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1.
J Phys Chem Lett ; 15(18): 4844-4850, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38682807

RESUMO

Most single quantum emitters display non-steady emission properties. Models that explain this effect have primarily relied on photoluminescence measurements that reveal variations in intensity, wavelength, and excited-state lifetime. While photoluminescence excitation spectroscopy could provide complementary information, existing experimental methods cannot collect spectra before individual emitters change in intensity (blink) or wavelength (spectrally diffuse). Here, we present an experimental approach that circumvents such issues, allowing the collection of excitation spectra from individual emitters. Using rapid modulation of the excitation wavelength, we collect and classify excitation spectra from individual CdSe/CdS/ZnS core/shell/shell quantum dots. The spectra, along with simultaneous time-correlated single-photon counting, reveal two separate emission-reduction mechanisms caused by charging and trapping, respectively. During bright emission periods, we also observe a correlation between emission red-shifts and the increased oscillator strength of higher excited states. Quantum-mechanical modeling indicates that diffusion of charges in the vicinity of an emitter polarizes the exciton and transfers the oscillator strength to higher-energy transitions.

2.
ACS Nano ; 17(20): 20053-20061, 2023 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-37797269

RESUMO

Controlling and understanding reaction temperature variations in catalytic processes are crucial for assessing the performance of a catalyst material. Local temperature measurements are challenging, however. Luminescence thermometry is a promising remote-sensing tool, but it is cross-sensitive to the optical properties of a sample and other external parameters. In this work, we measure spatial variations in the local temperature on the micrometer length scale during carbon dioxide (CO2) methanation over a TiO2-supported Ni catalyst and link them to variations in catalytic performance. We extract local temperatures from the temperature-dependent emission of Y2O3:Nd3+ particles, which are mixed with the CO2 methanation catalyst. Scanning, where a near-infrared laser locally excites the emitting Nd3+ ions, produces a temperature map with a micrometer pixel size. We first designed the Y2O3:Nd3+ particles for optimal temperature precision and characterized cross-sensitivity of the measured signal to parameters other than temperature, such as light absorption by the blackened sample due to coke deposition at elevated temperatures. Introducing reaction gases causes a local temperature increase of the catalyst of on average 6-25 K, increasing with the reactor set temperature in the range of 550-640 K. Pixel-to-pixel variations in the temperature increase show a standard deviation of up to 1.5 K, which are attributed to local variations in the catalytic reaction rate. Mapping and understanding such temperature variations are crucial for the optimization of overall catalyst performance on the nano- and macroscopic scale.

3.
Nano Lett ; 23(18): 8697-8703, 2023 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-37672486

RESUMO

Indium phosphide colloidal quantum dots (CQDs) are the main alternative for toxic and restricted Cd based CQDs for lighting and display applications. Here we systematically report on the size-dependent optical absorption, ensemble, and single particle photoluminescence (PL) and biexciton lifetimes of core-only InP CQDs. This systematic study is enabled by improvements in the synthesis of InP CQDs to yield a broad size series of monodisperse core-only InP CQDs with narrow absorption and PL line width and significant PL quantum yield.

4.
Nano Lett ; 23(14): 6560-6566, 2023 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-37450686

RESUMO

Ongoing developments in science and technology require temperature measurements at increasingly higher spatial resolutions. Nanocrystals with temperature-sensitive luminescence are a popular thermometer for these applications offering high precision and remote read-out. Here, we demonstrate that ratiometric luminescence thermometry experiments may suffer from systematic errors in nanostructured environments. We place lanthanide-based luminescent nanothermometers at controlled distances of up to 600 nm from a Au surface. Although this geometry supports no absorption or scattering resonances, distortion of the emission spectra of the thermometers due to the modified density of optical states results in temperature read-out errors of up to 250 K. Our simple analytical model explains the effects of thermometer emission frequencies, experimental equipment, and sample properties on the magnitude of the errors. We discuss the relevance of our findings in several experimental scenarios. Such errors do not always occur, but they are expected in measurements near reflecting interfaces or scattering objects.

