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Sample records for temporal mesial paradigma

  1. Thalamic changes with mesial temporal sclerosis: MRI

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    Deasy, N.P.; Jarosz, J.M.; Cox, T.C.S. [Department of Neuroradiology, King' s College Hospital, London (United Kingdom); Elwes, R.C.D. [Department of Neurology, King' s College Hospital, London (United Kingdom); Polkey, C.E. [Department of Neurosurgery, King' s College and Maudsley Hospitals, London (United Kingdom)

    2000-05-01

    We reviewed the preoperative images of 28 patients with pathologically proven mesial temporal sclerosis, to assess thalamic asymmetry and signal change. A further 25 nonsurgical patients with temporal lobe epilepsy and unequivocal, unilateral changes of mesial temporal sclerosis, and 20 controls, were also reviewed. None of the control group had unequivocal asymmetry of the thalamus. There was an ipsilateral asymmetrically small thalamus in five (18 %) of the surgical group and in three (12 %) of the nonsurgical patients. In four cases there was thalamic signal change. In three patients with thalamic volume loss there was ipsilateral hemiatrophy. All patients with an asymmetrically small thalamus had an asymmetrically small fornix and all but one a small ipsilateral mamillary body. (orig.)

  2. Mesial temporal sclerosis in children Esclerose mesial temporal em crianças

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    Eliana Maria Domingues Brandão

    2007-12-01

    Full Text Available Mesial temporal sclerosis is the most frequent cause of drug-resistant temporal lobe epilepsy but has a satisfactory response to surgery, and is considered infrequent in children. OBJECTIVE: To evaluate the clinical, electrographic and radiological spectrum of the disease in children. METHOD: Retrospective study by review of charts of 44 children with a diagnosis of mesial temporal sclerosis on magnetic resonance imaging, attended at the "Hospital das Clínicas" of the University of São Paulo Faculty of Medicine. RESULTS: Febrile seizure was identified in the history of 54% of the patients. Injuries at the left side predominated in patients with schooling difficulties (p=0.049, in those with the first seizures between six months and five years (p=0.021 and in those with complex febrile seizure (p=0.032. Thirteen patients were submitted to surgery and of these, eight remained without seizures. CONCLUSION: Febrile seizure may be related in a more direct way to the presence of left-side mesial temporal sclerosis.Em adultos, esclerose mesial temporal é a causa mais freqüente de epilepsia do lobo temporal intratável por medicamentos e que responde satisfatoriamente a cirurgia, sendo considerada pouco freqüente em criança. OBJETIVO: Avaliar o espectro clínico, eletrográfico e radiológico desta patologia em crianças. MÉTODO: Estudo retrospectivo, por revisão de prontuário de 44 crianças com diagnóstico de esclerose mesial temporal na ressonância magnética, atendidos no Hospital das Clínicas da Faculdade de Medicina de São Paulo. RESULTADO: Foi identificado que 54% dos pacientes apresentaram antecedente de crise febril. Lesão no lado esquerdo predominou nos pacientes com dificuldade escolar (p=0.049, naqueles com primeiras crises entre seis meses e cinco anos (p=0,021 e naqueles com crise febril complicada (p=0,032. Treze pacientes foram operados, dos quais oito ficaram livres de crises. CONCLUSÃO: Crise febril pode estar

  3. Surgical Considerations of Intractable Mesial Temporal Lobe Epilepsy

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    Boling, Warren W.

    2018-01-01

    Surgery of temporal lobe epilepsy is the best opportunity for seizure freedom in medically intractable patients. The surgical approach has evolved to recognize the paramount importance of the mesial temporal structures in the majority of patients with temporal lobe epilepsy who have a seizure origin in the mesial temporal structures. For those individuals with medically intractable mesial temporal lobe epilepsy, a selective amygdalohippocampectomy surgery can be done that provides an excellent opportunity for seizure freedom and limits the resection to temporal lobe structures primarily involved in seizure genesis. PMID:29461485

  4. Surgical Considerations of Intractable Mesial Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Warren W. Boling

    2018-02-01

    Full Text Available Surgery of temporal lobe epilepsy is the best opportunity for seizure freedom in medically intractable patients. The surgical approach has evolved to recognize the paramount importance of the mesial temporal structures in the majority of patients with temporal lobe epilepsy who have a seizure origin in the mesial temporal structures. For those individuals with medically intractable mesial temporal lobe epilepsy, a selective amygdalohippocampectomy surgery can be done that provides an excellent opportunity for seizure freedom and limits the resection to temporal lobe structures primarily involved in seizure genesis.

  5. Atypical handedness in mesial temporal lobe epilepsy.

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    Doležalová, Irena; Schachter, Steven; Chrastina, Jan; Hemza, Jan; Hermanová, Markéta; Rektor, Ivan; Pažourková, Marta; Brázdil, Milan

    2017-07-01

    The main aim of our study was to investigate the handedness of patients with mesial temporal lobe epilepsy (MTLE). We also sought to identify clinical variables that correlated with left-handedness in this population. Handedness (laterality quotient) was assessed in 73 consecutive patients with MTLE associated with unilateral hippocampal sclerosis (HS) using the Edinburgh Handedness Inventory. Associations between right- and left-handedness and clinical variables were investigated. We found that 54 (74.0%) patients were right-handed, and 19 (26%) patients were left-handed. There were 15 (36.6%) left-handed patients with left-sided seizure onset compared to 4 (12.5%) left-handed patients with right-sided seizure onset (p=0.030). Among patients with left-sided MTLE, age at epilepsy onset was significantly correlated with handedness (8years of age [median; min-max 0.5-17] in left-handers versus 15years of age [median; min-max 3-30] in right-handers (p<0.001). Left-sided MTLE is associated with atypical handedness, especially when seizure onset occurs during an active period of brain development, suggesting a bi-hemispheric neuroplastic process for establishing motor dominance in patients with early-onset left-sided MTLE. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Radiosurgery in the Management of Intractable Mesial Temporal Lobe Epilepsy.

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    Peñagarícano, José; Serletis, Demitre

    2015-09-01

    Mesial temporal lobe epilepsy (MTLE) describes recurrent seizure activity originating from the depths of the temporal lobe. MTLE patients who fail two trials of medication now require testing for surgical candidacy at an epilepsy center. For these individuals, temporal lobectomy offers the greatest likelihood for seizure-freedom (up to 80-90%); unfortunately, this procedure remains largely underutilized. Moreover, for select patients unable to tolerate open surgery, novel techniques are emerging for selective ablation of the mesial temporal structures, including stereotactic radiosurgery (SRS). We present here a review of SRS as a potential therapy for MTLE, when open surgery is not an option.

  7. Functional connectivity between right and left mesial temporal structures.

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    Lacuey, Nuria; Zonjy, Bilal; Kahriman, Emine S; Kaffashi, Farhad; Miller, Jonathan; Lüders, Hans O

    2015-09-01

    The aim of this study is to investigate functional connectivity between right and left mesial temporal structures using cerebrocerebral evoked potentials. We studied seven patients with drug-resistant focal epilepsy who were explored with stereotactically implanted depth electrodes in bilateral hippocampi. In all patients cerebrocerebral evoked potentials evoked by stimulation of the fornix were evaluated as part of a research project assessing fornix stimulation for control of hippocampal seizures. Stimulation of the fornix elicited responses in the ipsilateral hippocampus in all patients with a mean latency of 4.6 ms (range 2-7 ms). Two patients (29 %) also had contralateral hippocampus responses with a mean latency of 7.5 ms (range 5-12 ms) and without involvement of the contralateral temporal neocortex or amygdala. This study confirms the existence of connections between bilateral mesial temporal structures in some patients and explains seizure discharge spreading between homotopic mesial temporal structures without neocortical involvement.

  8. MR imaging findings of patients with mesial temporal sclerosis

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    Kim, Min Jung; Kim, Sun Yong; Suh, Jung Ho [School of Medicine, Ajou University, Suwon (Korea, Republic of)

    2000-06-01

    To evaluate the MR imaging findings of patients with mesial temporal sclerosis. We retrospectively reviewed the MR imaging findings of 116 patients diagnosed by MRI as suffering from mesial temporal sclerosis. In 18 of these, the condition was also histologically proven. Among the 116 patients, volume loss of the hippocampus was found in 95 (81.9%) and signal changes of the hippocampus in 53 (45.7%). Decreased signal intensity in the hippocampus on T1-weighted images was found in 13 (11.2%) and increased signal on T2-weighted images in 50 (43.1%). Signal abnormality in the hippocampus on both T1- and T2-weighted images was found in ten, and associated extrahippocampal abnormalities, as follows, in 20 (17.2%): atrophy of fornix (n=3D10), atrophy of the mammillary body (n=3D8), atrophy of the amygdala (n=3D10), atrophy or increased T2 signal intensity of the anterior thalamic nuclei (n=3D2), atrophy of the cingulate gyrus (n=3D2), atrophy or increased signal intensity of the anterior temporal lobe (n=3D8), and cerebral hemiatrophy (n=3D4). A high T2 signal and atrophy of the hippocampus are the most common and important MRI findings of mesial temporal sclerosis. Other abnormal findings, if any, which may be found in extrahippocampal structures such as the fornix, mammillary body and temporal lobe, should, however, also be carefully observed. (author)

  9. Mesial temporal lobe epilepsy - An overview of surgical techniques.

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    Muzumdar, Dattatraya; Patil, Manoj; Goel, Atul; Ravat, Sangeeta; Sawant, Nina; Shah, Urvashi

    2016-12-01

    Mesial temporal lobe epilepsy is one of the commonest indications for epilepsy surgery. Presurgical evaluation for drug resistant epilepsy and identification of appropriate candidates for surgery is essential for optimal seizure freedom. The anatomy of mesial temporal lobe is complex and needs to be understood in the context of the advanced imaging, ictal and interictal Video_EEG monitoring, neuropsychology and psychiatric considerations. The completeness of disconnection of epileptogenic neural networks is paramount and is correlated with the extent of resection of the mesial temporal structures. In the Indian subcontinent, a standard but extended anterior temporal lobectomy is a viable option in view of the diverse socioeconomic, cultural and pathological considerations. The maximum utilization of epilepsy surgery services in this region is also a challenge. There is a need for regional comprehensive epilepsy care teams in a tertiary care academic hospital to form centers of excellence catering to a large population. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Complications after mesial temporal lobe surgery via inferiortemporal gyrus approach.

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    Vale, Fernando L; Reintjes, Stephen; Garcia, Hermes G

    2013-06-01

    The purpose of this study was to identify the complications associated with the inferior temporal gyrus approach to anterior mesial temporal lobe resection for temporal lobe epilepsy. This retrospective study examined complications experienced by 483 patients during the 3 months after surgery. All surgeries were performed during 1998-2012 by the senior author (F.L.V.). A total of 13 complications (2.7%) were reported. Complications were 8 delayed subdural hematomas (1.6%), 2 superficial wound infections (0.4%), 1 delayed intracranial hemorrhage (0.2%), 1 small lacunar stroke (0.2%), and 1 transient frontalis nerve palsy (0.2%). Three patients with subdural hematoma (0.6%) required readmission and surgical intervention. One patient (0.2%) with delayed intracranial hemorrhage required readmission to the neuroscience intensive care unit for observation. No deaths or severe neurological impairments were reported. Among the 8 patients with subdural hematoma, 7 were older than 40 years (87.5%); however, this finding was not statistically significant (p = 0.198). The inferior temporal gyrus approach to mesial temporal lobe resection is a safe and effective method for treating temporal lobe epilepsy. Morbidity and mortality rates associated with this procedure are lower than those associated with other neurosurgical procedures. The finding that surgical complications seem to be more common among older patients emphasizes the need for early surgical referral of patients with medically refractory epilepsy.

  11. Determinants of brain metabolism changes in mesial temporal lobe epilepsy.

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    Chassoux, Francine; Artiges, Eric; Semah, Franck; Desarnaud, Serge; Laurent, Agathe; Landre, Elisabeth; Gervais, Philippe; Devaux, Bertrand; Helal, Ourkia Badia

    2016-06-01

    To determine the main factors influencing metabolic changes in mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS). We prospectively studied 114 patients with MTLE (62 female; 60 left HS; 15- to 56-year-olds) with (18) F-fluorodeoxyglucose-positron emission tomography and correlated the results with the side of HS, structural atrophy, electroclinical features, gender, age at onset, epilepsy duration, and seizure frequency. Imaging processing was performed using statistical parametric mapping. Ipsilateral hypometabolism involved temporal (mesial structures, pole, and lateral cortex) and extratemporal areas including the insula, frontal lobe, perisylvian regions, and thalamus, more extensively in right HS (RHS). A relative increase of metabolism (hypermetabolism) was found in the nonepileptic temporal lobe and in posterior areas bilaterally. Voxel-based morphometry detected unilateral hippocampus atrophy and gray matter concentration decrease in both frontal lobes, more extensively in left HS (LHS). Regardless of the structural alterations, the topography of hypometabolism correlated strongly with the extent of epileptic networks (mesial, anterior-mesiolateral, widespread mesiolateral, and bitemporal according to the ictal spread), which were larger in RHS. Notably, widespread perisylvian and bitemporal hypometabolism was found only in RHS. Mirror hypermetabolism was grossly proportional to the hypometabolic areas, coinciding partly with the default mode network. Gender-related effect was significant mainly in the contralateral frontal lobe, in which metabolism was higher in female patients. Epilepsy duration correlated with the contralateral temporal metabolism, positively in LHS and negatively in RHS. Opposite results were found with age at onset. High seizure frequency correlated negatively with the contralateral metabolism in LHS. Epileptic networks, as assessed by electroclinical correlations, appear to be the main determinant of

  12. Mesial temporal lobe epilepsy diminishes functional connectivity during emotion perception.

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    Steiger, Bettina K; Muller, Angela M; Spirig, Esther; Toller, Gianina; Jokeit, Hennric

    2017-08-01

    Unilateral mesial temporal lobe epilepsy (MTLE) has been associated with impaired recognition of emotional facial expressions. Correspondingly, imaging studies showed decreased activity of the amygdala and cortical face processing regions in response to emotional faces. However, functional connectivity among regions involved in emotion perception has not been studied so far. To address this, we examined intrinsic functional connectivity (FC) modulated by the perception of dynamic fearful faces among the amygdala and limbic, frontal, temporal and brainstem regions. Regions of interest were identified in an activation analysis by presenting a block-design with dynamic fearful faces and dynamic landscapes to 15 healthy individuals. This led to 10 predominately right-hemispheric regions. Functional connectivity between these regions during the perception of fearful faces was examined in drug-refractory patients with left- (n=16) or right-sided (n=17) MTLE, epilepsy patients with extratemporal seizure onset (n=15) and a second group of 15 healthy controls. Healthy controls showed a widespread functional network modulated by the perception of fearful faces that encompassed bilateral amygdalae, limbic, cortical, subcortical and brainstem regions. In patients with left MTLE, a downsized network of frontal and temporal regions centered on the right amygdala was present. Patients with right MTLE showed almost no significant functional connectivity. A maintained network in the epilepsy control group indicates that findings in mesial temporal lobe epilepsy could not be explained by clinical factors such as seizures and antiepileptic medication. Functional networks underlying facial emotion perception are considerably changed in left and right MTLE. Alterations are present for both hemispheres in either MTLE group, but are more pronounced in right MTLE. Disruption of the functional network architecture possibly contributes to deficits in facial emotion recognition frequently

  13. Atypical febrile seizures, mesial temporal lobe epilepsy, and dual pathology.

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    Sanon, Nathalie T; Desgent, Sébastien; Carmant, Lionel

    2012-01-01

    Febrile seizures occurring in the neonatal period, especially when prolonged, are thought to be involved in the later development of mesial temporal lobe epilepsy (mTLE) in children. The presence of an often undetected, underlying cortical malformation has also been reported to be implicated in the epileptogenesis process following febrile seizures. This paper highlights some of the various animal models of febrile seizures and of cortical malformation and portrays a two-hit model that efficiently mimics these two insults and leads to spontaneous recurrent seizures in adult rats. Potential mechanisms are further proposed to explain how these two insults may each, or together, contribute to network hyperexcitability and epileptogenesis. Finally the clinical relevance of the two-hit model is briefly discussed in light of a therapeutic and preventive approach to mTLE.

