Longer epilepsy duration and multiple lobe involvement predict worse seizure outcomes for patients with refractory temporal lobe epilepsy associated with neurocysticercosis

Meguins, Lucas Crociati; Adry, Rodrigo Antonio Rocha da Cruz; Júnior, Sebastião Carlos da Silva; Pereira, Carlos Umberto; Oliveira, Jean Gonçalves de; Morais, Dionei Freitas de; Filho, Gerardo Maria de Araújo; Marques, Lúcia Helena Neves

doi:10.1590/0004-282x20150175

Cited by 9 publications

(7 citation statements)

References 18 publications

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“…In our study longer duration of epilepsy was associated with a higher seizure count. A similar conclusion comes from the abovementioned study in which a longer period of disease duration counted from the occurrence of the first to the last seizure is associated with a higher lower risk of seizure recurrence at two and five years and a higher ten-year chance of seizure freedom [ 99 ] and from the study assessing prognostic factors in patients with epilepsy who underwent surgery due to HS or neurocysticercosis [ 100 ]. Male sex was associated with a higher seizure count, a result also obtained by other authors [ 101 ] but not consistent in the literature [ 102 , 103 ].…”

Section: Discussionsupporting

confidence: 59%

Serum Proteins Associated with Blood–Brain Barrier as Potential Biomarkers for Seizure Prediction

Bronisz

Cudna

Wierzbicka

et al. 2022

IJMS

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As 30% of epileptic patients remain drug-resistant, seizure prediction is vital. Induction of epileptic seizure is a complex process that can depend on factors such as intrinsic neuronal excitability, changes in extracellular ion concentration, glial cell activity, presence of inflammation and activation of the blood–brain barrier (BBB). In this study, we aimed to assess if levels of serum proteins associated with BBB can predict seizures. Serum levels of MMP-9, MMP-2, TIMP-1, TIMP-2, S100B, CCL-2, ICAM-1, P-selectin, and TSP-2 were examined in a group of 49 patients with epilepsy who were seizure-free for a minimum of seven days and measured by ELISA. The examination was repeated after 12 months. An extensive medical history was taken, and patients were subjected to a follow-up, including a detailed history of seizures. Serum levels of MMP-2, MMP-9, TIMP-1, CCL-2, and P-selectin differed between the two time points (p < 0.0001, p < 0.0001, p < 0.0001, p < 0.0001, p = 0.0035, respectively). General linear model analyses determined the predictors of seizures. Levels of MMP-2, MMP-9, and CCL-2 were found to influence seizure count in 1, 3, 6, and 12 months of observation. Serum levels of MMP-2, MMP-9, and CCL-2 may be considered potential biomarkers for seizure prediction and may indicate BBB activation.

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Section: Discussionsupporting

confidence: 59%

Serum Proteins Associated with Blood–Brain Barrier as Potential Biomarkers for Seizure Prediction

Bronisz

Cudna

Wierzbicka

et al. 2022

IJMS

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“…The co-existence of NC and TLE associated with HS is common in regions where NC is endemic (31, 33). It is believed that, as in febrile seizures, NC functions as an initial precipitating lesion that would later lead to hippocampal sclerosis (9, 17, 26, 38, 39).…”

Section: Introductionmentioning

confidence: 99%

Neurocysticercosis and Hippocampal Atrophy: MRI Findings and the Evolution of Viable or Calcified Cysts in Patients With Neurocysticercosis

2019

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Neurocysticercosis (NC) is the most common parasitic infection of the central nervous system (CNS). Several studies have reported an association between NC and mesial temporal lobe epilepsy (MTLE). We intended to evaluate the frequency of hippocampal atrophy (HA), clinical evolution and imaging findings in patients with calcified neurocysticercotic lesions (CNLs). Methods: One hundred and eighty-one subjects (70 cases and 111 controls) were evaluated for the presence or absence of HA. We assessed the imaging findings, and the evolution of patients with NC treated or not with anthelmintics for NC. Results: Hippocampal volumes were different between cases and controls ( p < 0.001). Seventy percent of the cases presented HA. 52.2% of the patients without a history of anthelmintic treatment for NC had reports of epileptic seizures. There was an association between non-treatment and the later occurrence of epileptic seizures ( p = 0.006). There was an association between perilesional edema on MRI and the presence of uncontrolled epileptic seizures ( p = 0.004). Conclusions: Hippocampal atrophy is frequent in patients with NCC. There was an association between no anthelmintic treatment in the acute phase of NC, perilesional edema, more pronounced hippocampal atrophy, and the occurrence of refractory seizures.