5.
J Phys Chem Lett ; 14(23): 5353-5361, 2023 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-37276380

RESUMO

Experiments on single colloidal quantum dots (QDs) have revealed temporal fluctuations in the emission efficiency of the single-exciton state. These fluctuations, often termed "blinking", are caused by opening/closing of charge-carrier traps and/or charging/discharging of the QD. In the regime of strong optical excitation, multiexciton states are formed. The emission efficiencies of multiexcitons are lower because of Auger processes, but a quantitative characterization is challenging. Here, we quantify fluctuations of the biexciton efficiency for single CdSe/CdS/ZnS core-shell QDs. We find that the biexciton efficiency "blinks" significantly. The additional electron due to charging of a QD accelerates Auger recombination by a factor of 2 compared to the neutral biexciton, while opening/closing of a charge-carrier trap leads to an increase of the nonradiative recombination rate by a factor of 4. To understand the fast rate of trap-assisted recombination, we propose a revised model for trap-assisted recombination based on reversible trapping. Finally, we discuss the implications of biexciton blinking for lasing applications.

6.
J Phys Chem Lett ; 13(18): 4145-4151, 2022 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-35506998

RESUMO

In semiconductor nanocrystals, excited electrons relax through multiple radiative and nonradiative pathways. This complexity complicates characterization of their decay processes with standard time- and temperature-dependent photoluminescence studies. Here, we exploit a simple nanophotonic approach to augment such measurements and to address open questions related to nanocrystal emission. We place nanocrystals at different distances from a gold reflector to affect radiative rates through variations in the local density of optical states. We apply this approach to spherical CdSe-based nanocrystals to probe the radiative efficiency and polarization properties of the lowest dark and bright excitons by analyzing temperature-dependent emission dynamics. For CdSe-based nanoplatelets, we identify the charge-carrier trapping mechanism responsible for strongly delayed emission. Our method, when combined with careful modeling of the influence of the nanophotonic environment on the relaxation dynamics, offers a versatile strategy to disentangle the complex excited-state decay pathways present in fluorescent nanocrystals as well as other emitters.

7.
J Neurol Sci ; 431: 120043, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34753039

RESUMO

The course of established epilepsy in late life is not fully known. One key question is whether the resolution of an epileptic diathesis is a natural outcome in some people with long-standing epilepsy. We investigated this with a view to generating a hypothesis. We retrospectively explored whether terminal seizure-freedom occurs in older people with previous drug-resistant epilepsy at the Chalfont Centre for Epilepsy over twenty years. Of the 226 people followed for a median period of 52 years, 39 (17%) achieved late-life terminal seizure-freedom of at least two years before death, which occurred at a median age of 68 years with a median duration of 7 years. Multivariate analysis suggests that a high initial seizure frequency was a negative predictor (p < 0.0005). Our findings indicate that the 'natural' course of long-standing epilepsy in some people is one of terminal seizure freedom. We also consider the concept of "remission" in epilepsy, its definition challenges, and the evolving terminology used to describe the state of seizure freedom. The intersection of ageing and seizure freedom is an essential avenue of future investigation, especially in light of current demographic trends. Gaining mechanistic insights into this phenomenon may help broaden our understanding of the neurobiology of epilepsy and potentially provide targets for therapeutic intervention.


Assuntos
Epilepsia , Preparações Farmacêuticas , Idoso , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Liberdade , Humanos , Estudos Retrospectivos , Convulsões/tratamento farmacológico , Resultado do Tratamento
8.
Epilepsy Behav Rep ; 16: 100487, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34697604

RESUMO

The COVID-19 pandemic has created an immense pressure on healthcare providers, resulting in a shift to remote consultations and the redeployment of healthcare workers (HCWs). We present survey data from the United Kingdom (UK) HCWs to outline how changes in healthcare provision impact clinicians' wellbeing and ability to provide adequate care. We designed an online survey to gather the experiences of HCWs providing care to people with epilepsy. We received seventy-nine responses from UK-based HCWs, of whom 43% reported an impact on their mental health. Changes to service delivery have resulted in 71% of clinicians performing > 75% of their consultations remotely. Diagnosing and treating epilepsy has changed, with a fifth of respondents being significantly less confident in diagnosing epilepsy. Ultimately, these results show that COVID-19 has had an overall negative impact on HCWs and their ability to provide epilepsy care. These results must be considered when reorganizing health services to ensure optimal outcomes for people with epilepsy.

