RESUMO
The authors report the case of 3 patients with bilateral temporal lobe epilepsy demonstrated by EEG and sphenoïdal electrodes. Two out of the 3 patients presented with childhood febrile convulsions. Their neurological and mental examination was normal. EEG showed spikes within the anterior part of the 2 temporal lobes. CT scan and MRI showed no atrophic lesion within the 2 temporal lobes. Proton magnetic resonance spectroscopy, performed within a cube of 8 cube-centimetres localized in the anterior part of the 2 temporal lobes showed a significant decrease of N-acetyl-aspartate in the 2 temporal lobes of the 3 cases, compared with controls matched with age, sex and laterality. Because N-acetyl-aspartate is a marker of the neuronal cells, the decreased level of NAA in the temporal area with spikes, may be related to a decreased number of neuronal cells, developing an abnormal tendency to seizures.
Assuntos
Epilepsia do Lobo Temporal/metabolismo , Epilepsia do Lobo Temporal/fisiopatologia , Lobo Temporal/metabolismo , Adolescente , Adulto , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Colina/metabolismo , Creatina/metabolismo , Eletroencefalografia , Epilepsia do Lobo Temporal/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Valores de Referência , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia , Tomografia Computadorizada por Raios XRESUMO
The authors report 10 cases of epileptic patients with the onset in childhood of the clinical and EEG features of cryptogenic generalized epilepsy which evolved into frontal epilepsy, confirmed by the clinical and EEG features and was associated with a frontal syndrome. CT-scan and MRI showed mild atrophy in the frontal area, while SPECT showed a decrease in the frontal blood flow in 70% of the cases. The authors consider that frontal epilepsy may mimic generalized epilepsy.
Assuntos
Epilepsias Parciais/fisiopatologia , Epilepsia Generalizada/fisiopatologia , Lobo Frontal/fisiopatologia , Adolescente , Adulto , Idade de Início , Atrofia , Circulação Cerebrovascular , Criança , Pré-Escolar , Estudos de Coortes , Diagnóstico Diferencial , Eletroencefalografia , Epilepsias Parciais/diagnóstico , Epilepsias Parciais/diagnóstico por imagem , Epilepsias Parciais/epidemiologia , Epilepsia Generalizada/diagnóstico , Epilepsia Generalizada/diagnóstico por imagem , Epilepsia Generalizada/epidemiologia , Epilepsia Tônico-Clônica/fisiopatologia , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Humanos , Masculino , Radiografia , Síndrome , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
We report 2 cases of lissencephaly and review the cardinal symptoms: microcephalia, mental retardation, pyramidal syndrome and generalized epilepsy. CT-Scan and MRI show the anatomical abnormalities of this malformation: microcephalia, smooth cortex reducing the surface of white matter and lack of sulci and gyri. The fact that the myelin is normal on MRI suggests that this major disorder of neuronal migration does not come from radial glial fibers.
Assuntos
Córtex Cerebral/anormalidades , Doenças do Sistema Nervoso/congênito , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/patologia , Eletroencefalografia , Epilepsia Generalizada/etiologia , Evolução Fatal , Humanos , Recém-Nascido , Deficiência Intelectual/etiologia , Imageamento por Ressonância Magnética , Microcefalia/etiologia , Tomografia Computadorizada por Raios XRESUMO
Four patients with acute inflammatory polyradiculoneuropathy were evaluated with MRI. In 3 of 4 cases, gadolinium enhancement was observed in the nerve roots of cauda equina, on frontal and horizontal slices. This enhancement was correlated with the severity of the clinical picture and the cerebrospinal-fluid inflammatory protein concentration and supports the inflammatory nature of this forms of acute polyradiculoneuropathy.
Assuntos
Imageamento por Ressonância Magnética , Polirradiculoneuropatia/patologia , Raízes Nervosas Espinhais/patologia , Doença Aguda , Adulto , Albuminas/líquido cefalorraquidiano , Gadolínio , Humanos , Aumento da Imagem , Plexo Lombossacral , Masculino , Polirradiculoneuropatia/líquido cefalorraquidiano , Polirradiculoneuropatia/fisiopatologia , Fatores de TempoRESUMO
We report four cases of progressive thalamic atrophy following ipsilateral cerebral infarction in the territory of the middle cerebral artery in neonates, with prospective radiological and clinical follow-up. This type of atrophy appears within 6 months after the onset of cerebral infarction. In the short term, this atrophy has no action on sensory and memory function and/or on sensory evoked potentials. This atrophy is not the result of secondary ischemic neuronal damage. Judging from several other experimental studies, thalamic atrophy may primarily result from retrograde degeneration. It would be interesting to observe the consequences of this atrophy on sensory and memory function over a long period.