There have been many advances in the diagnosis and management of focal epilepsies particularly with neuroimaging techniques and magnetic resonance imaging(MRI).Special MRI sequences can be employed to localize and res...There have been many advances in the diagnosis and management of focal epilepsies particularly with neuroimaging techniques and magnetic resonance imaging(MRI).Special MRI sequences can be employed to localize and resect the epileptogenic lesions responsible for focal epilepsy.This study aims to show the benefit of dedicated epilepsy MRI sequences in the diagnosis of focal epilepsies.A general electric 1.5 Tesla MRI machine was used with standard and special sequences.Also,a Nihon Kohden electroencephalography(EEG)machine was used.This is a prospective observational study that included 51 patients with focal epilepsies who had an initial negative brain imaging.They underwent epilepsy MRI sequences along with a prolonged video EEG monitoring to localize the lesion,and then results were analyzed statistically using SPSS 22 program.The majority of patients were males(62.75%)with a mean age of 30 years.The grand majority of patients(74.5%,p value of 0.001)had their lesion localized by the epilepsy MRI.The most commonly found pathology was mesial temporal sclerosis.A significant number of patients(23.5%)were sent for an epilepsy surgery(p value 0.002).This study shows the significant impact of dedicated epilepsy MRI sequences on the diagnosis and management of focal epilepsy in the Lebanese population.展开更多
Focal cortical dysplasia(FCD)is one of the most common causes of drug-resistant epilepsy.Dysmorphic neurons are the major histopathological feature of typeⅡFCD,but their role in seizure genesis in FCD is unclear.Here...Focal cortical dysplasia(FCD)is one of the most common causes of drug-resistant epilepsy.Dysmorphic neurons are the major histopathological feature of typeⅡFCD,but their role in seizure genesis in FCD is unclear.Here we performed whole-cell patch-clamp recording and morphological reconstruction of cortical principal neurons in postsurgical brain tissue from drug-resistant epilepsy patients.Quantitative analyses revealed distinct morphological and electrophysiological characteristics of the upper layer dysmorphic neurons in typeⅡFCD,including an enlarged soma,aberrant dendritic arbors,increased current injection for rheobase action potential firing,and reduced action potential firing frequency.Intriguingly,the upper layer dysmorphic neurons received decreased glutamatergic and increased GABAergic synaptic inputs that were coupled with upregulation of the Na^(+)-K^(+)-Cl^(−)cotransporter.In addition,we found a depolarizing shift of the GABA reversal potential in the CamKⅡ-cre::PTENflox/flox mouse model of drug-resistant epilepsy,suggesting that enhanced GABAergic inputs might depolarize dysmorphic neurons.Thus,imbalance of synaptic excitation and inhibition of dysmorphic neurons may contribute to seizure genesis in typeⅡFCD.展开更多
文摘There have been many advances in the diagnosis and management of focal epilepsies particularly with neuroimaging techniques and magnetic resonance imaging(MRI).Special MRI sequences can be employed to localize and resect the epileptogenic lesions responsible for focal epilepsy.This study aims to show the benefit of dedicated epilepsy MRI sequences in the diagnosis of focal epilepsies.A general electric 1.5 Tesla MRI machine was used with standard and special sequences.Also,a Nihon Kohden electroencephalography(EEG)machine was used.This is a prospective observational study that included 51 patients with focal epilepsies who had an initial negative brain imaging.They underwent epilepsy MRI sequences along with a prolonged video EEG monitoring to localize the lesion,and then results were analyzed statistically using SPSS 22 program.The majority of patients were males(62.75%)with a mean age of 30 years.The grand majority of patients(74.5%,p value of 0.001)had their lesion localized by the epilepsy MRI.The most commonly found pathology was mesial temporal sclerosis.A significant number of patients(23.5%)were sent for an epilepsy surgery(p value 0.002).This study shows the significant impact of dedicated epilepsy MRI sequences on the diagnosis and management of focal epilepsy in the Lebanese population.
基金supported by grants from the Ministry of Science and Technology(2019YFA0110103)the National Natural Science Foundation of China(81870898,82071287,and 81870916)+1 种基金the Fundamental Research Funds for the Central Universities(2019FZA7009 and 2021FZZX001-37)the Zhejiang Provincial Natural Science Foundation(LR18H090002).
文摘Focal cortical dysplasia(FCD)is one of the most common causes of drug-resistant epilepsy.Dysmorphic neurons are the major histopathological feature of typeⅡFCD,but their role in seizure genesis in FCD is unclear.Here we performed whole-cell patch-clamp recording and morphological reconstruction of cortical principal neurons in postsurgical brain tissue from drug-resistant epilepsy patients.Quantitative analyses revealed distinct morphological and electrophysiological characteristics of the upper layer dysmorphic neurons in typeⅡFCD,including an enlarged soma,aberrant dendritic arbors,increased current injection for rheobase action potential firing,and reduced action potential firing frequency.Intriguingly,the upper layer dysmorphic neurons received decreased glutamatergic and increased GABAergic synaptic inputs that were coupled with upregulation of the Na^(+)-K^(+)-Cl^(−)cotransporter.In addition,we found a depolarizing shift of the GABA reversal potential in the CamKⅡ-cre::PTENflox/flox mouse model of drug-resistant epilepsy,suggesting that enhanced GABAergic inputs might depolarize dysmorphic neurons.Thus,imbalance of synaptic excitation and inhibition of dysmorphic neurons may contribute to seizure genesis in typeⅡFCD.