9.
ACS Appl Nano Mater ; 4(4): 4208-4215, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-34085030

RESUMO

The temperature-sensitive luminescence of nanoparticles enables their application as remote thermometers. The size of these nanothermometers makes them ideal to map temperatures with a high spatial resolution. However, high spatial resolution mapping of temperatures >373 K has remained challenging. Here, we realize nanothermometry with high spatial resolutions at elevated temperatures using chemically stable upconversion nanoparticles and confocal microscopy. We test this method on a microelectromechanical heater and study the temperature homogeneity. Our experiments reveal distortions in the luminescence spectra that are intrinsic to high-resolution measurements of samples with nanoscale photonic inhomogeneities. In particular, the spectra are affected by the high-power excitation as well as by scattering and reflection of the emitted light. The latter effect has an increasing impact at elevated temperatures. We present a procedure to correct these distortions. As a result, we extend the range of high-resolution nanothermometry beyond 500 K with a precision of 1-4 K. This work will improve the accuracy of nanothermometry not only in micro- and nanoelectronics but also in other fields with photonically inhomogeneous substrates.

10.
Nano Lett ; 21(13): 5760-5766, 2021 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-34133188

RESUMO

Broadening of multiexciton emission from colloidal quantum dots (QDs) at room temperature is important for their use in high-power applications, but an in-depth characterization has not been possible until now. We present and apply a novel spectroscopic method to quantify the biexciton line width and biexciton binding energy of single CdSe/CdS/ZnS colloidal QDs at room temperature. In our method, which we term "cascade spectroscopy", we select emission events from the biexciton cascade and reconstruct their spectrum. The biexciton has an average emission line width of 86 meV on the single-QD scale, similar to that of the exciton. Variations in the biexciton repulsion (Eb = 4.0 ± 3.1 meV; mean ± standard deviation of 15 QDs) are correlated with but are more narrowly distributed than variations in the exciton energy (10.0 meV standard deviation). Using a simple quantum-mechanical model, we conclude that inhomogeneous broadening in our sample is primarily due to variations in the CdS shell thickness.


Assuntos
Compostos de Cádmio , Pontos Quânticos , Compostos de Selênio , Análise Espectral , Temperatura
11.
ACS Nano ; 15(6): 9935-9944, 2021 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-34029074

RESUMO

Plasmonic modes in optical cavities can be amplified through stimulated emission. Using this effect, plasmonic lasers can potentially provide chip-integrated sources of coherent surface plasmon polaritons (SPPs). However, while plasmonic lasers have been experimentally demonstrated, they have not generated propagating plasmons as their primary output signal. Instead, plasmonic lasers typically involve significant emission of free-space photons that are intentionally outcoupled from the cavity by Bragg diffraction or that leak from reflector edges due to uncontrolled scattering. Here, we report a simple cavity design that allows for straightforward extraction of the lasing mode as SPPs while minimizing photon leakage. We achieve plasmonic lasing in 10-µm-long distributed-feedback cavities consisting of a Ag surface periodically patterned with ridges coated by a thin layer of colloidal semiconductor nanoplatelets as the gain material. The diffraction to free-space photons from cavities designed with second-order feedback allows a direct experimental examination of the lasing-mode profile in real- and momentum-space, in good agreement with coupled-wave theory. In contrast, we demonstrate that first-order-feedback cavities remain "dark" above the lasing threshold and the output signal leaves the cavity as propagating SPPs, highlighting the potential of such lasers as on-chip sources of plasmons.

12.
ACS Nano ; 15(4): 7216-7225, 2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33759503

RESUMO

Trap states can strongly affect semiconductor nanocrystals, by quenching, delaying, and spectrally shifting the photoluminescence (PL). Trap states have proven elusive and difficult to study in detail at the ensemble level, let alone in the single-trap regime. CdSe nanoplatelets (NPLs) exhibit significant fractions of long-lived "delayed emission" and near-infrared "trap emission". We use these two spectroscopic handles to study trap states at the ensemble and the single-particle level. We find that reversible hole trapping leads to both delayed and trap PL, involving the same trap states. At the single-particle level, reversible trapping induces exponential delayed PL and trap PL, with lifetimes ranging from 40 to 1300 ns. In contrast with exciton PL, single-trap PL is broad and shows spectral diffusion and strictly single-photon emission. Our results highlight the large inhomogeneity of trap states, even at the single-particle level.