  14. Paradigma

    DEFF Research Database (Denmark)

    Ravn, Ib

    2006-01-01

    Paradigma var et dansk tidsskrift, der havde undertitlen "Tidskrift om videnskab og virkeligheder" og som udkom fra 1986 til 1990. Det præsenterede dansk og udenlandsk forskning i fysik, biologi, sociologi, filosofi mv., som udfordrede velkendte videnskabelige paradigmer.......Paradigma var et dansk tidsskrift, der havde undertitlen "Tidskrift om videnskab og virkeligheder" og som udkom fra 1986 til 1990. Det præsenterede dansk og udenlandsk forskning i fysik, biologi, sociologi, filosofi mv., som udfordrede velkendte videnskabelige paradigmer....

  15. Verbal memory after temporal lobe epilepsy surgery in children: Do only mesial structures matter?

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    Law, Nicole; Benifla, Mony; Rutka, James; Smith, Mary Lou

    2017-02-01

    Previous findings have been mixed regarding verbal memory outcome after left temporal lobectomy in children, and there are few studies comparing verbal memory change after lateral versus mesial temporal lobe resections. We compared verbal memory outcome associated with sparing or including the mesial structures in children who underwent left or right temporal lobe resection. We also investigated predictors of postsurgical verbal memory change. We retrospectively assessed verbal memory change approximately 1 year after unilateral temporal lobe epilepsy surgery using a list learning task. Participants included 23 children who underwent temporal lobe surgery with sparing of the mesial structures (13 left), and 40 children who had a temporal lobectomy that included resection of mesial structures (22 left). Children who underwent resection from the left lateral and mesial temporal lobe were the only group to show decline in verbal memory. Furthermore, when we considered language representation in the left temporal resection group, patients with left language representation and spared mesial structures showed essentially no change in verbal memory from preoperative to follow-up, whereas those with left language representation and excised mesial structures showed a decline. Postoperative seizure status had no effect on verbal memory change in children after left temporal lobe surgery. Finally, we found that patients with intact preoperative verbal memory experienced a significant decline compared to those with below average preoperative verbal memory. Our findings provide evidence of significant risk factors for verbal memory decline in children, specific to left mesial temporal lobe epilepsy. Children who undergo left temporal lobe surgery that includes mesial structures may be most vulnerable for verbal memory decline, especially when language representation is localized to the left hemisphere and when preoperative verbal memory is intact. Wiley Periodicals, Inc.

  16. Electroencephalography in Mesial Temporal Lobe Epilepsy: A Review

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    Javidan, Manouchehr

    2012-01-01

    Electroencephalography (EEG) has an important role in the diagnosis and classification of epilepsy. It can provide information for predicting the response to antiseizure drugs and to identify the surgically remediable epilepsies. In temporal lobe epilepsy (TLE) seizures could originate in the medial or lateral neocortical temporal region, and many of these patients are refractory to medical treatment. However, majority of patients have had excellent results after surgery and this often relies on the EEG and magnetic resonance imaging (MRI) data in presurgical evaluation. If the scalp EEG data is insufficient or discordant, invasive EEG recording with placement of intracranial electrodes could identify the seizure focus prior to surgery. This paper highlights the general information regarding the use of EEG in epilepsy, EEG patterns resembling epileptiform discharges, and the interictal, ictal and postictal findings in mesial temporal lobe epilepsy using scalp and intracranial recordings prior to surgery. The utility of the automated seizure detection and computerized mathematical models for increasing yield of non-invasive localization is discussed. This paper also describes the sensitivity, specificity, and predictive value of EEG for seizure recurrence after withdrawal of medications following seizure freedom with medical and surgical therapy. PMID:22957235

  17. Episodic and semantic memory in children with mesial temporal sclerosis.

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    Rzezak, Patricia; Guimarães, Catarina; Fuentes, Daniel; Guerreiro, Marilisa M; Valente, Kette Dualibi Ramos

    2011-07-01

    The aim of this study was to analyze semantic and episodic memory deficits in children with mesial temporal sclerosis (MTS) and their correlation with clinical epilepsy variables. For this purpose, 19 consecutive children and adolescents with MTS (8 to 16 years old) were evaluated and their performance on five episodic memory tests (short- and long-term memory and learning) and four semantic memory tests was compared with that of 28 healthy volunteers. Patients performed worse on tests of immediate and delayed verbal episodic memory, visual episodic memory, verbal and visual learning, mental scanning for semantic clues, object naming, word definition, and repetition of sentences. Clinical variables such as early age at seizure onset, severity of epilepsy, and polytherapy impaired distinct types of memory. These data confirm that children with MTS have episodic memory deficits and add new information on semantic memory. The data also demonstrate that clinical variables contribute differently to episodic and semantic memory performance. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Intact information sampling in mesial temporal lobe epilepsy.

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    Zamarian, Laura; Trinka, Eugen; Kuchukhidze, Giorgi; Bodner, Thomas; Unterberger, Iris; Luef, Gerhard; Delazer, Margarete

    2015-11-01

    Previous studies have reported deficits in decision making under ambiguity for patients with mesial temporal lobe epilepsy (mTLE). It is unknown whether mTLE is also associated with alterations at a predecisional stage. This study aimed to gain insight into predecisional processing of patients with mTLE. We compared performance of patients with mTLE (n = 25) with that of healthy controls (n = 75) on the information sampling task (IST), a task assessing reflection-impulsivity and predecisional information sampling. Patients and healthy controls showed a similar performance pattern in both conditions of the IST as indicated by the amount of information gathered, the degree of uncertainty tolerated, and the number of decision errors made. They both also demonstrated a significant sensitivity to the different reward characteristics of the task. For the patient group, we found no significant effects on performance on the IST of epilepsy lateralization, abnormality side, structural abnormality (hippocampus vs. amygdala), and medication (monotherapy vs. polytherapy). Reflection processes and predecisional information sampling as tested by the IST are intact in mTLE. Patients collect as much information as healthy individuals and adapt their behavior according to the changing reward conditions. Our findings indicate that in well-defined risk situations, where memory demands are sufficiently minimized, patients with mTLE should be able to gather sufficient information, weight risks and benefits, and make advantageous decisions. (c) 2015 APA, all rights reserved).

  19. The circuit of Papez in mesial temporal sclerosis: MRI

    International Nuclear Information System (INIS)

    Oikawa, H.; Sasaki, M.; Tamakawa, Y.; Kamei, A.

    2001-01-01

    We looked at abnormalities in the circuit of Papez in patients with the mesial temporal sclerosis (MTS). We reviewed the MRI studies of 15 patients with probable MTS, seeking changes in the fornix, mamillary body, mamillothalamic tract, thalamus and cingulate and parahippocampal gyri. We correlated any abnormalities with each other and with clinical severity. Atrophy and/or signal change in one or more structures in the circuit of Papez were found in five patients. They involved the parahippocampal gyri in all five, the fornices in four, mamillary bodies in three, the thalamus in two and the cingulate gyrus in one. Changes in the fornix, mamillary body, thalamus or cingulate gyrus were always accompanied by hippocampal and parahippocampal atrophy. The patients with abnormalities of the circuit of Papez did not have more severe epilepsy than those without. Changes in the parahippocampal gyrus, including the entorhinal cortex and subiculum, in which forniceal fibres originate, may be crucial in causing abnormalities more distally in the circuit. (orig.)

  20. Exome sequencing identifies SUCO mutations in mesial temporal lobe epilepsy.

    Science.gov (United States)

    Sha, Zhiqiang; Sha, Longze; Li, Wenting; Dou, Wanchen; Shen, Yan; Wu, Liwen; Xu, Qi

    2015-03-30

    Mesial temporal lobe epilepsy (mTLE) is the main type and most common medically intractable form of epilepsy. Severity of disease-based stratified samples may help identify new disease-associated mutant genes. We analyzed mRNA expression profiles from patient hippocampal tissue. Three of the seven patients had severe mTLE with generalized-onset convulsions and consciousness loss that occurred over many years. We found that compared with other groups, patients with severe mTLE were classified into a distinct group. Whole-exome sequencing and Sanger sequencing validation in all seven patients identified three novel SUN domain-containing ossification factor (SUCO) mutations in severely affected patients. Furthermore, SUCO knock down significantly reduced dendritic length in vitro. Our results indicate that mTLE defects may affect neuronal development, and suggest that neurons have abnormal development due to lack of SUCO, which may be a generalized-onset epilepsy-related gene. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Stereotactic radiosurgery for the treatment of mesial temporal lobe epilepsy.

    Science.gov (United States)

    Feng, E-S; Sui, C-B; Wang, T-X; Sun, G-L

    2016-12-01

    Stereotactic radiosurgery (RS) is a potential option for some patients with temporal lobe epilepsy (TLE). The aim of this meta-analysis was to determine the pooled seizure-free rate and the time interval to seizure cessation in patients with lesions in the mesial temporal lobe, and who were eligible for either stereotactic or gamma knife RS. We searched the Medline, Cochrane, EMBASE, and Google Scholar databases using combinations of the following terms: RS, stereotactic radiosurgery, gamma knife, and TLE. We screened 103 articles and selected 13 for inclusion in the meta-analysis. Significant study heterogeneity was detected; however, the included studies displayed an acceptable level of quality. We show that approximately half of the patients were seizure free over a follow-up period that ranged from 6 months to 9 years [pooled estimate: 50.9% (95% confidence interval: 0.381-0.636)], with an average of 14 months to seizure cessation [pooled estimate: 14.08 months (95% confidence interval: 11.95-12.22 months)]. Nine of 13 included studies reported data for adverse events (AEs), which included visual field deficits and headache (the two most common AEs), verbal memory impairment, psychosis, psychogenic non-epileptic seizures, and dysphasia. Patients in the individual studies experienced AEs at rates that ranged from 8%, for non-epileptic seizures, to 85%, for headache. Our findings indicate that RS may have similar or slightly less efficacy in some patients compared with invasive surgery. Randomized controlled trials of both treatment regimens should be undertaken to generate an evidence base for patient decision-making. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Neuronal autoantibodies in mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Vanli-Yavuz, Ebru Nur; Erdag, Ece; Tuzun, Erdem; Ekizoglu, Esme; Baysal-Kirac, Leyla; Ulusoy, Canan; Peach, Sian; Gundogdu, Gokcen; Sencer, Serra; Sencer, Altay; Kucukali, Cem Ismail; Bebek, Nerses; Gurses, Candan; Gokyigit, Aysen; Baykan, Betul

    2016-07-01

    Our aim was to investigate the prevalence of neuronal autoantibodies (NAbs) in a large consecutive series with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and to elucidate the clinical and laboratory clues for detection of NAbs in this prototype of frequent, drug-resistant epilepsy syndrome. Consecutive patients diagnosed with MTLE fulfilling the MRI criteria for HS were enrolled. The sera of patients and various control groups (80 subjects) were tested for eight NAbs after ethical approval and signed consents. Brain tissues obtained from surgical specimens were also investigated by immunohistochemical analysis for the presence of inflammatory infiltrates. The features of seropositive versus seronegative groups were compared and binary logistic regression analysis was performed to explore the differentiating variables. We found antibodies against antigens, contactin-associated protein-like 2 in 11 patients, uncharacterised voltage-gated potassium channel (VGKC)-complex antigens in four patients, glycine receptor (GLY-R) in 5 patients, N-methyl-d-aspartate receptor in 4 patients and γ-aminobutyric acid receptor A in 1 patient of 111 patients with MTLE-HS and none of the control subjects. The history of status epilepticus, diagnosis of psychosis and positron emission tomography or single-photon emission CT findings in temporal plus extratemporal regions were found significantly more frequently in the seropositive group. Binary logistic regression analysis disclosed that status epilepticus, psychosis and cognitive dysfunction were statistically significant variables to differentiate between the VGKC-complex subgroup versus seronegative group. This first systematic screening study of various NAbs showed 22.5% seropositivity belonging mostly to VGKC-complex antibodies in a large consecutive series of patients with MTLE-HS. Our results indicated a VGKC-complex autoimmunity-related subgroup in the syndrome of MTLE-HS. Published by the BMJ

  3. Radiosurgery for Medial Temporal Lobe Epilepsy Resulting from Mesial Temporal Sclerosis.

    Science.gov (United States)

    Gianaris, Thomas; Witt, Thomas; Barbaro, Nicholas M

    2016-01-01

    Medial temporal lobe epilepsy associated with mesial temporal sclerosis (MTS) is perhaps the most well-defined epilepsy syndrome that is responsive to structural interventions such as surgery. Several minimally invasive techniques have arisen that provide additional options for the treatment of MTS while potentially avoiding many of open surgery's associated risks. By evading these risks, they also open up treatment options to patients who otherwise are poor surgical candidates. Radiosurgery is one of the most intensively studied of these alternatives and has found a growing role in the treatment of medial temporal lobe epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Age-Dependent Mesial Temporal Lobe Lateralization in Language FMRI

    Science.gov (United States)

    Sepeta, Leigh N.; Berl, Madison M.; Wilke, Marko; You, Xiaozhen; Mehta, Meera; Xu, Benjamin; Inati, Sara; Dustin, Irene; Khan, Omar; Austermuehle, Alison; Theodore, William H.; Gaillard, William D.