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“…All the studies were published between 1984 and 2016. Of the included studies, seven were conducted in North America (four in the USA and three in Canada) ( 23 – 27 , 39 , 44 ), six in Asia (two in China, two in India, one in the State of Qatar, and one in South Korea) ( 36 , 37 , 40 , 41 , 43 , 46 ), two in Europe (one in Spain and one in Austria) ( 38 , 45 ), one in South America (Brazil) ( 17 ), and one in Oceania (Australia) ( 42 ). Regarding the writing language, 15 articles were written in English, and two were published in Chinese.…”

Section: Resultsmentioning

confidence: 99%

“…A full-text review of the remaining 244 papers excluded 227 studies for the following reasons: 211 had an unrelated population or outcome, and 16 did not report outcomes of interest. Finally, 17 articles containing 390 patients who met all inclusion criteria were enrolled in the meta-analysis (17,(23)(24)(25)(26)(27)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46). All articles were subjected to intention-to-treat (ITT) analysis.…”

Section: Literature Searchmentioning

confidence: 99%

“…The surgical outcomes of postinfectious epilepsy are encouraging in general; however, the prognostic factors that predict surgical outcomes remain unclear, although various potential risk factors have been identified. A recent case-control study showed that longer epilepsy durations and multiple lobe involvement predicted worse outcomes in NCC-related epilepsy ( 17 ), whereas another retrospective study reported that the age of occurrence of previous meningitis or a history of encephalitis contributed to outcomes after anterior temporal lobectomy. However, the predictors that have been related to surgical outcomes have varied among numerous studies.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of Seizure Freedom in Patients Undergoing Surgery for Central Nervous System Infection-Related Epilepsy: A Systematic Review and Meta-Analysis

Hou

Duan

et al. 2021

Front. Neurol.

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Objective: Central nervous system infections (CNSIs), especially viral encephalitis and meningitis, are well-recognized causes of medically refractory epilepsy. Although surgery is an effective and durable intervention against these infections, the seizure control outcomes described in previous surgical series have been variable. Accordingly, it is not clear which variables are most valuable in predicting seizure control following surgery for CNSI. The aim of this meta-analysis was to identify the predictors of favorable surgical outcomes in CNSI-related epilepsy.Methods: The PubMed, EMBASE, Cochrane Library, WANGFANG, VIP, CBM, and CNKI databases were searched for studies according to the inclusion criteria. Prognostic factors, surgical outcomes, and patient characteristics were extracted. Heterogeneity was detected by the I2 and Q statistics.Results: Seventeen studies were included in our meta-analysis. Eight predictors of favorable outcomes (Engel Class I/II) were determined, including abnormal MRI findings, meningitis, temporal location only, regional ictal pattern, unilateral ictal pattern, older age at epilepsy, longer silent period, and longer time from infection, as follows: OR = 3.34 (95% CI 1.44–7.74), OR = 0.31 (95% CI 0.13–0.70), OR = 0.34 (95% CI 0.16–0.74), OR = 5.65 (95% CI 1.75–18.30), and OR = 9.53 (95% CI 2.36–38.48), respectively, and MD = 2.15 (95% CI 0.20–4.11), MD = 2.40 (95% CI 0.09–4.70), and MD = 8.49 (95% CI 1.50–15.48), respectively. A subgroup analysis found the following associations: regional and unilateral ictal patterns in viral encephalitis, a younger age at infection in parasitic encephalopathy, an older age at surgery, a longer time from onset, and a longer time from infection in unexplained meningitis. A sensitivity analysis restricted to studies that included each variable yielded robust results. Little evidence of publication bias was observed.Conclusions: This meta-analysis suggests that abnormal MRI findings, meningitis, temporal location only, regional and unilateral ictal patterns, older age at epilepsy, longer silent period, and longer time from infection are predictive factors in patients with favorable surgical outcomes in CNSI-related epilepsy. In addition, different infective agents influenced the results in regional and unilateral ictal patterns in ictal electroencephalography, as well as the relationship between age at infection and surgery and the time from epilepsy onset and infection.

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Longer epilepsy duration and multiple lobe involvement predict worse seizure outcomes for patients with refractory temporal lobe epilepsy associated with neurocysticercosis

Cited by 9 publications

References 18 publications

Serum Proteins Associated with Blood–Brain Barrier as Potential Biomarkers for Seizure Prediction

Serum Proteins Associated with Blood–Brain Barrier as Potential Biomarkers for Seizure Prediction

Neurocysticercosis and Hippocampal Atrophy: MRI Findings and the Evolution of Viable or Calcified Cysts in Patients With Neurocysticercosis

Predictors of Seizure Freedom in Patients Undergoing Surgery for Central Nervous System Infection-Related Epilepsy: A Systematic Review and Meta-Analysis

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