13.
Nature ; 582(7813): 506-510, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32581384

RESUMO

Gratings1 and holograms2 use patterned surfaces to tailor optical signals by diffraction. Despite their long history, variants with remarkable functionalities continue to be developed3,4. Further advances could exploit Fourier optics5, which specifies the surface pattern that generates a desired diffracted output through its Fourier transform. To shape the optical wavefront, the ideal surface profile should contain a precise sum of sinusoidal waves, each with a well defined amplitude, spatial frequency and phase. However, because fabrication techniques typically yield profiles with at most a few depth levels, complex 'wavy' surfaces cannot be obtained, limiting the straightforward mathematical design and implementation of sophisticated diffractive optics. Here we present a simple yet powerful approach to eliminate this design-fabrication mismatch by demonstrating optical surfaces that contain an arbitrary number of specified sinusoids. We combine thermal scanning-probe lithography6-8 and templating9 to create periodic and aperiodic surface patterns with continuous depth control and sub-wavelength spatial resolution. Multicomponent linear gratings allow precise manipulation of electromagnetic signals through Fourier-spectrum engineering10. Consequently, we overcome a previous limitation in photonics by creating an ultrathin grating that simultaneously couples red, green and blue light at the same angle of incidence. More broadly, we analytically design and accurately replicate intricate two-dimensional moiré patterns11,12, quasicrystals13,14 and holograms15,16, demonstrating a variety of previously unattainable diffractive surfaces. This approach may find application in optical devices (biosensors17, lasers18,19, metasurfaces4 and modulators20) and emerging areas in photonics (topological structures21, transformation optics22 and valleytronics23).

14.
J Phys Chem C Nanomater Interfaces ; 124(14): 8047-8054, 2020 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-32421082

RESUMO

Metal-halide perovskite nanocrystals show promise as the future active material in photovoltaics, lighting, and other optoelectronic applications. The appeal of these materials is largely due to the robustness of the optoelectronic properties to structural defects. The photoluminescence quantum yield (PLQY) of most types of perovskite nanocrystals is nevertheless below unity, evidencing the existence of nonradiative charge-carrier decay channels. In this work, we experimentally elucidate the nonradiative pathways in CsPbBr3 nanoplatelets, before and after chemical treatment with PbBr2 that improves the PLQY. A combination of picosecond streak camera and nanosecond time-correlated single-photon counting measurements is used to probe the excited-state dynamics over 6 orders of magnitude in time. We find that up to 40% of the nanoplatelets from a synthesis batch are entirely nonfluorescent and cannot be turned fluorescent through chemical treatment. The other nanoplatelets show fluorescence, but charge-carrier trapping leads to losses that are prevented by chemical treatment. Interestingly, even without chemical treatment, some losses due to trapping are mitigated because trapped carriers spontaneously detrap on nanosecond-to-microsecond timescales. Our analysis shows that multiple nonradiative pathways are active in perovskite nanoplatelets, which are affected differently by chemical treatment with PbBr2. More generally, our work highlights that in-depth studies using a combination of techniques are necessary to understand nonradiative pathways in fluorescent nanocrystals. Such understanding is essential to optimize synthesis and treatment procedures.

15.
J Phys Chem Lett ; 11(12): 4755-4761, 2020 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-32459489

RESUMO

Bright and fast fluorescence makes semiconductor nanocrystals, or quantum dots (QDs), appealing for applications ranging from biomedical research to display screens. However, a few percent of their fluorescence intensity is surprisingly slow. Research into this "delayed emission" has been scarce, despite undesired consequences for some applications and potential opportunities for others. Here, we characterize the dynamics of delayed emission exhibited by individual CdSe/CdS core/shell QDs and correlate these with changes in the emission spectrum. The delayed-emission intensity from a single QD fluctuates strongly during an experiment of several minutes and is thus not always "on", implying that control over delayed emission may be possible. Periods of bright delayed emission correlate with red-shifted emission spectra. This behavior is consistent with exciton polarization by fluctuating electric fields due to diffusing surface charges, which have been known to cause spectral diffusion in QDs. Our findings thus provide a stepping stone for future efforts to control delayed emission.