    2015-01-01

    Objective FMRI activation of the mesial temporal lobe (MTL) may be important for epilepsy surgical planning. We examined MTL activation and lateralization during language fMRI in children and adults with focal epilepsy. Methods 142 controls and patients with left hemisphere focal epilepsy (Pediatric: epilepsy, n = 17, mean age = 9.9 ± 2.0; controls, n = 48; mean age = 9.1 ± 2.6; Adult: epilepsy, n = 20, mean age = 26.7 ± 5.8; controls, n = 57, mean age = 26.2 ± 7.5) underwent 3T fMRI using a language task (auditory description decision task). Image processing and analyses were conducted in SPM8; ROIs included MTL, Broca’s area, and Wernicke’s area. We assessed group and individual MTL activation, and examined degree of lateralization. Results Patients and controls (pediatric and adult) demonstrated group and individual MTL activation during language fMRI. MTL activation was left lateralized for adults but less so in children (p’s < 0.005). Patients did not differ from controls in either age group. Stronger left-lateralized MTL activation was related to older age (p = 0.02). Language lateralization (Broca’s and Wernicke’s) predicted 19% of the variance in MTL lateralization for adults (p = 0.001), but not children. Significance Language fMRI may be used to elicit group and individual MTL activation. The developmental difference in MTL lateralization and its association with language lateralization suggests a developmental shift in lateralization of MTL function, with increased left lateralization across the age span. This shift may help explain why children have better memory outcomes following resection compared to adults. PMID:26696589

  5. Temporal lobe epilepsy with mesial temporal sclerosis: hippocampal neuronal loss as a predictor of surgical outcome

    Directory of Open Access Journals (Sweden)

    Anaclara Prada Jardim

    2012-05-01

    Full Text Available OBJECTIVE: To analyze retrospectively a series of patients with temporal lobe epilepsy (TLE and mesial temporal sclerosis (MTS, and the association of patterns of hippocampal sclerosis with clinical data and surgical prognosis. METHOD: Sixty-six patients with medically refractory TLE with unilateral MTS after anterior temporal lobectomy were included. Quantitative neuropathological evaluation was performed on NeuN-stained hippocampal sections. Patient's clinical data and surgical outcome were reviewed. RESULTS: Occurrence of initial precipitating insult (IPI, as well as better postoperative seizure control (i.e. Engel class 1, were associated with classical and severe patterns of hippocampal sclerosis (MTS type 1a and 1b, respectively. CONCLUSION: Quantitative evaluation of hippocampal neuronal loss patterns predicts surgical outcome in patients with TLE-MTS.

  6. Temporal lobe epilepsy with mesial temporal sclerosis: hippocampal neuronal loss as a predictor of surgical outcome.

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    Jardim, Anaclara Prada; Neves, Rafael Scarpa da Costa; Caboclo, Luís Otávio Sales Ferreira; Lancellotti, Carmen Lucia Penteado; Marinho, Murilo Martinez; Centeno, Ricardo Silva; Cavalheiro, Esper Abrão; Scorza, Carla Alessandra; Yacubian, Elza Márcia Targas

    2012-05-01

    To analyze retrospectively a series of patients with temporal lobe epilepsy (TLE) and mesial temporal sclerosis (MTS), and the association of patterns of hippocampal sclerosis with clinical data and surgical prognosis. Sixty-six patients with medically refractory TLE with unilateral MTS after anterior temporal lobectomy were included. Quantitative neuropathological evaluation was performed on NeuN-stained hippocampal sections. Patient's clinical data and surgical outcome were reviewed. Occurrence of initial precipitating insult (IPI), as well as better postoperative seizure control (i.e. Engel class 1), were associated with classical and severe patterns of hippocampal sclerosis (MTS type 1a and 1b, respectively). Quantitative evaluation of hippocampal neuronal loss patterns predicts surgical outcome in patients with TLE-MTS.

  7. Time reversibility of intracranial human EEG recordings in mesial temporal lobe epilepsy

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    van der Heyden, M. J.; Diks, C.; Pijn, J. P. M.; Velis, D. N.

    1996-02-01

    Intracranial electroencephalograms from patients suffering from mesial temporal lobe epilepsy were tested for time reversibility. If the recorded time series is irreversible, the input of the recording system cannot be a realisation of a linear Gaussian random process. We confirmed experimentally that the measurement equipment did not introduce irreversibility in the recorded output when the input was a realisation of a linear Gaussian random process. In general, the non-seizure recordings are reversible, whereas the seizure recordings are irreversible. These results suggest that time reversibility is a useful property for the characterisation of human intracranial EEG recordings in mesial temporal lobe epilepsy.

  8. Temporal lobe volume predicts Wada memory test performance in patients with mesial temporal sclerosis.

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    Ding, Kan; Gong, Yunhua; Modur, Pradeep N; Diaz-Arrastia, Ramon; Agostini, Mark; Gupta, Puneet; McColl, Roderick; Hays, Ryan; Van Ness, Paul

    2016-02-01

    The Wada test is widely used in the presurgical evaluation of potential temporal lobectomy patients to predict postoperative memory function. Expected asymmetry (EA), defined as Wada memory lateralized to the nonsurgical hemisphere, or a higher score after injection of the surgical hemisphere would be considered favorable in terms of postoperative memory outcome. However, in some cases, nonlateralized memory (NM) results, with no appreciable asymmetry, may occur because of impaired scores after both injections, often leading to denial of surgery. The reason for such nonlateralized Wada memory in patients with intractable temporal lobe epilepsy (TLE) remains unclear. Given that quantitative morphometric magnetic resonance imaging studies in TLE patients have shown bilateral regional atrophy in temporal and extratemporal structures, we hypothesized that the volume loss in contralateral temporal structures could contribute to nonlateralized Wada memory performance. To investigate this, we examined the relationship between the volume changes of temporal structures and Wada memory scores in patients with intractable TLE with mesial temporal sclerosis (MTS) using an age- and gender-matched control group. Memory was considered nonlateralized if the absolute difference in the total correct recall scores between ipsilateral and contralateral injections was memory was lateralized in 15 and nonlateralized in 6 patients, with all the nonlateralized scores being observed in left TLE. The recall scores after ipsilateral injection were significantly lower in patients with an NM profile than an EA profile (23 ± 14% vs. 59 ± 18% correct recall, p ≤ 0.001). However, the recall scores after contralateral injection were low but similar between the two groups (25 ± 17% vs. 25 ± 15% correct recall, p=0.97). Compared to controls, all the patients showed greater volume loss in the temporal regions. However, patients with a NM profile showed significantly more volume loss than those

  9. Fluoxetine Restores Spatial Learning but Not Accelerated Forgetting in Mesial Temporal Lobe Epilepsy

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    Barkas, Lisa; Redhead, Edward; Taylor, Matthew; Shtaya, Anan; Hamilton, Derek A.; Gray, William P.

    2012-01-01

    Learning and memory dysfunction is the most common neuropsychological effect of mesial temporal lobe epilepsy, and because the underlying neurobiology is poorly understood, there are no pharmacological strategies to help restore memory function in these patients. We have demonstrated impairments in the acquisition of an allocentric spatial task,…

  10. Improved Cerebral Function in Mesial Temporal Lobe Epilepsy after Subtemporal Amygdalohippocampectomy

    Science.gov (United States)

    Takaya, Shigetoshi; Mikuni, Nobuhiro; Mitsueda, Takahiro; Satow, Takeshi; Taki, Junya; Kinoshita, Masako; Miyamoto, Susumu; Hashimoto, Nobuo; Ikeda, Akio; Fukuyama, Hidenao

    2009-01-01

    The functional changes that occur throughout the human brain after the selective removal of an epileptogenic lesion remain unclear. Subtemporal selective amygdalohippocampectomy (SAH) has been advocated as a minimally invasive surgical procedure for patients with medically intractable mesial temporal lobe epilepsy (MTLE). We evaluated the effects…

  11. Correlation between memory, proton magnetic resonance spectroscopy, and interictal epileptiform discharges in temporal lobe epilepsy related to mesial temporal sclerosis.

    Science.gov (United States)

    Mantoan, Marcele Araújo Silva; Caboclo, Luís Otávio Sales Ferreira; de Figueiredo Ferreira Guilhoto, Laura Maria; Lin, Katia; da Silva Noffs, Maria Helena; de Souza Silva Tudesco, Ivanda; Belzunces, Erich; Carrete, Henrique; Bussoletti, Renato Tavares; Centeno, Ricardo Silva; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas

    2009-11-01

    The aim of the study described here was to examine the relationship between memory function, proton magnetic resonance spectroscopy ((1)H-MRS) abnormalities, and interictal epileptiform discharge (IED) lateralization in patients with temporal lobe epilepsy (TLE) related to unilateral mesial temporal sclerosis. We assessed performance on tests of memory function and intelligence quotient (IQ) in 29 right-handed outpatients and 24 controls. IEDs were assessed on 30-minute-awake and 30-minute-sleep EEG samples. Patients had (1)H-MRS at 1.5 T. There was a negative correlation between IQ (P=0.031) and Rey Auditory Verbal Learning Test results (P=0.022) and epilepsy duration; between(1)H-MRS findings and epilepsy duration (P=0.027); and between N-acetylaspartate (NAA) levels and IEDs (P=0.006) in contralateral mesial temporal structures in the left MTS group. (1)H-MRS findings, IEDs, and verbal function were correlated. These findings suggest that IEDs and NAA/(Cho+Cr) ratios reflecting neural metabolism are closely related to verbal memory function in mesial temporal sclerosis. Higher interictal activity on the EEG was associated with a decline in total NAA in contralateral mesial temporal structures.

  12. Neuropsychology Outcomes Following Trephine Epilepsy Surgery: The Inferior Temporal Gyrus Approach for Amygdalohippocampectomy in Medically Refractory Mesial Temporal Lobe Epilepsy.

    Science.gov (United States)

    Schoenberg, Mike R; Clifton, William E; Sever, Ryan W; Vale, Fernando L

    2017-06-08

    Surgery is indicated in cases of mesial temporal lobe epilepsy(MTLE) that are refractory to medical management. The inferior temporal gyrus (ITG) approach provides access to the mesial temporal lobe (MTL) structures with minimal tissue disruption. Reported neuropsychology outcomes following this approach are limited. To report neuropsychological outcomes using an ITG approach to amygdalohippocampectomy (AH) in patients with medically refractory MTLE based on a prospective design. Fifty-four participants had Engel class I/II outcome following resection of MTL using the ITG approach. All participants had localization-related epilepsy confirmed by long-term surface video-electroencephalography and completed pre/postsurgical evaluations that included magnetic resonance imaging (MRI), Wada test or functional MRI, and neuropsychology assessment. Clinical semiology/video-electroencephalography indicated that of the 54 patients, 28 (52%) had left MTLE and 26 (48%) had right MTLE. Dominant hemisphere resections were performed on 23 patients (43%), nondominant on 31(57%). Twenty-nine (29) had pathology-confirmed mesial temporal sclerosis (MTS). Group level analyses found declines in verbal memory for patients with language-dominant resections ( P .05). Neuropsychology outcomes of an ITG approach for selective mesial temporal resection are comparable to other selective AH techniques showing minimal adverse cognitive effects. These data lend support to the ITG approach for selective AH as an option for MTLE. © Congress of Neurological Surgeons 2017.

  13. MR imaging findings in patients with mesial temporal sclerosis

    International Nuclear Information System (INIS)

    Zimmerman, R.A.; Sperling, M.; Bilaniuk, L.T.; O'Connor, M.; Hackney, D.B.; Grossman, R.I.; Goldberg, H.I.; Gonatas, N.

    1987-01-01

    Eleven patients (aged 19-37) with temporal lobe epilepsy were evaluated by 1.5-T MR imaging. The MR imaging followed a negative CT examination. All patients underwent ictal and interictal, depth electrode EEG recording, carotid arteriography with amytol test, neuropsychological testing, subsequent unilateral temporal lobectomy, and pathologic correlation. MR images were retrospectively reviewed and correlated. MR images in ten patients showed a small temporal lobe on the abnormal side. Abnormal signal intensity was not found within the temporal lobe despite the use of coronal and axial long TR (2,500 msec) and short and long TE(30 and 80 msec) studies

  14. Carbamazepine reduces memory induced activation of mesial temporal lobe structures: a pharmacological fMRI-study

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    Okujava Michael

    2001-11-01

    Full Text Available Abstract Background and Purpose It is not known whether carbamazepine (CBZ; a drug widely used in neurology and psychiatry influences the blood oxygenation level dependent (BOLD contrast changes induced by neuronal activation and measured by functional MRI (fMRI. We aimed to investigate the influence of CBZ on memory induced activation of the mesial temporal lobes in patients with symptomatic temporal lobe epilepsy (TLE. Material and Methods Twenty-one individual patients with refractory symptomatic TLE with different CBZ serum levels and 20 healthy controls were studied using BOLD fMRI. Mesial temporal lobe (MTL activation was induced by a task that is based on the retrieval of individually familiar visuo-spatial knowledge. The extent of significant MTL fMRI activation was measured and correlated with the CBZ serum level. Results In TLE patients, the extent of significant fMRI activation over both MTL was negatively correlated to the CBZ serum level (Spearman r = -0.654, P Conclusions In TLE patients, carbamazepine reduces the fMRI-detectable changes within the mesial temporal lobes as induced by effortful memory retrieval. FMRI appears to be suitable to study the effects of chronic drug treatment in patients with epilepsy.

