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Temporal lobe epilepsy clinical, laboratory (serum antinuclear antibodies) and MRI study

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Neurology

Advisors

Barrada, Usama , Esmaeil, Eihab , El-Fayyoumi, Nervana

Authors

Abdel-Atti, Azza Abdel-Hamid

Accessioned

2017-03-30 06:20:37

Available

2017-03-30 06:20:37

type

M.Sc. Thesis

Abstract

The present study was conducted on 13 males (52%) and 12 females (48%).Their age ranged between 20 and 48 years with a mean age of 28.08± 8.85 years. These were compared with 10 age matched normal control subjects, consisted of 4 males (40%) and 6 females (60%), their age ranged from 20 to 43 years with a mean age of 26.30± 6.65 years. The duration of epilepsy in the patients group ranged from 3 months to 27 years with a mean of 9.27± 8.56 years. The frequency of the attacks ranged from 4 per day to 2 per year. According to the international classification of seizures (1981), 2 patients (8%) had simple partial seizures, 7 patients (28%) had complex partial seizures, 4 patients (16%) had simple partial seizures with secondary generalization, and 12 patients (48%) had complex partial seizures with secondary generalization. 44% of our patients had past history of medical illness in the form of febrile convulsions (FC) in 8%, head trauma in 20%, perinatal insult in 8%,CNS infection in 8%. As regards drug treatment ;72% was on polytherapy,24% on monotherapy , and 4% received no treatment. All subjects were submitted to history taking, thorough clinical examination, conventional interictal EEG, MRI study, ANA and aCL antibody test. EEG was normal in 20% of our patients, focal discharges in 44%, and focal with secondary generalization in 36%.EEG changes had no significant relation to age, sex, seizure frequency , duration of illness, seizure type and type of treatment. MRI studies revealed: Primary features of HS in 28%, secondary features of HS in 12%, encephalomalacia in 12%, cyst in 4%, and calcification in 4%. 40% of cases had a normal MRI. The most frequent feature of HS was dilatation of the temporal horn of the lateral ventricle (40%). The presence of MRI abnormality was significantly associated with higher frequency of the attacks. (P=0.016**). In the present study 60% of patients with positive past history had an abnormal MRI study (P=0.048**). There was no statistically significant relation between routine EEG and MRI study.57%of patients with CPS showed 1ry features of hippocampal scelerosis which was statistically significant (P=0.037**).Laboratory investigations revealed that 3 of the patients (12%) were positive for aCL IgG, while none of the patients or the control subjects was positive for aCL IgM. 18 of our patients (72%) were positive for ANA test, while in the control group, 5 subjects (50%) were positive for ANA. We didn't find aCL antibodies frequently in the group of patients with ANA, than in the group without ANA. No sex difference was found between those with antibody -positive tests and those with negative tests .We found no correlation between aCL IgM and ANA and AED, however there was a significant association between aCL IgG and phenytoin (P=0.002**), and there was a significant increase in the mean value of the frequency of the attacks among the positive group of ANA test. (P=0.018**). Among those with abnormal MRI study 93.3% were ANA positive (P= 0.004**), and 13% were positive for aCL .Moreover 100% of patients with dilated temporal horn of the lateral ventricle in MRI had positive test for ANA and this was statistically significant (P=0.011**).No significant relation was found between ANA, aCL and EEG changes .EEG was more sensitive than MRI for diagnosis of temporal lobe epilepsy (80% vs 60%).

Issued

1 Jan 2003

Details

Type

Thesis

Created At

28 Jan 2023