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Objective To evaluate the feasibility of the lateralization of unilateral medial temporal lobe epilepsy(mTLE)by using arterial-spin-labeling(ASL)based perfusion MR imaging and investigate the changes of perfusion in the regions related to mTLE network and the relationship between the perfusion and the clinical status.Methods Twenty-five patients with left-sided and 23 with right-sided mTLE were enroiled,and 30 healthy volunteers were recruited.The cerebral blood flow(CBF)of related region was measured based on pulsed-ASL sequence on Siemens 3 T scanner.The CBF of the mTLE group were compared with that in the controls by using ANOVA analysis.The asymmetric indices of CBF in the medial temporal lobe were calculated as the lesion side compared with the normal side in matched region in mTLE group.Results Compared with the volunteers,the patients with mTLE showed the decrease of CBF in the bilateral medial and lateral temporal,the frontal and parietal regions relating to the default-mode network and more serious in lesion side.The CBF values of the medial temporal lobe were negatively correlated with the epilepsy duration(r =-0.51,P ＜0.01).The asymmetric index of CBF as-0.01 has a 76.0％(19/25)sensitivity and a 78.3％(18/23)specificity to distinguish the lesion side.Conclusions The decrease of CBF in the temporal and extra-temporal region by ASL-based MRI suggests the functional abnormalities in the network involved by mTLE.The ASL technique is a useful tool for lateralizing the unilateral mTLE.
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Objective:To discuss the surgical outcome of pediatric intractable temporal epilepsy. Methods:This observation included 34 pediatric patients with intractable temporal epilepsy who were admitted to our hospital from 1990 to 2001.CT or MRI,EEG and neuropsychological examinations were taken to determine the situations of the patients.They all underwent improved anterior temporal lobectomy. Results:The patients have been followed up for 2-13 years.According to Engel's classification,the achieved outcomes were seizure-free in 22(65 %) patients,apparently improved in 3(9 %) patients,improved in 3(9 %) patients,no effect in 2(6 %) patients,and lost of follow-up in 4(12 %) patients,respectively. Conclusion:Surgical treatment to pediatric intractable temporal epilepsy is safe and effective.The most common pathological causes for pediatric epilepsy are tumor and hippocampus sclerosis.Early surgery of pediatric temporal epilepsy could improve the life qualities of patients.
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Objectives:To discuss the effects of stereotactic techniques in treating brain deep lesions. Methods: Eighty-two patients with deep brain lesions were treated by fisher stereotactic apparatus and ASA-601S. Among these, stereotactic biopsy was performed in 22, clearance of haematoma in 5 (2 located in brain stem), aspiration of brain abscess in 2 and placement of Ommaya tube into cystic craniopharyngioma in 53. Results: All of the 22 biopsies were pathologically diagnosed, which included 10 cases of glioma, 4 cases of germ cell tumor, 3 cases of brain parasite, 4 cases of metastatic lung tumor and one case of hyperplasia of colloid cells at rear end of third ventricle, which turned to be glioma in follow-up period. Tumor resection was performed in 4 patients with glioma and radiation therapy for other tumors. After the treatment, 6 patients were fully recovered ( 4 with germ cell tumor and 2 with metastatec tumor). All brain parasite, brain abscess and brain haematoma were cured. Three patients with craniopharyngioma were cured after the placement of Ommaya tube (with radiation therapy inside the cyst), and others were improved. Conclusions:Stereotaxy has the advantages of precise location, less damage, easy manipulation and on the safe side. It is worth advocating.
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C-fos,one of the immediate-early genes,encodes Fos,which appears to modulate the express of more “downstream” genes and attribute to long-term changes in cellular function.Recently,c-fos has been researched on extensively and progress has been acquired greatly.This article summarizes c-fos on structure,function and the relationship to epilepsy.
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Objectives:To explore the antiepileptic cellular mechanism of chronic vagus nerve stimulation (VNS). Methods: The rats were kindled by intraperitoneal injection of pentylenetetrazol (PTZ) (45mg/kg weight), and chronic VNS was applied to the kindled-rats. The effects of glutamate (Glu) on the intracellular free calcium (［Ca2+］i) of cortical and hippocampal neurons of normal, PTZ-kindled and VNS-treated rats were examined with fluorescence spectrophotometry respectively. The behavioral changes of all rats were observed. Results: The neuronal ［Ca2+］i of the VNS-treated rats were significantly lower than that of the PTZ-kindled rats. VNS could significantly inhibit the augmentation of neuronal ［Ca2+］i induced by Glu. Behavioral changes demonstrated that VNS could significantly reduce the severity and prolong the latency of seizures of PTZ-kindled rats. Conclusions: VNS could significantly inhibit the kindling effect of PTZ and reduce the excitability of neurons induced by Glu. VNS might exerted the antiepileptic effects by influencing the activation of neural receptors.
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Objective To study a simple, measurable and objective method for fixing stereotactic head frame. Methods A self-made stereotactic head frame ruler was used in the localization in operations of 29 cases of Parkinson's disease and 1 case of intractable cancer pain. Results Of the 30 cases,significant effects were obtained in 29 coses(96.7%) and curative effects in 1 case (3.3%). Conclusions The improved ruler can be fully applicable to the ASA-602S model stereotactic frame, being a simple, measurable and objective method for fixing stereotactic head frame and applying CT scanning orientation.
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Objective To observe the change of nitric oxide(NO) and superoxide dismutase(SOD) in the epileptic rat brain cortex, and study the effect of the redox states of NO on epilepsy.Methods Using epileptic rat model induced by bemegride, the level of NO and the activity of SOD were measured in rat cerebral motor cortex during and only after seizures.Results The level of NO in rat cerebral motor cortex was significantly increased during and only after seizures than the normal controls. During seizures, SOD activity was decreased; but only after seizures, SOD activity was significantly increased.Conclusion The value of SOD activity than NO content had significantly difference in rat cerebral cortex between during and only after transient seizures. These results suggested that the different redox state of NO would play different role du ring the seizure.