  15. EEG-fMRI Evaluation of Patients with Mesial Temporal Lobe Sclerosis

    Science.gov (United States)

    Avesani, Mirko; Giacopuzzi, Silvia; Bongiovanni, Luigi Giuseppe; Borelli, Paolo; Cerini, Roberto; Pozzi Mucelli, Roberto; Fiaschi, Antonio

    2014-01-01

    Summary This preliminary study sought more information on blood oxygen level dependent (BOLD) activation, especially contralateral temporal/extratemporal spread, during continuous EEG-fMRI recordings in four patients with mesial temporal sclerosis (MTS). In two patients, EEG showed unilateral focal activity during the EEG-fMRI session concordant with the interictal focus previously identified with standard and video-poly EEG. In the other two patients EEG demonstrated a contralateral diffusion of the irritative focus. In the third patient (with the most drug-resistant form and also extratemporal clinical signs), there was an extratemporal diffusion over frontal regions, ipsilateral to the irritative focus. fMRI analysis confirmed a single activation in the mesial temporal region in two patients whose EEG showed unilateral focal activity, while it demonstrated a bilateral activation in the mesial temporal regions in the other two patients. In the third patient, fMRI demonstrated an activation in the supplementary motxor area. This study confirms the most significant activation with a high firing rate of the irritative focus, but also suggests the importance of using new techniques (such as EEG-fMRI to examine cerebral blood flow) to identify the controlateral limbic activation, and any other extratemporal activations, possible causes of drug resistance in MTS that may require a more precise pre-surgical evaluation with invasive techniques. PMID:24571833

  16. Neuropsychological results after gamma knife radiosurgery for mesial temporal lobe epilepsy.

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    Vojtěch, Zdeněk; Krámská, Lenka; Malíková, Hana; Stará, Michaela; Liščák, Roman

    2015-01-01

    The aim of this study is to summarize our experience with neuropsychological changes after radiosurgical treatment for mesial temporal lobe epilepsy and subsequent surgery due to insufficient seizure control. Between November 1995 and May 1999, 14 patients underwent radiosurgical entorhinoamygdalohippocampectomy with a marginal dose of 18, 20 or 25 Gy to the 50% isodose. 9 of these patients subsequently underwent surgery. We compared Memory Quotients and Intelligence Quotients before and after the interventions. We found a slight, but nonsignificant decline in intelligence and memory quotients one year after GKRS. Two years after radiosurgery there were no significant changes in any of the quotients. After surgery, we found significant increase in Global and Visual MQ, (pmemory and intelligence performance after surgery. Epilepsy surgery after unsuccessful radiosurgery could lead to improvements in cognitive functions in patients with mesial temporal lobe epilepsy.

  17. A pediatric patient with refractory seizures and a mesial temporal lobe lesion

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    Marisa eMcGinley

    2015-06-01

    Full Text Available A 12 year old adolescent presented with refractory seizures and was found to have a mesial temporal lobe lesion. The patient underwent biopsy and was diagnosed with an arteriorvenous malformation. Supratentorial lesions in the pediatric population can have a large variety of underlying etiologies and it can challenging to differentiate on neuroimaging. In this report we discuss the key features on MRI of several neoplastic, vascular, and infectious processes that can aide in the diagnosis.

  18. Uso da sequência FLAIR-EPI na análise da esclerose mesial temporal EPI-FLAIR sequence in the evaluation of mesial temporal sclerosis

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    Marcos Alberto da Costa Machado Júnior

    2001-06-01

    Full Text Available O objetivo deste estudo é analisar as alterações morfológicas e de intensidade de sinal das regiões hipocampais em pacientes, com epilepsia temporal fármaco-resistente. Para tal, estudamos 8 pacientes com esclerose mesial temporal, utilizando aparelhagem de RM de 1,5T, com sequências Spin Eco - SE, Fast Spin Eco - FSE, Fluid Atenuation Inversion Recovery, com Eco Planar Imaging - FLAIR-EPI. Observamos a superioridade da sequência FLAIR na detecção do aumento da intensidade de sinal da região hipocampal, particularmente com cortes coronais, em relação às sequências SE e FSE, com a vantagem de ser uma técnica de rápida execução. A sequência STIR evidenciou adelgaçamento da cortical do hipocampo, na metade dos casos que apresentavam alteração de sinal.The purpose of this study is to evaluate morpholologycal and signal intensity changes in the hippocampus in patients with medically intractable temporal lobe epilepsy. We studied 8 patients with mesial temporal sclerosis using a 1.5 -T MR and the following sequences Spin Eco- SE, Fast Spin Echo- FSE, Fluid Atenuation Inversion Recovery Echo Planar Imaging - FLAIR-EPI. We noticed a sensitive increase signal intensity on FLAIR- EPI sequences, particularly, in coronal images, than on SE and FSE sequences. The STIR sequence showed a cortical hippocampus atrophy in half of the cases, in whom signal abnormalities were present.

  19. [Two cases of mesial temporal lobe epilepsy associated with old intracerebral hemorrhage in the lateral temporal lobe without "dual pathology"].

    Science.gov (United States)

    Morioka, T; Nishio, S; Hisada, K; Muraishi, M; Ishibashi, H; Mamiya, K; Ohfu, M; Fukui, M

    1998-05-01

    Two cases of intractable temporal lobe epilepsy associated with old intracerebral hemorrhage in the lateral temporal lobe were reported. Although preoperative magnetic resonance imaging (MRI) failed to reveal hippocampal atrophy with T2 hyperintensity, electrocorticographic (ECoG) recording with chronic invasive subdural electrodes indicated the mesial temporal lobe to be an ictal onset zone. After anterior temporal lobectomy involving the lesion and hippocampectomy, the patients became seizure-free. Hippocampal sclerosis, namely "dual pathology", was not noted on histological examination. Careful ECoG recording with chronic subdural electrodes is mandatory even when the preoperative MRI does not demonstrate the radiological hippocampal sclerosis.

  20. Granule cell dispersion is not a predictor of surgical outcome in temporal lobe epilepsy with mesial temporal sclerosis.

    Science.gov (United States)

    da Costa Neves, Rafael Scarpa; Jardim, Anaclara Prada; Caboclo, Luís Otávio; Lancellotti, Carmen; Marinho, Taissa Ferrari; Hamad, Ana Paula; Marinho, Murilo; Centeno, Ricardo; Cavalheiro, Esper Abrão; Scorza, Carla Alessandra; Targas Yacubian, Elza Márcia

    2013-01-01

    The aim of this retrospective study of a series of patients with mesial temporal lobe epilepsy (MTLE) and mesial temporal sclerosis (MTS) was to analyze the association of granule cell dispersion (GCD) with surgical prognosis, patterns of MTS and clinical data. Hippocampal specimens from 66 patients with MTLE and unilateral MTS and from 13 controls were studied. Quantitative neuropathological evaluation was performed on NeuN-stained hippocampal sections. Patients' clinical data, types of MTS and surgical outcome were reviewed. GCD occurred in 45.5% of cases and was not correlated with clinical variable. More severe neuronal loss was observed in patients with GCD. Except for MTS Type 2 - observed only in four no- GCD patients - groups did not differ with respect to the types of MTS. Surgical outcome was similar in both groups. In conclusion, GCD was associated with the degree of hippocampal cell loss, but was not a predictor of surgical outcome.

  1. Triple pathological findings in a surgically amenable patient with mesial temporal lobe epilepsy

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    Fumin Tong

    2015-01-01

    Full Text Available Mesial temporal sclerosis (MTS is a well-recognized cause of intractable epilepsy; however, coexistence with focal cortical dysplasia (FCD is less common. Middle fossa epidermoid cysts are rare and may involve the temporal lobe. Most epidermoids are clinically silent, slow-growing, and seldom associated with overt symptomatology, including seizures. We describe a patient with multiple comorbidities including left MTS and a large epidermoid cyst involving the left quadrigeminal plate cistern compressing upon the cerebellar vermis and tail of the left hippocampus, resulting in refractory left temporal lobe epilepsy. The patient underwent left anterior temporal lobectomy. The surgical pathology demonstrated a third pathological finding of left temporal FCD type Ia. The patient has been seizure-free since the surgery. This case provides additional information with regard to the understanding of epileptogenicity and surgical planning in patients with MTS and epidermoid cysts.

  2. Laser interstitial thermal therapy for medically intractable mesial temporal lobe epilepsy.

    Science.gov (United States)

    Kang, Joon Y; Wu, Chengyuan; Tracy, Joseph; Lorenzo, Matthew; Evans, James; Nei, Maromi; Skidmore, Christopher; Mintzer, Scott; Sharan, Ashwini D; Sperling, Michael R

    2016-02-01

    To describe mesial temporal lobe ablated volumes, verbal memory, and surgical outcomes in patients with medically intractable mesial temporal lobe epilepsy (mTLE) treated with magnetic resonance imaging (MRI)-guided stereotactic laser interstitial thermal therapy (LiTT). We prospectively tracked seizure outcome in 20 patients at Thomas Jefferson University Hospital with drug-resistant mTLE who underwent MRI-guided LiTT from December 2011 to December 2014. Surgical outcome was assessed at 6 months, 1 year, 2 years, and at the most recent visit. Volume-based analysis of ablated mesial temporal structures was conducted in 17 patients with mesial temporal sclerosis (MTS) and results were compared between the seizure-free and not seizure-free groups. Following LiTT, proportions of patients who were free of seizures impairing consciousness (including those with auras only) are as follows: 8 of 15 patients (53%, 95% confidence interval [CI] 30.1-75.2%) after 6 months, 4 of 11 patients (36.4%, 95% CI 14.9-64.8%) after 1 year, 3 of 5 patients (60%, 95% CI 22.9-88.4%) at 2-year follow-up. Median follow-up was 13.4 months after LiTT (range 1.3 months to 3.2 years). Seizure outcome after LiTT suggests an all or none response. Four patients had anterior temporal lobectomy (ATL) after LiTT; three are seizure-free. There were no differences in total ablated volume of the amygdalohippocampus complex or individual volumes of hippocampus, amygdala, entorhinal cortex, parahippocampal gyrus, and fusiform gyrus between seizure-free and non-seizure-free patients. Contextual verbal memory performance was preserved after LiTT, although decline in noncontextual memory task scores were noted. We conclude that MRI-guided stereotactic LiTT is a safe alternative to ATL in patients with medically intractable mTLE. Individualized assessment is warranted to determine whether the reduced odds of seizure freedom are worth the reduction in risk, discomfort, and recovery time. Larger prospective

  3. Brain-responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy.

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    Geller, Eric B; Skarpaas, Tara L; Gross, Robert E; Goodman, Robert R; Barkley, Gregory L; Bazil, Carl W; Berg, Michael J; Bergey, Gregory K; Cash, Sydney S; Cole, Andrew J; Duckrow, Robert B; Edwards, Jonathan C; Eisenschenk, Stephan; Fessler, James; Fountain, Nathan B; Goldman, Alicia M; Gwinn, Ryder P; Heck, Christianne; Herekar, Aamar; Hirsch, Lawrence J; Jobst, Barbara C; King-Stephens, David; Labar, Douglas R; Leiphart, James W; Marsh, W Richard; Meador, Kimford J; Mizrahi, Eli M; Murro, Anthony M; Nair, Dileep R; Noe, Katherine H; Park, Yong D; Rutecki, Paul A; Salanova, Vicenta; Sheth, Raj D; Shields, Donald C; Skidmore, Christopher; Smith, Michael C; Spencer, David C; Srinivasan, Shraddha; Tatum, William; Van Ness, Paul C; Vossler, David G; Wharen, Robert E; Worrell, Gregory A; Yoshor, Daniel; Zimmerman, Richard S; Cicora, Kathy; Sun, Felice T; Morrell, Martha J

    2017-06-01

    Evaluate the seizure-reduction response and safety of mesial temporal lobe (MTL) brain-responsive stimulation in adults with medically intractable partial-onset seizures of mesial temporal lobe origin. Subjects with mesial temporal lobe epilepsy (MTLE) were identified from prospective clinical trials of a brain-responsive neurostimulator (RNS System, NeuroPace). The seizure reduction over years 2-6 postimplantation was calculated by assessing the seizure frequency compared to a preimplantation baseline. Safety was assessed based on reported adverse events. There were 111 subjects with MTLE; 72% of subjects had bilateral MTL onsets and 28% had unilateral onsets. Subjects had one to four leads placed; only two leads could be connected to the device. Seventy-six subjects had depth leads only, 29 had both depth and strip leads, and 6 had only strip leads. The mean follow-up was 6.1 ± (standard deviation) 2.2 years. The median percent seizure reduction was 70% (last observation carried forward). Twenty-nine percent of subjects experienced at least one seizure-free period of 6 months or longer, and 15% experienced at least one seizure-free period of 1 year or longer. There was no difference in seizure reduction in subjects with and without mesial temporal sclerosis (MTS), bilateral MTL onsets, prior resection, prior intracranial monitoring, and prior vagus nerve stimulation. In addition, seizure reduction was not dependent on the location of depth leads relative to the hippocampus. The most frequent serious device-related adverse event was soft tissue implant-site infection (overall rate, including events categorized as device-related, uncertain, or not device-related: 0.03 per implant year, which is not greater than with other neurostimulation devices). Brain-responsive stimulation represents a safe and effective treatment option for patients with medically intractable epilepsy, including patients with unilateral or bilateral MTLE who are not candidates for

  4. Benign mesial temporal lobe epilepsy: A clinical cohort and literature review.

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    AlQassmi, Amal; Burneo, Jorge G; McLachlan, Richard S; Mirsattari, Seyed M

    2016-12-01

    We present a single-center retrospective study of benign mesial temporal lobe epilepsy (bMTLE) between 1995 and 2014. Hospital records and clinic charts were reviewed. The clinical, Eelectroencephalographic (EEG), imaging features, and response to treatment with antiepileptic drugs (AEDs) were documented. Patients were included in this study if they were seizure-free for a minimum of 24months with or without an AED. Twenty-seven patients were identified. There were 19 (70%) females, mean age at first seizure was 32.2 (range: 15-80years). In all patients, seizures were mild, and seizure freedom was readily achieved with the initiation of AED therapy. Sixteen patients (59%) had mesial temporal sclerosis (MTS). In three patients, we attempted to discontinue AED therapy after a prolonged period of remission (5-8years), but all had seizure recurrence within 2 to 4weeks. Not all temporal lobe epilepsy is refractory to medication, despite the presence of MTS. Until clinical trials indicate otherwise, surgery is not indicated but life-long medical treatment is advocated. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Hipometabolismo cerebral em pacientes com esclerose mesial temporal demonstrado pelo FDG-PET Brain hypometabolism in patients with mesial-temporal sclerosis demonstrated by FDG-PET