16.
Eur J Neurol ; 26(6): 856-864, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30223294

RESUMO

BACKGROUND AND PURPOSE: Juvenile myoclonic epilepsy (JME) is a common epilepsy syndrome for which treatment response is generally assumed to be good. We aimed to determine the prevalence and prognostic risk factors for refractoriness of JME. METHODS: We systematically searched PubMed and EMBASE and included 43 eligible studies, reporting seizure outcome after antiepileptic drug (AED) treatment in JME cohorts. We defined refractory JME as persistence of any seizure despite AED treatment and performed a random-effects meta-analysis to assess the prevalence of refractory JME and of seizure recurrence after AED withdrawal in individuals with well-controlled seizures. Studies reporting potential prognostic risk factors in relation to seizure outcome were included for subsequent meta-analysis of risk factors for refractoriness. RESULTS: Overall, 35% (95% confidence interval, 29-41%) of individuals (n = 3311) were refractory. There was marked heterogeneity between studies. Seizures recurred in 78% (95% confidence interval, 52-94%) of individuals who attempted to withdraw from treatment after a period of seizure freedom (n = 246). Seizure outcome by publication year suggested that prognosis did not improve over time. Meta-analysis suggested six variables as prognostic factors for refractoriness, i.e. having three seizure types, absence seizures, psychiatric comorbidities, earlier age at seizure onset, history of childhood absence epilepsy and praxis-induced seizures. CONCLUSION: One-third of people with JME were refractory, which is a higher prevalence than expected. Risk factors were identified and can be used to guide treatment and counselling of people with JME.


Assuntos
Epilepsia Mioclônica Juvenil/epidemiologia , Anticonvulsivantes/uso terapêutico , Humanos , Epilepsia Mioclônica Juvenil/tratamento farmacológico , Epilepsia Mioclônica Juvenil/etiologia , Prevalência , Prognóstico , Fatores de Risco
17.
Eur J Neurol ; 26(3): 422-427, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30414301

RESUMO

BACKGROUND AND PURPOSE: The International League against Epilepsy (ILAE) updated the classifications of seizures and epilepsies in 2017. The 2017 classifications were compared with the 1980s classifications in rural China. METHODS: People with epilepsy receiving treatment under the National Epilepsy Control Programme were recruited from rural areas in China. Their seizures and epileptic syndrome were classified using the 1980s ILAE classification system and then re-classified according to the 2017 system. Differences in seizure, epilepsy and aetiology classifications were identified. RESULTS: A total of 597 individuals (58% males, aged 6-78 years) were included. Amongst them 535 (90%) had a single seizure type, 57 (9.55%) had two types and five (0.84%) had three. There was complete agreement between the 1981 and 2017 classifications for the 525 individuals with focal seizures. Seizures originally classified as generalized in 10 of 65 individuals were re-classified as unknown in the 2017 classification. Compared to the 1980s classifications, the proportion of individuals with unknown seizures and unknown epilepsy increased from 1.2% (7/597) to 2.8% (17/597, P = 0.002), and unknown aetiology increased from 32% (189/597: 182 cryptogenic and seven unclassified) to 39% (230/597; P < 0.001) in the 2017 classifications. CONCLUSIONS: The 1980s and 2017 classifications had 100% agreement in classifying focal seizures and epilepsy in rural China. A small but significant proportion of generalized seizures and epilepsy and aetiologies classified in the old classifications were re-classified to unknown in the new classifications. These results highlight the need for improvement in clinical evaluation of people with epilepsy in resource-poor settings.


Assuntos
Epilepsia/classificação , Convulsões/classificação , Adolescente , Adulto , Idoso , Criança , China , Epilepsia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População Rural , Convulsões/etiologia , Adulto Jovem
18.
Eur J Neurol ; 25(9): 1121-1127, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29611888

RESUMO

BACKGROUND AND PURPOSE: Good practice guidelines highlight the importance of making people with epilepsy aware of the risk of premature mortality in epilepsy particularly due to sudden unexpected death in epilepsy (SUDEP). The SUDEP and Seizure Safety Checklist ('Checklist') is a structured risk communication tool used in UK clinics. It is not known if sharing structured information on risk factors allows individuals to reduce SUDEP and premature mortality risks. The aim of this study was to ascertain if the introduction of the Checklist in epilepsy clinics led to individual risk reduction. METHODS: The Checklist was administered to 130 consecutive people with epilepsy attending a specialized epilepsy neurology clinic and 129 attending an epilepsy intellectual disability (ID) clinic within a 4-month period. At baseline, no attendees at the neurology clinic had received formal risk advice, whereas all those attending the ID clinic had received formal risk advice on multiple occasions for 6 years. The Checklist was readministered 1 year later to each group and scores were compared with baseline and between groups. RESULTS: Of 12 risk factors considered, there was an overall reduction in mean risk score for the general (P = 0.0049) but not for the ID (P = 0.322) population. Subanalysis of the 25% of people at most risk in both populations showed that both sets had a significant reduction in risk scores (P < 0.001). CONCLUSION: Structured discussion results in behavioural change that reduces individual risk factors. This impact seems to be higher in those who are at current higher risk. It is important that clinicians share risk information with individuals as a matter of public health and health promotion.


