ABSTRACT
Contexte et objectifs Environ 30% des patients epileptiques ne repondent pas au traitement medical et deviennent des candidats potentiels pour un traitement chirurgical dont l'indication repose sur les donnees electro-cliniques et d'imagerie. L'objectif de cette etude etait de decrire les caracteristiques anthropometriques et cliniques ainsi que l'evolution sous traitement des patients epileptiques; de documenter le niveau d'investigation de cette pathologie afin d'identifier les patients potentiellement eligibles pour un traitement chirurgical. Methodologie Il s'agit d'une etude documentaire descriptive couvrant une periode de 2 ans. Les variables d'interet comprenaient : les donnees anthropometriques; les caracteristiques de l'epilepsie; les donnees therapeutiques; le niveau et les resultats des investigations complementaires. Resultats Au total; 1184 dossiers de nouveaux cas d'epilepsie ont ete retenus. L'age median etait de 19 ans avec un sex ratio H/F de 1;1. 68% des patients avaient un age de debut inferieur a 20 ans et plus de 90% avaient des crises generalisees tonico-cloniques. La disparition des crises sous traitement etait observee chez 31% des patients et 22% avaient une persistance ou une aggravation. L'EEG etait realise chez 17% des patients et le scanner cerebral chez 0;8%. Vingt (20 )% des patients avaient recu au moins 2 antiepileptiques. Environ 26 % des patients suivis pendant 2 ans ou plus etaient consideres refractaires. Conclusion L'epilepsie affecte les patients en age scolaire et les jeunes adultes qui sont des candidats de choix pour la chirurgie en cas de pharmaco-resistance. La pathologie reste cependant tres peu investiguee. Un programme d'investigation plus large permettra d'identifier notamment les epilepsies lesionnelles afin de soumettre ces patients a une evaluation en vue d'un traitement neurochirurgical
ABSTRACT
OBJECTIVES@#To investigate the effect of osteoporosis and intervertebral disc degeneration on the endplate cartilage injury in rats.@*METHODS@#A total of 48 female Sprague Dawley rats (3 months) were randomly divided into Groups A, B, C and D with 12 rats in each group. Osteoporosis and intervertebral disc degeneration composite model, simple degeneration model and simple osteoporosis model were prepared in Groups A, B and C respectively. After modeling, four rats of each group at 12th, 18th and 24th week were sacrificed. Intervertebral height of cervical vertebra C6/C7 was measured. Micro-CT was used to image the endplate of cephalic and caudal cartilage at C6/C7 intervertebral disc. Abraded area rate of C6 caudal and C7 cephalic cartilage endplate was calculated, and then C6/C7 intervertebral disc was routinely embedded and sectioned, stained with safranin O to observe histological changes microscopically.@*RESULTS@#At 12, 18 and 24 weeks, intervertebral disc height of C6/C7 were (0.58±0.09) mm, (0.53±0.04) mm and (0.04±0.06) mm in Group A rats, (0.55±0.05) mm, (0.52±0.07) mm and (0.07±0.05) mm in Group B rats. At 24th week, intervertebral disc height of Group A rats was significantly lower than that of Group B rats (P0.05). At 12 and 18 weeks, the abraded rate of C6 caudal and C7 cephalic cartilage endplate in Group A rats were significantly higher than that in Groups B, C and D rats (P0.05). Microscopic observation of CT showed that ventral defects in C6 caudal or C7 cephalic cartilage endplate in Groups A and B appeared after 12 weeks of modeling; obvious cracks were found in front of the C6 and C7 vertebral body, and cartilage defect shown the trend of "repairing" at 18 and 24 weeks after modeling.@*CONCLUSIONS@#Intervertebral disc degeneration and osteoporosis can cause damage to the cartilage endplate. Co-existence of these two factors can induce more serious damage to the endplate, which has possitive correlation with intervertebral disc degeneration. Osteoporosis plays a certain role in intervertebral disc degeneration process, and accelerates the degeneration of intervertebral disc in a specific time window.