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    PAULO S. DUARTE

    2000-09-01

    Full Text Available O objetivo deste estudo foi avaliar a extensão do hipometabolismo cerebral em pacientes com esclerose mesial temporal (EMT. MÉTODO: Este estudo retrospectivo incluiu 21 pacientes que apresentavam epilepsia parcial complexa refrataria à terapia e que foram selecionados para cirurgia após análise extensa que incluía: EEG de superfície e estudos de neuroimagem (PET, SPECT e ressonância magnética. Todos os pacientes foram submetidos a intervenção cirúrgica e tiveram confirmação histológica de EMT. Uma análise semi-quantitativa foi realizada, utilizando regiões de interesse (ROIs nas seguintes estruturas: lobos frontais, parietais e occipitais, gânglios da base, tálamos, cerebelo e três diferentes regiões nos lobos temporais, que compreendiam o córtex medial, inferior e lateral. Um índice de assimetria (IA foi calculado, comparando as contagens por pixel nas estruturas homólogas em ambos os hemisférios cerebrais. Os IAs das diferentes estruturas foram então correlacionados. RESULTADOS: Uma correlação significativa foi demonstrada entre os IAs do córtex medial dos lobos temporais e aqueles dos lobos frontais, dos lobos parietais, dos gânglios da base e dos tálamos (r = 0,72, 0,62, 0,47 e 0,47 respectivamente com p The purpose of this study was to evaluate the extent of brain hypometabolism in patients with mesial-temporal sclerosis (MTS. METHOD: This retrospective study included 21 patients who had medically refractory complex partial seizures and were selected for surgical therapy after a comprehensive evaluation which included surface EEG recordings and neuroimaging studies (PET, SPECT and MRI. All patients were subjected to surgical intervention and had an histopathological confirmation of MTS. A semi-quantitative analysis of the PET images was performed using regions of interest in the following structures: frontal, parietal and occipital lobes, basal ganglia, thalami, cerebellum and three different regions in the

  6. Differentiation of cryptogenic lateral from mesial temporal lobe epilepsy using regional asymmetric index of F-18-FDG PET

    International Nuclear Information System (INIS)

    Song, H. C.; Lee, D. S.; Lee, S. K.; Jeong, J. M.; Jeong, Z. K.; Lee, M. C.; Ko, C. S.

    1997-01-01

    We tried to find the possibility of utilization of F-18-FDG PET to differentiate lateral (neocortical) from mesial temporal lobe epilepsy(TLE) if we adopted quantitative comparison of regional metabolic activities using asymmetric index. We studied 22 pathologically proven mesial TLE(group C in Figure), and 27 lateral TLE patients. Lateral TLE patients were normal on MR(cryptogenic: 15; group A) or had structural lesions (12: group B). Asymmetric index (AI) was calculated as (ipsilateral -contralateral) / (ipsilateral + contralateral ) x 200. AI of medial lobe of cryptogenic lateral TLE was not decreased (-4.66.2, > 0.05) and AI of medial lobe of cryptogenic lateral TLE was not decreased (-4.66.2, >0.05) and AI of lateral lobe was decreased (-13.68.9). AI of medial and lateral lobes of mesial TLE was decreased (-3.44.7 and -16.58.9, respectively). AI of medial lobe of lesional lateral TLE was -7.39.1 (p<0.05 compared with mesial TEL). It was evident that lateral lobe of lesional lateral TLE had metabolic defect or decrease (AI: -21.410.4). While we could not find difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by AI quantitation. An AI value larger than -10 (cutoff: AI) predicted positively for lateral TLE(PPV:80%) and negatively for mesial TLE(NPV:77%). Asymmetry of metabolic activity in medial and not in lateral lobe of temporal lobe could give hints about whether the epileptogenic zones were mesial or lateral

  7. Neuropsychological outcomes after Gamma Knife radiosurgery for mesial temporal lobe epilepsy: a prospective multicenter study.

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    Quigg, Mark; Broshek, Donna K; Barbaro, Nicholas M; Ward, Mariann M; Laxer, Kenneth D; Yan, Guofen; Lamborn, Kathleen

    2011-05-01

    To assess outcomes of language, verbal memory, cognitive efficiency and mental flexibility, mood, and quality of life (QOL) in a prospective, multicenter pilot study of Gamma Knife radiosurgery (RS) for mesial temporal lobe epilepsy (MTLE). RS, randomized to 20 Gy or 24 Gy comprising 5.5-7.5 ml at the 50% isodose volume, was performed on mesial temporal structures of patients with unilateral MTLE. Neuropsychological evaluations were performed at preoperative baseline, and mean change scores were described at 12 and 24 months postoperatively. QOL data were also available at 36 months. Thirty patients were treated and 26 were available for the final 24-month neuropsychological evaluation. Language (Boston Naming Test), verbal memory (California Verbal Learning Test and Logical Memory subtest of the Wechsler Memory Scale-Revised), cognitive efficiency and mental flexibility (Trail Making Test), and mood (Beck Depression Inventory) did not differ from baseline. QOL scores improved at 24 and 36 months, with those patients attaining seizure remission by month 24s accounting for the majority of the improvement. The serial changes in cognitive outcomes, mood, and QOL are unremarkable following RS for MTLE. RS may provide an alternative to open surgery, especially in those patients at risk of cognitive impairment or who desire a noninvasive alternative to open surgery. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  8. Granule cell dispersion is associated with memory impairment in right mesial temporal lobe epilepsy.

    Science.gov (United States)

    Neves, Rafael Scarpa da Costa; de Souza Silva Tudesco, Ivanda; Jardim, Anaclara Prada; Caboclo, Luís Otávio Sales Ferreira; Lancellotti, Carmen; Ferrari-Marinho, Taíssa; Hamad, Ana Paula; Marinho, Murilo; Centeno, Ricardo Silva; Cavalheiro, Esper Abrão; Scorza, Carla Alessandra; Yacubian, Elza Márcia Targas

    2012-11-01

    We analyzed the association of granule cell dispersion (GCD) with memory performance, clinical data and surgical outcome in a series of patients with mesial temporal lobe epilepsy (MTLE) and mesial temporal sclerosis (MTS). Hippocampal specimens from 54 patients with MTLE (27 patients with right MTLE and 27 with left MTLE) and unilateral MTS, who were separated into GCD and no-GCD groups and thirteen controls were studied. Quantitative neuropathological evaluation was performed using hippocampal sections stained with NeuN. Patients' neuropsychological measures, clinical data, type of MTS and surgical outcome were reviewed. GCD occurred in 28 (51.9%) patients. No correlation between GCD and MTS pattern, clinical data or surgical outcome was found. The presence of GCD was correlated with worse visuospatial memory performance in right MTLE, but not with memory performance in left MTLE. GCD may be related to memory impairment in right MTLE-MTS patients. However, the role of GCD in memory function is not precisely defined. Copyright © 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  9. Decision making under ambiguity and under risk in mesial temporal lobe epilepsy.

    Science.gov (United States)

    Delazer, Margarete; Zamarian, Laura; Bonatti, Elisabeth; Kuchukhidze, Giorgi; Koppelstätter, Florian; Bodner, Thomas; Benke, Thomas; Trinka, Eugen

    2010-01-01

    Decision making is essential in everyday life. Though the importance of the mesial temporal lobe in emotional processing and feedback learning is generally recognized, decision making in mesial temporal lobe epilepsy (mTLE) is almost unexplored so far. Twenty-eight consecutive epilepsy patients with drug resistant mTLE and fifty healthy controls performed decision tasks under initial ambiguity (participants have to learn by feedback to make advantageous decisions) and under risk (advantageous choices may be made by estimating risks and by rational strategies). A subgroup analysis compared the performance of patients affected by MRI-verified abnormalities of the hippocampus or amygdala. The effect of lesion side was also assessed. In decision under ambiguity, mTLE patients showed marked deficits and did not improve over the task. Patients with hippocampus abnormality and patients with amygdala abnormality showed comparable deficits. No difference was found between right and left TLE groups. In decision under risk, mTLE patients performed at the same level as controls. Results suggest that mTLE patients have difficulties in learning from feedback and in making decisions in uncertain, ambiguous situations. By contrast, they are able to make advantageous decisions when full information is given and risks, possible gains and losses are exactly defined.

  10. Right mesial temporal lobe epilepsy impairs empathy-related brain responses to dynamic fearful faces.

    Science.gov (United States)

    Toller, Gianina; Adhimoolam, Babu; Grunwald, Thomas; Huppertz, Hans-Jürgen; Kurthen, Martin; Rankin, Katherine P; Jokeit, Hennric

    2015-03-01

    Unilateral mesial temporal lobe epilepsy (MTLE) has been associated with reduced amygdala responsiveness to fearful faces. However, the effect of unilateral MTLE on empathy-related brain responses in extra-amygdalar regions has not been investigated. Using functional magnetic resonance imaging, we measured empathy-related brain responses to dynamic fearful faces in 34 patients with unilateral MTLE (18 right sided), in an epilepsy (extra-MTLE; n = 16) and in a healthy control group (n = 30). The primary finding was that right MTLE (RMTLE) was associated with decreased activity predominantly in the right amygdala and also in bilateral periaqueductal gray (PAG) but normal activity in the right anterior insula. The results of the extra-MTLE group demonstrate that these reduced amygdala and PAG responses go beyond the attenuation caused by antiepileptic and antidepressant medication. These findings clearly indicate that RMTLE affects the function of mesial temporal and midbrain structures that mediate basic interoceptive input necessary for the emotional awareness of empathic experiences of fear. Together with the decreased empathic concern found in the RMTLE group, this study provides neurobehavioral evidence that patients with RMTLE are at increased risk for reduced empathy towards others' internal states and sheds new light on the nature of social-cognitive impairments frequently accompanying MTLE.

  11. Small calcified lesions suggestive of neurocysticercosis are associated with mesial temporal sclerosis

    Directory of Open Access Journals (Sweden)

    Marcos C. B. Oliveira

    2014-07-01

    Full Text Available Recent studies have suggested a possible relationship between temporal lobe epilepsy with mesial temporal sclerosis (MTS and neurocysticercosis (NC. We performed a case-control study to evaluate the association of NC and MTS. Method: We randomly selected patients with different epilepsy types, including: MTS, primary generalized epilepsy (PGE and focal symptomatic epilepsy (FSE. Patients underwent a structured interview, followed by head computed tomography (CT. A neuroradiologist evaluated the scan for presence of calcified lesions suggestive of NC. CT results were matched with patients’ data. Results: More patients in the MTS group displayed calcified lesions suggestive of NC than patients in the other groups (p=0.002. On multivariate analysis, MTS was found to be an independent predictor of one or more calcified NC lesions (p=0.033. Conclusion: After controlling for confounding factors, we found an independent association between NC calcified lesions and MTS.

  12. Topographical, autobiographical and semantic memory in a patient with bilateral mesial temporal and retrosplenial infarction.

    Science.gov (United States)

    Hepner, Ilana J; Mohamed, Armin; Fulham, Michael J; Miller, Laurie A

    2007-04-01

    According to Consolidation Theory (Squire, 1992, Psychological Review, 99, 195; Squire & Alvarez, 1995, Current Opinion in Neurobiology, 5, 169), the mesial temporal lobes have a time-limited role in the maintenance, storage and retrieval of retrograde declarative memories, such that they are not necessary for recalling remote memories. In contrast, proponents of the Multiple Trace Theory (Fuji, Moscovitch, & Nadel, 2000, Handbook of neuropsychology, 2nd ed., p 223, Amsterdam, New York: Elsevier; Nadel & Moscovitch, 1999, Current Opinion in Neurobiology, 7, 217) posit that the mesial temporal lobe (MTL) is necessary for remembering detailed autobiographical and topographical material from all time periods. A third theory of hippocampal function, the Cognitive Map Theory (O'Keefe & Nadel, 1978, The hippocampus as a cognitive map. Oxford: Clarendon), states that the hippocampus is involved in the processing of allocentric spatial representations. The precise role of the MTL in remote memory has been difficult to elucidate, as the majority of studies present cases with widespread brain damage that often occurred many years prior to testing. We investigated retrograde autobiographical, semantic and topographical memories in a subject (SG) who had recently sustained infarctions confined to the MTL and retrosplenial region bilaterally. Inconsistent with the predictions of Cognitive Map Theory, memory for spatial maps that were learned in the past was preserved. Additional testing indicated that SG suffered from a landmark agnosia, which affected remotely and recently acquired information equally. SG was also poor at imagining which direction he would have to turn his body to move from one landmark to another. In accordance with Consolidation Theory, SG performed similarly to control subjects for remote time periods on various measures of retrograde autobiographical memory and demonstrated intact knowledge regarding famous faces and vocabulary terms that were acquired in

  13. Spatial memory for asymmetrical dot locations predicts lateralization among patients with presurgical mesial temporal lobe epilepsy.

    Science.gov (United States)

    Brown, Franklin C; Hirsch, Lawrence J; Spencer, Dennis D

    2015-11-01

    This study examined the ability of an asymmetrical dot location memory test (Brown Location Test, BLT) and two verbal memory tests (Verbal Selective Reminding Test (VSRT) and California Verbal Learning Test, Second Edition (CVLT-II)) to correctly lateralize left (LTLE) or right (RTLE) mesial temporal lobe epilepsy that was confirmed with video-EEG. Subjects consisted of 16 patients with medically refractory RTLE and 13 patients with medically refractory LTLE who were left hemisphere language dominant. Positive predictive values for lateralizing TLE correctly were 87.5% for the BLT, 72.7% for the VSRT, and 80% for the CVLT-II. Binary logistic regression indicated that the BLT alone correctly classified 76.9% of patients with left temporal lobe epilepsy and 87.5% of patients with right temporal lobe epilepsy. Inclusion of the verbal memory tests improved this to 92.3% of patients with left temporal lobe epilepsy and 100% correct classification of patients with right temporal lobe epilepsy. Though of a limited sample size, this study suggests that the BLT alone provides strong laterality information which improves with the addition of verbal memory tests. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. [A surgical case of mesial temporal lobe epilepsy associated with hippocampal sclerosis and traumatic neocortical lesion].

