Résumé
Objective Few studies are reported on the clinical characteristics of glioma-related epilepsy (GRE).Postoperative recurrence of epilepsy in some patients seriously affects their recovery.We aimed to explore the duration, frequency and type of the epileptic seizure as well as possible factors for postoperative recurrence of epilepsy.Methods We recorded the frequency and duration of epileptic seizures, analyzed the recurrence-related factors using the Cox regression model, and investigated the risk factors of recurrent epilepsy.Results The postoperative recurrence of epilepsy was found in 24 (26.97%) of the 89 cases, which, compared with the 65 non-recurrence cases, had a significantly longer seizure duration (7[3-10] vs 5[2-9] min, P2 cm) (HR=2.867, 95% CI: 1.210-6.795), brain wave type (HR=2.501, 95% CI: 1.058-5.914), and preoperative frequency of epileptic seizure (>6 times/mo) (HR=5.100, 95% CI: 2.437-10.677).Conclusion Postoperative recurrence of epilepsy is associated with the clinical pathological parameters, and the changes of the frequency and duration of epileptic seizures before and after surgery may provide some new theoretical reference for the treatment and prognosis of the disease.
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Objective To explore expression of HMGB1 and TLR4 in epileptogenic focus brain tissue of temporal lobe intractable epilepsy patients, and analyze its significance in epileptic seizures. Methods 85 tempo-ral lobe intractable epilepsy patients were included in the research. Patients underwent resection of epileptogenic focus in Neurosurgery Department of The Fifth Affiliated Hospital of Zhengzhou University during January 2011 to January 2012. Epileptogenic focus brain tissue during operation were studied. 20 patients underwent intracranial decompression were selected as control group. Normal brain tissue during operation were studied. Immunohisto-chemical method was applied to detect HMGB1 and TLR4 expression level in epileptogenic focus brain tissue of ex-perimental group patients and normal brain tissue of control group patients. Correlation of HMGB1 and TLR4 expres-sion level and epileptic seizures was analyzed. Results Positive expression rate of HMGB1 (χ2= 74.375, P =0.000) and TLR4(χ2= 57.495, P = 0.000) in epileptogenic focus brain tissue of experimental group patients are both higher than that in normal brain tissue of control group patients. Expression of HMGB1 and TLR4 in epilepto-genic focus brain tissue is correlated with course of epilepsy (χ2= 25.798, P = 0.000), (χ2= 10.548, P = 0.001) preoperative epileptic seizure duration(χ2=8.403, P=0.004),(χ2=10.564, P= 0.001) and preoperative epilep-tic seizure frequency (χ2=4.912, P=0.027), (χ2=5.567, P=0.018). Conclusions HMGB1-TLR4 passageway may become new direction to study pathogenesis, diagnosis, and treatment of intractable epilepsy.
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Objective To investigate the protective effect of allopurinol in kainic acid-induced epileptic rats and to explore new ideas and methods for the clinical treatment of epilepsy. Methods 120 Wistar rats were randomly divided into sham group, KA epilepsy group and allopurinol groups. Six rats of each group were randomly selected and were given electrodes into their left frontal and hippocampal regions. After injection, behavior changes were observed in all rates without electrodes. 24 h later, MDA level and SOD enzymatic activity of the left hippocampi were measured. One week later, the EEGs were recorded in rates with electrode, as well as total time of seizures /30 min and numbers of seizures / 30 min. Results Compared with the KA model group, latency period of the epilepsy in the allopurinol group was longer (P < 0.05) and the extent was lighter (P < 0.05); the MDA level was significantly lower (P < 0.01), the SOD enzymatic activity was significantly higher (P < 0.01). The total time of seizures / 30min and numbers of seizures / 30 min in allopurinol group reduced significantly (P < 0.01). Conclusion Allopurinol has potential antiepileptic and antioxidative activities in kainic acid-induced epileptic rats.