarcadores/análise
Epilepsia/imunologia
Inflamação Neurogênica/imunologia
[Mh] Termos MeSH secundário: Animais
Astrócitos/fisiologia
Encéfalo/diagnóstico por imagem
Encéfalo/imunologia
Encéfalo/fisiopatologia
Lesões Encefálicas/complicações
Lesões Encefálicas/diagnóstico por imagem
Lesões Encefálicas/imunologia
Lesões Encefálicas/fisiopatologia
Modelos Animais de Doenças
Progressão da Doença
Eletroencefalografia
Epilepsia/diagnóstico por imagem
Epilepsia/fisiopatologia
Epilepsia/prevenção & controle
Seres Humanos
Aumento da Imagem
Imagem por Ressonância Magnética
Inflamação Neurogênica/diagnóstico por imagem
Inflamação Neurogênica/fisiopatologia
Inflamação Neurogênica/prevenção & controle
Espectroscopia de Prótons por Ressonância Magnética
Ratos
Fatores de Risco
Convulsões Febris/diagnóstico por imagem
Convulsões Febris/fisiopatologia
Estado Epiléptico/complicações
Estado Epiléptico/diagnóstico por imagem
Estado Epiléptico/imunologia
Estado Epiléptico/fisiopatologia
Acidente Vascular Cerebral/complicações
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/imunologia
Acidente Vascular Cerebral/fisiopatologia
Molécula 1 de Adesão de Célula Vascular/análise
Gravação em Vídeo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Vascular Cell Adhesion Molecule-1)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE
[do] DOI:10.1111/epi.13778


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[PMID]:28628235
[Au] Autor:Gadoth A; Pittock SJ; Dubey D; McKeon A; Britton JW; Schmeling JE; Smith A; Kotsenas AL; Watson RE; Lachance DH; Flanagan EP; Lennon VA; Klein CJ
[Ad] Endereço:Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN.
[Ti] Título:Expanded phenotypes and outcomes among 256 LGI1/CASPR2-IgG-positive patients.
[So] Source:Ann Neurol;82(1):79-92, 2017 Jul.
[Is] ISSN:1531-8249
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe an expanded phenotypic spectrum and longitudinal outcome in 256 LGI1-IgG-seropositive and/or CASPR2-IgG-seropositive patients. METHODS: Patients were identified through service neural autoantibody evaluation. Ninety-five had longitudinal follow-up (7-456 months; median = 35). RESULTS: Among 3,910 patients tested, 196 were LGI1-IgG positive, 51 were CASPR2-IgG positive, and 9 were dual positive. Cerebrospinal fluid testing was less sensitive than serum testing, detecting only 24 of 38 (63%) LGI1-IgG-positive and 5 of 6 (83%) CASPR2-IgG-positive patients. LGI1-IgG-positive specimens had higher voltage-gated potassium channel-IgG immunoprecipitation values (0.33nmol/l, range = 0.02-5.14) than CASPR2-IgG-positive specimens (0.10nmol/l, range = 0.00-0.45, p < 0.001). Of patients presenting with pain or peripheral nervous system (PNS) manifestations, 39% were LGI1-IgG seropositive (7% had solely neuropathy or pain). Multivariate analysis identified age as the only significant predictor of central nervous system (CNS) versus PNS involvement (>50 years; odds ratio = 15, p < 0.001). Paroxysmal dizziness spells (PDS), a unique LGI1-IgG accompaniment (14% of patients), frequently delayed the diagnosis. T2-mesiotemporal hyperintensity was more common in LGI1-IgG-positive (41%) than in CASPR2-IgG-positive patients (p = 0.033). T1-bright basal ganglia were confined to LGI1-IgG-positive patients with faciobrachial-dystonic seizures (9 of 39, 31%). Cancer was found in 44% of LGI1-IgG/CASPR2-IgG dual seropositive patients (one-third thymoma). Response to initial immunotherapy was favorable in 97%; mean modified Rankin score was 3 (range = 1-5) at onset and 1.74 (range = 0-6) at last follow-up, with 9% having severe refractory disability, 20% being asymptomatic, 28% receiving immunotherapy, and 58% receiving antiepileptic medication. INTERPRETATION: Older age is a strong predictor of CNS involvement in patients seropositive for CASPR2-IgG or LGI1-IgG. Pain, peripheral manifestations, and stereotypic paroxysmal dizziness spells are common with LGI1-IgG. Response to initial immunotherapy is often favorable, but some patients remain severely disabled, requiring long-term immunotherapy and/or antiepileptic medications. Ann Neurol 2017;82:79-92.
[Mh] Termos MeSH primário: Imunoglobulina G/imunologia
Proteínas de Membrana/imunologia
Proteínas do Tecido Nervoso/imunologia
Proteínas/imunologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Doenças do Sistema Nervoso Central/imunologia
Líquido Cefalorraquidiano/imunologia
Avaliação da Deficiência
Tontura/imunologia
Feminino
Seres Humanos
Imunoterapia
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Minnesota/epidemiologia
Neoplasias/imunologia
Neuroimagem
Dor/imunologia
Doenças do Sistema Nervoso Periférico/imunologia
Fenótipo
Canais de Potássio de Abertura Dependente da Tensão da Membrana/imunologia
Convulsões Febris/congênito
Convulsões Febris/imunologia
Estudos Soroepidemiológicos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (CNTNAP2 protein, human); 0 (Immunoglobulin G); 0 (LGI1 protein, human); 0 (Membrane Proteins); 0 (Nerve Tissue Proteins); 0 (Potassium Channels, Voltage-Gated); 0 (Proteins)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE
[do] DOI:10.1002/ana.24979



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