    Science.gov (United States)

    Kitazawa, Yu; Jin, Kazutaka; Iwasaki, Masaki; Suzuki, Hiroyoshi; Tanaka, Fumiaki; Nakasato, Nobukazu

    2017-11-25

    A 26-year-old right-handed woman, with a history of left temporal lobe contusion caused by a fall at the age of 9 months, started to have complex partial seizures with oral automatism at the age of 7 years. The seizures occurred once or twice a month despite combination therapy with several antiepileptic agents. Her history and imaging studies suggested the diagnosis of epilepsy arising from traumatic neocortical temporal lesion. Comprehensive assessment including long-term video EEG monitoring, MRI, FDG-PET, MEG, and neuropsychological evaluation was performed at the age of 26 years. The diagnosis was left mesial temporal lobe epilepsy associated with hippocampal atrophy and traumatic temporal cortical lesion. The patient was readmitted for surgical treatment at the age of 27 years. Intracranial EEG monitoring showed that ictal discharges started in the left hippocampus and spread to the traumatic lesion in the left posterior superior temporal gyrus 10 seconds after the onset. This case could not be classified as dual pathology exactly, because the traumatic left temporal cortical lesion did not show independent epileptogenicity. However, the traumatic lesion was highly likely to be the source of the epileptogenicity, and she had right hemispheric dominance for language and functional deterioration in the whole temporal cortex. Therefore, left amygdalo-hippocampectomy and left temporal lobectomy including the traumatic lesion were performed according to the diagnosis of dual pathology. Subsequently, she remained seizure-free for 3 years. Comprehensive assessment of seizure semiology, neurophysiology, neuroradiology, and neuropsychology is important to determine the optimum therapeutic strategies for drug-resistant epilepsy.

  15. Survival of mossy cells of the hippocampal dentate gyrus in humans with mesial temporal lobe epilepsy.

    Science.gov (United States)

    Seress, László; Abrahám, Hajnalka; Horváth, Zsolt; Dóczi, Tamás; Janszky, József; Klemm, Joyce; Byrne, Richard; Bakay, Roy A E

    2009-12-01

    Hippocampal sclerosis can be identified in most patients with mesial temporal lobe epilepsy (TLE). Surgical removal of the sclerotic hippocampus is widely performed to treat patients with drug-resistant mesial TLE. In general, both epilepsy-prone and epilepsy-resistant neurons are believed to be in the hippocampal formation. The hilar mossy cells of the hippocampal dentate gyrus are usually considered one of the most vulnerable types of neurons. The aim of this study was to clarify the fate of mossy cells in the hippocampus in epileptic humans. Of the 19 patients included in this study, 15 underwent temporal lobe resection because of drug-resistant TLE. Four patients were used as controls because they harbored tumors that had not invaded the hippocampus and they had experienced no seizures. Histological evaluation of resected hippocampal tissues was performed using immunohistochemistry. Mossy cells were identified in the control as well as the epileptic hippocampi by using cocaine- and amphetamine-regulated transcript peptide immunohistochemistry. In most cases the number of mossy cells was reduced and thorny excrescences were smaller in the epileptic hippocampi than in controls; however, there was a significant loss of pyramidal cells and a partial loss of granule cells in the same epileptic hippocampi in which mossy cell loss was apparent. The loss of mossy cells could be correlated with the extent of hippocampal sclerosis, patient age at seizure onset, duration of epilepsy, and frequency of seizures. In many cases large numbers of mossy cells were present in the hilus of the dentate gyrus when most pyramidal neurons of the CA1 and CA3 areas of the Ammon's horn were lost, suggesting that mossy cells may not be more vulnerable to epileptic seizures than the hippocampal pyramidal neurons.

  16. Uncinate fasciculus fiber tracking in mesial temporal lobe epilepsy. Initial findings

    International Nuclear Information System (INIS)

    Rodrigo, S.; Oppenheim, C.; Meder, J.F.; Chassoux, F.; Golestani, N.; Cointepas, Y.; Poupon, C.; Semah, F.; Mangin, J.F.; Le Bihan, D.

    2007-01-01

    In temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS), ictal discharge spread to the frontal and insulo-perisylvian cortex is commonly observed. The implication of white matter pathways in this propagation has not been investigated. We compared diffusion tensor imaging (DTI) measurements along the uncinate fasciculus (UF), a major tract connecting the frontal and temporal lobes, in patients and controls. Ten right-handed patients referred for intractable TLE due to a right HS were investigated on a 1.5-T MR scanner including a DTI sequence. All patients had interictal fluorodeoxyglucose PET showing an ipsilateral temporal hypometabolism associated with insular and frontal or perisylvian hypometabolism. The controls consisted of ten right-handed healthy subjects. UF fiber tracking was performed, and its fractional anisotropy (FA) values were compared between patients and controls, separately for the right and left UF. The left-minus-right FA UF asymmetry index was computed to test for intergroup differences. Asymmetries were found in the control group with right-greater-than-left FA. This asymmetrical pattern was lost in the patient group. Right FA values were lower in patients with right HS versus controls. Although preliminary, these findings may be related to the preferential pathway of seizure spread from the mesial temporal lobe to frontal and insulo-perisylvian areas. (orig.)

  17. Uncinate fasciculus fiber tracking in mesial temporal lobe epilepsy. Initial findings

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigo, S.; Oppenheim, C.; Meder, J.F. [Universite Paris-Descartes, Faculte de Medecine, Centre Hospitalier Sainte-Anne, Departement d' Imagerie Morphologique et Fonctionnelle, Paris (France); Chassoux, F. [Universite Paris-Descartes, Faculte de Medecine, Service de Neurochirurgie, Centre Hospitalier Sainte-Anne, Paris (France); Golestani, N.; Cointepas, Y.; Poupon, C.; Semah, F.; Mangin, J.F.; Le Bihan, D. [Service Hospitalier Frederic Joliot, CEA, Orsay (France)

    2007-07-15

    In temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS), ictal discharge spread to the frontal and insulo-perisylvian cortex is commonly observed. The implication of white matter pathways in this propagation has not been investigated. We compared diffusion tensor imaging (DTI) measurements along the uncinate fasciculus (UF), a major tract connecting the frontal and temporal lobes, in patients and controls. Ten right-handed patients referred for intractable TLE due to a right HS were investigated on a 1.5-T MR scanner including a DTI sequence. All patients had interictal fluorodeoxyglucose PET showing an ipsilateral temporal hypometabolism associated with insular and frontal or perisylvian hypometabolism. The controls consisted of ten right-handed healthy subjects. UF fiber tracking was performed, and its fractional anisotropy (FA) values were compared between patients and controls, separately for the right and left UF. The left-minus-right FA UF asymmetry index was computed to test for intergroup differences. Asymmetries were found in the control group with right-greater-than-left FA. This asymmetrical pattern was lost in the patient group. Right FA values were lower in patients with right HS versus controls. Although preliminary, these findings may be related to the preferential pathway of seizure spread from the mesial temporal lobe to frontal and insulo-perisylvian areas. (orig.)

  18. Hippocampal Atrophy Is Associated with Altered Hippocampus-Posterior Cingulate Cortex Connectivity in Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis.

    Science.gov (United States)

    Shih, Y C; Tseng, C E; Lin, F-H; Liou, H H; Tseng, W Y I

    2017-03-01

    Unilateral mesial temporal lobe epilepsy and hippocampal sclerosis have structural and functional abnormalities in the mesial temporal regions. To gain insight into the pathophysiology of the epileptic network in mesial temporal lobe epilepsy with hippocampal sclerosis, we aimed to clarify the relationships between hippocampal atrophy and the altered connection between the hippocampus and the posterior cingulate cortex in patients with mesial temporal lobe epilepsy with hippocampal sclerosis. Fifteen patients with left mesial temporal lobe epilepsy with hippocampal sclerosis and 15 healthy controls were included in the study. Multicontrast MR imaging, including high-resolution T1WI, diffusion spectrum imaging, and resting-state fMRI, was performed to measure the hippocampal volume, structural connectivity of the inferior cingulum bundle, and intrinsic functional connectivity between the hippocampus and the posterior cingulate cortex, respectively. Compared with controls, patients had decreased left hippocampal volume (volume ratio of the hippocampus and controls, 0.366% ± 0.029%; patients, 0.277% ± 0.063%, corrected P = .002), structural connectivity of the bilateral inferior cingulum bundle (generalized fractional anisotropy, left: controls, 0.234 ± 0.020; patients, 0.193 ± 0.022, corrected P = .0001, right: controls, 0.226 ± 0.022; patients, 0.208 ± 0.017, corrected P = .047), and intrinsic functional connectivity between the left hippocampus and the left posterior cingulate cortex (averaged z-value: controls, 0.314 ± 0.152; patients, 0.166 ± 0.062). The left hippocampal volume correlated with structural connectivity positively (standardized β = 0.864, P = .001), but it had little correlation with intrinsic functional connectivity (standardized β = -0.329, P = .113). On the contralesional side, the hippocampal volume did not show any significant correlation with structural connectivity or intrinsic functional connectivity ( F 2,12 = 0.284, P = .757, R 2

  19. Magnetic resonance in the diagnostic imaging study of mesial temporal sclerosis; Diagnostico por imagen con resonancia magnetica de la esclerosis temporal mesial

    Energy Technology Data Exchange (ETDEWEB)

    Pastor, E; Sanchez, J C; Rodriguez, I; Altuzarra, A; Machado, F [Hospital Universitario Virgen de las Nieves. Granada (Spain); Aguilar, D [Hospital Clinico Universitario San Cecilio. Granada (Spain)

    2001-07-01

    Mesial temporal sclerosis (MTS) consists of hippocampal atrophy and gliosis and is the most common cause of temporal lobe epilepsy. The objective of the authors was to establish a magnetic resonance imaging (MRI) protocol for its diagnosis. A prospective study was carried out in 72 patients with drug resistant complex partial seizures (42 women and 30 men ranging in age from 6 to 66 year: mean: 30 years). Using a 1.5-Tesla magnet, paracoronal sections were made in hippocampi for T1-weighted inversion-recovery images and volume measurements, fluid-attenuated inversion-recovery (FLAIR) and T2 relaxometry. A control group of 30 health volunteers was included in the study. MTS was considered to be indicated by the presence of atrophy and hyperintensity in hippocampi on T2-weighted images. There were no differences among the hippocampi of the healthy individuals. The confidence intervals (mean{+-} 1.96 SD) were 4169 mm''3-5911 mm''3 for volume of right side, 4097 mm''3-5940 mm''3 for volume of left side and 98-113 ms for T2 relaxation time. MTS was detected in 40 patients (55.5%): 23 cases involving the left side, 13 involving the right and 4 cases of bilateral asymmetric involvement. The 95% confidence intervals for the diagnostic validity of the results (sensitivity/specificity) were (88.8%-97.2%)/(87.6%-96.4%) for T1 volumetry, (88.8%-97.2%)(95.7%-100.3%) for FLAIR and (85.4%-96.6%)/(85.4%-96.6%) for T2 relaxometry. In 5 cases of MTS, astrophy of other extra hippocampal structures was also observed, and MTS was associated with an extra hippocampal lesion (dual pathology), especially neurona migration disorders, in 8 patients. Seventeen patients (23.5%) presented lesions without MTS (tumors, cortical dysplasias and heterotopias) and there was no MRI evidence of anomalies in 15 (21%). Twenty-five patients underwent surgical treatment: 20 with MTS (19 diagnosed according to MRI and one in whom there had been no abnormal findings), 4 with tumors and 1 with a ballooned

  20. Magnetic resonance in the diagnostic imaging study of mesial temporal sclerosis; Diagnostico por imagen con resonancia magnetica de la esclerosis temporal mesial

    Energy Technology Data Exchange (ETDEWEB)

    Pastor, E.; Sanchez, J. C.; Rodriguez, I.; Altuzarra, A.; Machado, F. [Hospital Universitario Virgen de las Nieves. Granada (Spain); Aguilar, D. [Hospital Clinico Universitario San Cecilio. Granada (Spain)

    2001-07-01

    Mesial temporal sclerosis (MTS) consists of hippocampal atrophy and gliosis and is the most common cause of temporal lobe epilepsy. The objective of the authors was to establish a magnetic resonance imaging (MRI) protocol for its diagnosis. A prospective study was carried out in 72 patients with drug resistant complex partial seizures (42 women and 30 men ranging in age from 6 to 66 year: mean: 30 years). Using a 1.5-Tesla magnet, paracoronal sections were made in hippocampi for T1-weighted inversion-recovery images and volume measurements, fluid-attenuated inversion-recovery (FLAIR) and T2 relaxometry. A control group of 30 health volunteers was included in the study. MTS was considered to be indicated by the presence of atrophy and hyperintensity in hippocampi on T2-weighted images. There were no differences among the hippocampi of the healthy individuals. The confidence intervals (mean{+-} 1.96 SD) were 4169 mm''3-5911 mm''3 for volume of right side, 4097 mm''3-5940 mm''3 for volume of left side and 98-113 ms for T2 relaxation time. MTS was detected in 40 patients (55.5%): 23 cases involving the left side, 13 involving the right and 4 cases of bilateral asymmetric involvement. The 95% confidence intervals for the diagnostic validity of the results (sensitivity/specificity) were (88.8%-97.2%)/(87.6%-96.4%) for T1 volumetry, (88.8%-97.2%)(95.7%-100.3%) for FLAIR and (85.4%-96.6%)/(85.4%-96.6%) for T2 relaxometry. In 5 cases of MTS, astrophy of other extra hippocampal structures was also observed, and MTS was associated with an extra hippocampal lesion (dual pathology), especially neurona migration disorders, in 8 patients. Seventeen patients (23.5%) presented lesions without MTS (tumors, cortical dysplasias and heterotopias) and there was no MRI evidence of anomalies in 15 (21%). Twenty-five patients underwent surgical treatment: 20 with MTS (19 diagnosed according to MRI and one in whom there had been no abnormal findings

  1. Navigation-assisted trans-inferotemporal cortex selective amygdalohippocampectomy for mesial temporal lobe epilepsy; preserving the temporal stem.