Assuntos
Morte Súbita/epidemiologia , Epilepsia/mortalidade , Epilepsia/terapia , Adulto , Lista de Checagem , Feminino , Seguimentos , Fidelidade a Diretrizes/estatística & dados numéricos , Guias como Assunto , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Fatores de Risco , Resultado do Tratamento , Reino Unido/epidemiologia
19.
Acta Neurol Scand ; 136(4): 352-359, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28573736

RESUMO

BACKGROUND: People with epilepsy have more concomitant medical conditions than the general population; these comorbidities play an important role in premature mortality. We sought to generate explanatory hypotheses about the co-occurrence of somatic comorbidities and epilepsy, avoiding causal and treatment-resultant biases. METHODS: We collected clinical, demographic and somatic comorbidity data for 2016 consecutive adults with epilepsy undergoing assessment at a tertiary centre and in 1278 people with epilepsy in the community. Underlying causes of epilepsy were not classed as comorbidities. RESULTS: Somatic comorbidities were more frequent in the referral centre (49%) where people more frequently had active epilepsy than in the community (36%). Consistent risk factors for comorbidities were found in both cohorts. Using multivariable ordinal regression adjusted for age, longer epilepsy duration and an underlying brain lesion were independently associated with a smaller burden of somatic conditions. The treatment burden, measured by the number of drugs to which people were exposed, was not an independent predictor. Shorter epilepsy duration was a predictor for conditions that conceivably harbour significant mortality risks. CONCLUSIONS: Somatic comorbidities do not occur randomly in relation to epilepsy; having more severe epilepsy seems to be a risk factor. Independently from age, the early period after epilepsy onset appears to be at particular risk, although it is not clear whether this relates to an early mortality or to a later decrease in the burden of comorbidities. These results suggest that, for some people, epilepsy should be considered a systemic condition not limited to the CNS.


Assuntos
Epilepsia/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
Acta Neurol Scand ; 136(6): 708-714, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28626979

RESUMO

OBJECTIVES: Mesial temporal lobe epilepsy syndrome (MTLE) with specific electrophysiological and clinical characteristics and hippocampal sclerosis (HS) on MRI is considered the prototype of a syndrome with good surgical prognosis. Ictal onset zones in MTLE have been found to extend outside the hippocampus and neocortical seizures often involve mesial structures. It can, thus, be questioned whether MTLE with HS is different from lesional temporal epilepsies with respect to electro-clinical characteristics and surgical prognosis. We assessed whether MTLE with HS is distinguishable from lesional TLE and which criteria determine surgical outcome. METHODS: People in a retrospective cohort of 389 individuals with MRI abnormalities who underwent temporal lobectomy, were divided into "HS only" or "lesional" TLEs. Twenty-six presented with dual pathology and were excluded from further analysis. We compared surgical outcome and electro-clinical characteristics. RESULTS: Over half (61%) had "HS only." Four electro-clinical characteristics (age at epilepsy onset, febrile seizures, memory dysfunction and contralateral dystonic posturing) distinguished "HS only" from "lesional" TLE, but there was considerable overlap. Seizure freedom 2 years after surgery (Engel class 1) was similar: 67% ("HS only") vs 69% ("lesional" TLE). Neither presence of HS nor electro-clinical criteria was associated with surgical outcome. CONCLUSIONS: Despite small differences in electrophysiological and clinical characteristics between MTLE with HS and lesional TLE, surgical outcomes are similar, indicating that aetiology seems irrelevant in the referral for temporal surgery.


Assuntos
Lobectomia Temporal Anterior/efeitos adversos , Epilepsia do Lobo Temporal/cirurgia , Complicações Pós-Operatórias/epidemiologia , Adulto , Epilepsia do Lobo Temporal/diagnóstico , Epilepsia do Lobo Temporal/diagnóstico por imagem , Feminino , Hipocampo/diagnóstico por imagem , Hipocampo/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia
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