Epilepsia e desordens de malformação do desenvolvimento cortical

Abstract

OBJETIVOS: As desordens do desenvolvimento cortical (DDC) constituem a segunda causa de epilepsia refratária. Diversas patologias estão incluídas nas DDC. Seu diagnóstico foi facilitado com o desenvolvimento na neuroimagem. MÉTODOS: No presente artigo, apresentamos sete casos divididos em três grupos, de acordo com o mecanismo de produção das DDC: 1) anormalidades da proliferação e diferenciação de neurônios da glia; 2) anormalidades de migração neuronal; 3) anormalidades na organização neuronal. A investigação consistiu em história mais exame neurológico, avaliação neuropsicológica, ressonância magnética e eletrencefalograma. RESULTADOS E CONCLUSÕES: Três pacientes apresentaram displasia cortical focal, dois apresentaram heterotopia em banda, um paciente apresentava lisencefalia e uma apresentava esquizencefalia. Todos os pacientes apresentavam epilepsia de difícil controle. Malformações corticais constituem um grupo heterogêneo de causas de epilepsia de difícil controle. É importante para o manejo médico que as diversas formas de malformações corticais sejam conhecidas e diagnosticadas, o que foi facilitado pelo advento da ressonância magnética.

Schizencephaly: Case Report

“…Several cortical malformations represents a multifaceted group of etiologies/causes related to epilepsy and also difficult the clinical control (Meneses et al, 2006). Our patient demonstrated delay in neuropsychomotor development of milestones (at first, he walked at six years old and learned to read at ten), Alongside the presence of a 4/d spastic tertraparesis, hyperrreflexia and cognitive deficits were associated to a clinical epilepsy history, in his third decade of life.…”

“…In mammals, the conformation of cerebral cortex is a process featured of proliferation, migration, differentiation and cell death (Meneses et al, 2006;Silva and Cavalheiro, 2004). The cortical development disorders results in changes in cytoarchitecture of the cerebral cortical layers (Meneses et al, 2006;Sarkis et al, 2010). Innumerable classification of these disorders ranging from anatomy, histopathology, embryology until genetics (Meneses et al, 2006;Barkovich et al, 2005).…”

“…The cortical development disorders results in changes in cytoarchitecture of the cerebral cortical layers (Meneses et al, 2006;Sarkis et al, 2010). Innumerable classification of these disorders ranging from anatomy, histopathology, embryology until genetics (Meneses et al, 2006;Barkovich et al, 2005). As such, schizencephaly is a developmental cortical desorder, integrating group of malformations in cortical organization.…”

“…As such, schizencephaly is a developmental cortical desorder, integrating group of malformations in cortical organization. It is believed that an initial genetic or enviromental injury occurs just after neuronal migration, under this circunstances, the cytoarchitecture of the cortex when continuity begins to develop between itself and the telecephalon (Meneses et al, 2006;Palmini, 2000).…”

Vagus nerve stimulation may be a sound therapeutic option in the treatment of refractory epilepsy

“…However, the remaining 20 to 30% who are refractory to antiepileptic drugs have an important burden regarding their labor, social and cognitive aspects as a result of their seizures, its etiology and sometimes the effects of their drug treatment 2,3 . People with medically refractory epilepsy may be included in pre-operative protocols for epilepsy surgery, and as a result, to undergo microsurgical resection for curative treatment [2][3][4][5] .…”