    Science.gov (United States)

    Kishima, Haruhiko; Kato, Amami; Oshino, Satoru; Tani, Naoki; Maruo, Tomoyuki; Khoo, Hui Ming; Yanagisawa, Takufumi; Edakawa, Kotaro; Kobayashi, Maki; Tanaka, Masataka; Hosomi, Koichi; Hirata, Masayuki; Yoshimine, Toshiki

    2017-03-01

    Selective amygdalohippocampectomy (SAH) can be used to obtain satisfactory seizure control in patients with mesial temporal lobe epilepsy (MTLE). Several SAH procedures have been reported to achieve satisfactory outcomes for seizure control, but none yield fully satisfactory outcomes for memory function. We hypothesized that preserving the temporal stem might play an important role. To preserve the temporal stem, we developed a minimally invasive surgical procedure, 'neuronavigation-assisted trans-inferotemporal cortex SAH' (TITC-SAH). TITC-SAH was performed in 23 patients with MTLE (MTLE on the language-non-dominant hemisphere, n = 11). The inferior horn of the lateral ventricle was approached via the inferior or middle temporal gyrus along the inferior temporal sulcus under neuronavigation guidance. The hippocampus was dissected in a subpial manner and resected en bloc together with the parahippocampal gyrus. Seizure control at one year and memory function at 6 months postoperatively were evaluated. One year after TITC-SAH, 20 of the 23 patients were seizure-free (ILAE class 1), 2 were class 2, and 1 was class 3. Verbal memory improved significantly in 13 patients with a diagnosis of hippocampal sclerosis, for whom WMS-R scores were available both pre- and post-operatively. Improvements were seen regardless of whether the SAH was on the language-dominant or non-dominant hemisphere. No major complication was observed. Navigation-assisted TITC-SAH performed for MTLE offers a simple, minimally invasive procedure that appears to yield excellent outcomes in terms of seizure control and preservation of memory function, because this procedure does not damage the temporal stem. TITC-SAH should be one of the feasible surgical procedures for MTLE. SAH: Amygdalohippocampectomy; MTLE: Mesial temporal lobe epilepsy (MTLE); TITC-SAH: Ttrans-inferotemporal cortex SAH; ILAE: International League Against Epilepsy (ILAE); MRI: Magnetic resonance imaging; EEG

  2. Psychiatric comorbidity in epilepsy: a study comparing patients with mesial temporal sclerosis and juvenile myoclonic epilepsy.

    Science.gov (United States)

    Filho, Gerardo Maria de Araújo; Rosa, Vivianne Pellegrino; Lin, Katia; Caboclo, Luís Otávio Sales Ferreira; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas

    2008-07-01

    We evaluated the frequency of psychiatric disorders (PDs) in a homogenous series of patients with temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS), as compared with patients with juvenile myoclonic epilepsy (JME), aiming to determine possible differences in psychiatric diagnoses between these two epileptic syndromes. Data from 170 patients with refractory TLE-MTS and from 100 patients with JME were reviewed and compared. The prevalence of PDs was high in both groups of patients with epilepsy: PDs were present in 85 patients with TLE-MTS (50%) and 49 patients with JME (49%). Among the TLE-MTS group, mood (25.8%), psychotic (15.8%), and anxiety (14.1%) disorders were the most frequent diagnoses, whereas anxiety and mood disorders (23 and 19%, respectively) were the most common among patients with JME. Psychoses were significantly associated with MTS (P<0.01) and anxiety disorders with JME (P<0.05). These findings suggest the existence of an anatomic correlation between PDs and brain structures involved in both epilepsy syndromes.

  3. 1H MR spectroscopy in histopathological subgroups of mesial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Hajek, Milan; Dezortova, Monika; Krsek, Pavel; Komarek, Vladimir; Marusic, Petr; Tomasek, Martin; Krijtova, Hana; Zamecnik, Josef; Kyncl, Martin

    2009-01-01

    The aim of the study was to analyze the lateralizing value of proton magnetic resonance spectroscopy ( 1 H MRS) in histopathologically different subgroups of mesial temporal lobe epilepsies (MTLE) and to correlate results with clinical, MRI and seizure outcome data. A group of 35 patients who underwent resective epilepsy surgery was retrospectively studied. Hippocampal 1 H MR spectra were evaluated. Metabolite concentrations were obtained using LCModel and NAA/Cr, NAA/Cho, NAA/(Cr+Cho), Cho/Cr ratios and coefficients of asymmetry were calculated. MRI correctly lateralized 89% of subjects and 1 H MRS 83%. MRI together with 1 H MRS correctly lateralized 100% of patients. Nineteen subjects had ''classical'' hippocampal sclerosis (HS), whereas the remaining 16 patients had ''mild'' HS. Nineteen patients had histopathologically proven malformation of cortical development (MCD) in the temporal pole; 16 subjects had only HS. No difference in 1 H MRS findings was found between patients in different histopathological subgroups of MTLE. Our results support the hypothesis that 1 H MRS abnormalities do not directly reflect histopathological changes in MTLE patients. Subjects with non-lateralized 1 H MRS abnormalities did not have a worse postoperative seizure outcome. We found no significant impact of contralateral 1 H MRS abnormality on post-surgical seizure outcome. (orig.)

  4. Brain SPECT in mesial temporal lobe epilepsy: comparison between visual analysis and SPM (Statistical Parametric Mapping)

    Energy Technology Data Exchange (ETDEWEB)

    Amorim, Barbara Juarez; Ramos, Celso Dario; Santos, Allan Oliveira dos; Lima, Mariana da Cunha Lopes de; Camargo, Edwaldo Eduardo; Etchebehere, Elba Cristina Sa de Camargo, E-mail: juarezbarbara@hotmail.co [State University of Campinas (UNICAMP), SP (Brazil). School of Medical Sciences. Dept. of Radiology; Min, Li Li; Cendes, Fernando [State University of Campinas (UNICAMP), SP (Brazil). School of Medical Sciences. Dept. of Neurology

    2010-04-15

    Objective: to compare the accuracy of SPM and visual analysis of brain SPECT in patients with mesial temporal lobe epilepsy (MTLE). Method: interictal and ictal SPECTs of 22 patients with MTLE were performed. Visual analysis were performed in interictal (VISUAL(inter)) and ictal (VISUAL(ictal/inter)) studies. SPM analysis consisted of comparing interictal (SPM(inter)) and ictal SPECTs (SPM(ictal)) of each patient to control group and by comparing perfusion of temporal lobes in ictal and interictal studies among themselves (SPM(ictal/inter)). Results: for detection of the epileptogenic focus, the sensitivities were as follows: VISUAL(inter)=68%; VISUAL(ictal/inter)=100%; SPM(inter)=45%; SPM(ictal)=64% and SPM(ictal/inter)=77%. SPM was able to detect more areas of hyperperfusion and hypoperfusion. Conclusion: SPM did not improve the sensitivity to detect epileptogenic focus. However, SPM detected different regions of hypoperfusion and hyperperfusion and is therefore a helpful tool for better understand pathophysiology of seizures in MTLE. (author)

  5. Pathophysiogenesis of Mesial Temporal Lobe Epilepsy: Is Prevention of Damage Antiepileptogenic?

    Science.gov (United States)

    Curia, G.; Lucchi, C.; Vinet, J.; Gualtieri, F.; Marinelli, C.; Torsello, A.; Costantino, L.; Biagini*,, G.

    2014-01-01

    Temporal lobe epilepsy (TLE) is frequently associated with hippocampal sclerosis, possibly caused by a primary brain injury that occurred a long time before the appearance of neurological symptoms. This type of epilepsy is characterized by refractoriness to drug treatment, so to require surgical resection of mesial temporal regions involved in seizure onset. Even this last therapeutic approach may fail in giving relief to patients. Although prevention of hippocampal damage and epileptogenesis after a primary event could be a key innovative approach to TLE, the lack of clear data on the pathophysiological mechanisms leading to TLE does not allow any rational therapy. Here we address the current knowledge on mechanisms supposed to be involved in epileptogenesis, as well as on the possible innovative treatments that may lead to a preventive approach. Besides loss of principal neurons and of specific interneurons, network rearrangement caused by axonal sprouting and neurogenesis are well known phenomena that are integrated by changes in receptor and channel functioning and modifications in other cellular components. In particular, a growing body of evidence from the study of animal models suggests that disruption of vascular and astrocytic components of the blood-brain barrier takes place in injured brain regions such as the hippocampus and piriform cortex. These events may be counteracted by drugs able to prevent damage to the vascular component, as in the case of the growth hormone secretagogue ghrelin and its analogues. A thoroughly investigation on these new pharmacological tools may lead to design effective preventive therapies. PMID:24251566

  6. {sup 1}H MR spectroscopy in histopathological subgroups of mesial temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Hajek, Milan; Dezortova, Monika [Institute for Clinical and Experimental Medicine, MR Unit, Department of Diagnostic and Interventional Radiology, Prague (Czech Republic); Krsek, Pavel; Komarek, Vladimir [Charles University, Department of Pediatric Neurology, Prague 5 (Czech Republic); Marusic, Petr; Tomasek, Martin; Krijtova, Hana [Charles University, Department of Neurology, Prague (Czech Republic); Zamecnik, Josef [Charles University, Department of Pathology and Molecular Medicine, Prague (Czech Republic); Kyncl, Martin [Charles University, Department of Radiology, Prague (Czech Republic)

    2009-02-15

    The aim of the study was to analyze the lateralizing value of proton magnetic resonance spectroscopy ({sup 1}H MRS) in histopathologically different subgroups of mesial temporal lobe epilepsies (MTLE) and to correlate results with clinical, MRI and seizure outcome data. A group of 35 patients who underwent resective epilepsy surgery was retrospectively studied. Hippocampal {sup 1}H MR spectra were evaluated. Metabolite concentrations were obtained using LCModel and NAA/Cr, NAA/Cho, NAA/(Cr+Cho), Cho/Cr ratios and coefficients of asymmetry were calculated. MRI correctly lateralized 89% of subjects and {sup 1}H MRS 83%. MRI together with {sup 1}H MRS correctly lateralized 100% of patients. Nineteen subjects had 'classical' hippocampal sclerosis (HS), whereas the remaining 16 patients had 'mild' HS. Nineteen patients had histopathologically proven malformation of cortical development (MCD) in the temporal pole; 16 subjects had only HS. No difference in {sup 1}H MRS findings was found between patients in different histopathological subgroups of MTLE. Our results support the hypothesis that {sup 1}H MRS abnormalities do not directly reflect histopathological changes in MTLE patients. Subjects with non-lateralized {sup 1}H MRS abnormalities did not have a worse postoperative seizure outcome. We found no significant impact of contralateral {sup 1}H MRS abnormality on post-surgical seizure outcome. (orig.)

  7. Brain SPECT in mesial temporal lobe epilepsy: comparison between visual analysis and SPM (Statistical Parametric Mapping)

    International Nuclear Information System (INIS)

    Amorim, Barbara Juarez; Ramos, Celso Dario; Santos, Allan Oliveira dos; Lima, Mariana da Cunha Lopes de; Camargo, Edwaldo Eduardo; Etchebehere, Elba Cristina Sa de Camargo; Min, Li Li; Cendes, Fernando

    2010-01-01

    Objective: to compare the accuracy of SPM and visual analysis of brain SPECT in patients with mesial temporal lobe epilepsy (MTLE). Method: interictal and ictal SPECTs of 22 patients with MTLE were performed. Visual analysis were performed in interictal (VISUAL(inter)) and ictal (VISUAL(ictal/inter)) studies. SPM analysis consisted of comparing interictal (SPM(inter)) and ictal SPECTs (SPM(ictal)) of each patient to control group and by comparing perfusion of temporal lobes in ictal and interictal studies among themselves (SPM(ictal/inter)). Results: for detection of the epileptogenic focus, the sensitivities were as follows: VISUAL(inter)=68%; VISUAL(ictal/inter)=100%; SPM(inter)=45%; SPM(ictal)=64% and SPM(ictal/inter)=77%. SPM was able to detect more areas of hyperperfusion and hypoperfusion. Conclusion: SPM did not improve the sensitivity to detect epileptogenic focus. However, SPM detected different regions of hypoperfusion and hyperperfusion and is therefore a helpful tool for better understand pathophysiology of seizures in MTLE. (author)

  8. Late onset temporal lobe epilepsy with MRI evidence of mesial temporal sclerosis following acute neurocysticercosis. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Eliane; Guerreiro, Carlos A.M.; Cendes, Fernando [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Neurologia]. E-mail: fcendes@unicamp.br

    2001-06-01

    The objective of this case report is to describe magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS) in a patient with new onset temporal lobe epilepsy (TLE) and acute neurocysticercosis with multiple cysts. A 56 years old man with new onset headache, Simple Partial Seizures and Complex Partial Seizures underwent CT scan and lumbar puncture as diagnose proceeding. Multiple cysts and meningitis were identified, with a positive immunology for cysticercosis. Seizures were recorded over the left temporal region in a routine EEG. Treatment with al bendazole was performed for 21 days, with clinical improvement and seizure remission after 4 months. An MRI scan 11 months after treatment, showed complete resolution of those cystic lesions and a left hippocampal atrophy (HA) with hyperintense T2 signal. The presence of HA and hyperintense T 2 signal in this patient has not, to date, been associated with a poor seizure control. Conclusions: This patient presented with MRI evidence of left MTS after new onset partial seizures of left temporal lobe origin. Although we did not have a previous MRI scan, it is likely that this hippocampal abnormality was due to the acute inflammatory response to cysticercosis associated to repeated partial seizures. This suggests that acute neurocysticercosis associated with repeated seizures may cause MTS and late onset TLE. (author)

  9. Late onset temporal lobe epilepsy with MRI evidence of mesial temporal sclerosis following acute neurocysticercosis. Case report

    International Nuclear Information System (INIS)

    Kobayashi, Eliane; Guerreiro, Carlos A.M.; Cendes, Fernando

    2001-01-01

    The objective of this case report is to describe magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS) in a patient with new onset temporal lobe epilepsy (TLE) and acute neurocysticercosis with multiple cysts. A 56 years old man with new onset headache, Simple Partial Seizures and Complex Partial Seizures underwent CT scan and lumbar puncture as diagnose proceeding. Multiple cysts and meningitis were identified, with a positive immunology for cysticercosis. Seizures were recorded over the left temporal region in a routine EEG. Treatment with al bendazole was performed for 21 days, with clinical improvement and seizure remission after 4 months. An MRI scan 11 months after treatment, showed complete resolution of those cystic lesions and a left hippocampal atrophy (HA) with hyperintense T2 signal. The presence of HA and hyperintense T 2 signal in this patient has not, to date, been associated with a poor seizure control. Conclusions: This patient presented with MRI evidence of left MTS after new onset partial seizures of left temporal lobe origin. Although we did not have a previous MRI scan, it is likely that this hippocampal abnormality was due to the acute inflammatory response to cysticercosis associated to repeated partial seizures. This suggests that acute neurocysticercosis associated with repeated seizures may cause MTS and late onset TLE. (author)

  10. Does the patient's hand hold the key to preventing secondary generalization in mesial temporal lobe epilepsy?

    Science.gov (United States)

    Uchida, Carina Gonçalves Pedroso; Barsottini, Orlando Graziani Povoas; Caboclo, Luís Otávio Sales Ferreira; de Araújo Filho, Gerardo Maria; Centeno, Ricardo Silva; Carrete, Henrique; Yacubian, Elza Márcia Targas

    2013-07-01

    This study aimed to analyze the impact of ictal dystonic posturing (DP) in postoperative seizure outcome and to assess the influence of DP in generalized tonic-clonic seizure (GTCS) occurrence during video-EEG monitoring of patients with temporal lobe epilepsy with mesial temporal sclerosis. The impact of DP on surgical outcome remains controversial. Moreover, DP has been recently associated with brain networks avoiding GTCS occurrence. Five hundred twenty-seven seizures of 171 patients who were submitted to standard anterior temporal lobectomy (ATL) between 2002 and 2010, with at least one year of post-surgical follow-up, were retrospectively analyzed and classified as with or without DP and as evolving or not to GTCS. The ictal semiologic correlates of DP, timing elapsed since precedent seizure and antiepileptic drug (AED) intake before each seizure were evaluated. Seizure outcome after ATL was assessed according to Engel's scale. Fifty-eight out of 171 patients (34%) exhibited ictal DP, of which 91.5% were always unilateral and contralateral to the operated side. DP was related to shorter seizures (p=0.007) and a much lower likelihood of the seizure evolving to GTCS (p=0.001), even during AED withdrawal (p=0.002). There was no association between DP and prognosis regarding seizure control as the result of the surgical resection, either in patients with shorter or in those with longer period of follow-up. Our data support the hypothesis that DP reflects a brain network activation that helps avoid GTCS, even during AED withdrawal. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Widespread extrahippocampal NAA/(Cr+Cho) abnormalities in TLE with and without mesial temporal sclerosis.

    Science.gov (United States)

    Mueller, Susanne G; Ebel, Andreas; Barakos, Jerome; Scanlon, Cathy; Cheong, Ian; Finlay, Daniel; Garcia, Paul; Weiner, Michael W; Laxer, Kenneth D

    2011-04-01

    MR spectroscopy has demonstrated extrahippocampal NAA/(Cr+Cho) reductions in medial temporal lobe epilepsy with (TLE-MTS) and without (TLE-no) mesial temporal sclerosis. Because of the limited brain coverage of those previous studies, it was, however, not possible to assess differences in the distribution and extent of these abnormalities between TLE-MTS and TLE-no. This study used a 3D whole brain echoplanar spectroscopic imaging (EPSI) sequence to address the following questions: (1) Do TLE-MTS and TLE-no differ regarding severity and distribution of extrahippocampal NAA/(Cr+Cho) reductions? (2) Do extrahippocampal NAA/(Cr+Cho) reductions provide additional information for focus lateralization? Forty-three subjects (12 TLE-MTS, 13 TLE-no, 18 controls) were studied with 3D EPSI. Statistical parametric mapping (SPM2) was used to identify regions of significantly decreased NAA/(Cr+Cho) in TLE groups and in individual patients. TLE-MTS and TLE-no had widespread extrahippocampal NAA/(Cr+Cho) reductions. NAA/(Cr+Cho) reductions had a bilateral fronto-temporal distribution in TLE-MTS and a more diffuse, less well defined distribution in TLE-no. Extrahippocampal NAA/(Cr+Cho) decreases in the single subject analysis showed a large inter-individual variability and did not provide additional focus lateralizing information. Extrahippocampal NAA/(Cr+Cho) reductions in TLE-MTS and TLE-no are neither focal nor homogeneous. This reduces their value for focus lateralization and suggests a heterogeneous etiology of extrahippocampal spectroscopic metabolic abnormalities in TLE.

  12. Serious adverse effects of gamma knife radiosurgery for mesial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Kawamura, Tetsuro; Onishi, Hiroaki; Kohda, Yukihiko; Hirose, Genjiro

    2012-01-01

    Gamma knife radiosurgery (GKRS) for mesial temporal lobe epilepsy (MTLE) has been proposed as an alternative to surgical resection. We report serious adverse effects of the treatment after follow-up periods over 9 years in 11 patients treated with GKRS between 1997 and 2000. The target volume of the entorhinoamygdalohippocampectomy area was 4.8-17.1 ml. Marginal dose of 20-25 Gy to the 50% isodose was delivered. One patient was drowned after suffering seizure 7 months after GKRS. Two patients did not show any reduction in seizure frequency over 9 and 18 months. Both patients requested open surgery and became seizure-free postoperatively. Four of the other eight patients were classified as Engel's class I within 4 years after GKRS. One of the four patients experienced symptomatic radiation-induced cerebral edema transiently, one developed radiation necrosis and required surgery 5 years after GKRS, and one developed cognitive impairment with hemiparesis 10 years after GKRS. Magnetic resonance (MR) imaging showed a large cyst in the irradiated temporal lobe. This patient recovered fully after the cyst excision. Only one patient became seizure-free and antiepileptic drug-free without symptomatic radiation-induced complications. However, MR imaging revealed abnormal enhancement, cyst formation, and diffuse white matter change in the irradiated temporal lobe 9 years after GKRS. GKRS for MTLE causes adverse effects of delayed seizure remission and symptomatic radiation-induced complications. Therefore, GKRS cannot be considered as an ideal alternative to surgery for MTLE. Long-term follow-up studies including MR imaging with contrast medium are required for the patients even after successful control of seizures. (author)

  13. Nonvisual spatial navigation fMRI lateralizes mesial temporal lobe epilepsy in a patient with congenital blindness.

    Science.gov (United States)

    Toller, Gianina; Adhimoolam, Babu; Grunwald, Thomas; Huppertz, Hans-Jürgen; König, Kristina; Jokeit, Hennric

    2015-01-01

    Nonvisual spatial navigation functional magnetic resonance imaging (fMRI) may help clinicians determine memory lateralization in blind individuals with refractory mesial temporal lobe epilepsy (MTLE). We report on an exceptional case of a congenitally blind woman with late-onset left MTLE undergoing presurgical memory fMRI. To activate mesial temporal structures despite the lack of visual memory, the patient was requested to recall familiar routes using nonvisual multisensory and verbal cues. Our findings demonstrate the diagnostic value of a nonvisual fMRI task to lateralize MTLE despite congenital blindness and may therefore contribute to the risk assessment for postsurgical amnesia in rare cases with refractory MTLE and accompanying congenital blindness.

  14. Assessment of working memory in patients with mesial temporal lobe epilepsy associated with unilateral hippocampal sclerosis.

    Science.gov (United States)

    Tudesco, Ivanda de Souza Silva; Vaz, Leonardo José; Mantoan, Marcele Araújo Silva; Belzunces, Erich; Noffs, Maria Helena; Caboclo, Luís Otávio Sales Ferreira; Yacubian, Elza Márcia Targas; Sakamoto, Américo Ceiki; Bueno, Orlando Francisco Amodeo

    2010-07-01

    The aim of the present study was to investigate whether working memory is impaired in mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), a controversial and largely unexplored matter. Twenty subjects with left MTLE-HS, 19 with right MTLE-HS, and 21 control right-handed subjects underwent neuropsychological assessment of episodic and semantic memory, executive functions, and specific working memory components. Left and right epileptogenic foci resulted in impairment of verbal and nonverbal episodic memory (verbal memory deficit greater in left MTLE-HS than in right MTLE-HS). In addition, patients with left MTLE-HS were impaired in learning paired associates, verbal fluency, and Trail Making. No differences were seen in the tests carried out to evaluate the working memory components (except visuospatial short-term memory in right MTLE-HS). In this study we did not detect reliable working memory impairment in patients with MTLE-HS with either a left or right focus in most tasks considered as tests of working memory components. Copyright 2010 Elsevier Inc. All rights reserved.

  15. Effect of seizure on hippocampus in mesial temporal lobe epilepsy and neocortical epilepsy: an MRS study

    International Nuclear Information System (INIS)

    Lee, S.K.; Kim, D.W.; Kim, K.K.; Chung, C.K.; Song, I.C.; Chang, K.H.

    2005-01-01

    This study was performed to evaluate the effect of seizures on the bilateral hippocampus in mesial temporal lobe epilepsy (mTLE) and neocortical epilepsy by single voxel proton magnetic resonance spectroscopy (MRS). Forty-one patients with mTLE having unilateral hippocampal sclerosis and 43 patients with a neocortical epilepsy who underwent subsequent epilepsy surgery were recruited. Ninety-five percent confidence intervals of N-acetyl aspartate/choline (NAA/Cho) and NAA/creatine (NAA/Cr) ratios in 20 healthy control subjects were used as threshold values to determine abnormal NAA/Cho and NAA/Cr. NAA/Cho and NAA/Cr were significantly lower in the ipsilateral hippocampus of mTLE and neocortical epilepsy. Using asymmetry indices for patients with bilaterally abnormal ratios of NAA/Cho and NAA/Cr in addition to using unilateral abnormal ratio, the seizure focus was correctly lateralized in 65.9% of patients with mTLE and 48.8% of neocortical epilepsy patients. Bilateral NAA/Cho abnormality was significantly related to a poor surgical outcome in mTLE. No significant relationship was found between the results of NAA/Cho or NAA/Cr and surgical outcome in neocortical epilepsy. The mean contralateral NAA/Cr ratio of the hippocampus in mTLE was significantly lower in patients with a history of secondary generalized tonic-clonic seizure (SGTCS) than in those without. (orig.)

  16. Scale invariance properties of intracerebral EEG improve seizure prediction in mesial temporal lobe epilepsy.

    Directory of Open Access Journals (Sweden)

    Kais Gadhoumi

    Full Text Available Although treatment for epilepsy is available and effective for nearly 70 percent of patients, many remain in need of new therapeutic approaches. Predicting the impending seizures in these patients could significantly enhance their quality of life if the prediction performance is clinically practical. In this study, we investigate the improvement of the performance of a seizure prediction algorithm in 17 patients with mesial temporal lobe epilepsy by means of a novel measure. Scale-free dynamics of the intracerebral EEG are quantified through robust estimates of the scaling exponents--the first cumulants--derived from a wavelet leader and bootstrap based multifractal analysis. The cumulants are investigated for the discriminability between preictal and interictal epochs. The performance of our recently published patient-specific seizure prediction algorithm is then out-of-sample tested on long-lasting data using combinations of cumulants and state similarity measures previously introduced. By using the first cumulant in combination with state similarity measures, up to 13 of 17 patients had seizures predicted above chance with clinically practical levels of sensitivity (80.5% and specificity (25.1% of total time under warning for prediction horizons above 25 min. These results indicate that the scale-free dynamics of the preictal state are different from those of the interictal state. Quantifiers of these dynamics may carry a predictive power that can be used to improve seizure prediction performance.

  17. Effect of seizure on hippocampus in mesial temporal lobe epilepsy and neocortical epilepsy: an MRS study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, S.K.; Kim, D.W.; Kim, K.K. [Seoul National University College of Medicine, Seoul National University Hospital, Department of Neurology, Chongno ku, Seoul (Korea); Chung, C.K. [Seoul National University College of Medicine, Seoul National University Hospital, Department of Neurosurgery, Chongno ku, Seoul (Korea); Song, I.C.; Chang, K.H. [Seoul National University College of Medicine, Seoul National University Hospital, Department of Radiology, Chongno ku, Seoul (Korea)

    2005-12-01

    This study was performed to evaluate the effect of seizures on the bilateral hippocampus in mesial temporal lobe epilepsy (mTLE) and neocortical epilepsy by single voxel proton magnetic resonance spectroscopy (MRS). Forty-one patients with mTLE having unilateral hippocampal sclerosis and 43 patients with a neocortical epilepsy who underwent subsequent epilepsy surgery were recruited. Ninety-five percent confidence intervals of N-acetyl aspartate/choline (NAA/Cho) and NAA/creatine (NAA/Cr) ratios in 20 healthy control subjects were used as threshold values to determine abnormal NAA/Cho and NAA/Cr. NAA/Cho and NAA/Cr were significantly lower in the ipsilateral hippocampus of mTLE and neocortical epilepsy. Using asymmetry indices for patients with bilaterally abnormal ratios of NAA/Cho and NAA/Cr in addition to using unilateral abnormal ratio, the seizure focus was correctly lateralized in 65.9% of patients with mTLE and 48.8% of neocortical epilepsy patients. Bilateral NAA/Cho abnormality was significantly related to a poor surgical outcome in mTLE. No significant relationship was found between the results of NAA/Cho or NAA/Cr and surgical outcome in neocortical epilepsy. The mean contralateral NAA/Cr ratio of the hippocampus in mTLE was significantly lower in patients with a history of secondary generalized tonic-clonic seizure (SGTCS) than in those without. (orig.)

  18. Asymmetrical hippocampal connectivity in mesial temporal lobe epilepsy: evidence from resting state fMRI

    Directory of Open Access Journals (Sweden)

    Castellano Gabriela

    2010-06-01

    Full Text Available Abstract Background Mesial temporal lobe epilepsy (MTLE, the most common type of focal epilepsy in adults, is often caused by hippocampal sclerosis (HS. Patients with HS usually present memory dysfunction, which is material-specific according to the hemisphere involved and has been correlated to the degree of HS as measured by postoperative histopathology as well as by the degree of hippocampal atrophy on magnetic resonance imaging (MRI. Verbal memory is mostly affected by left-sided HS, whereas visuo-spatial memory is more affected by right HS. Some of these impairments may be related to abnormalities of the network in which individual hippocampus takes part. Functional connectivity can play an important role to understand how the hippocampi interact with other brain areas. It can be estimated via functional Magnetic Resonance Imaging (fMRI resting state experiments by evaluating patterns of functional networks. In this study, we investigated the functional connectivity patterns of 9 control subjects, 9 patients with right MTLE and 9 patients with left MTLE. Results We detected differences in functional connectivity within and between hippocampi in patients with unilateral MTLE associated with ipsilateral HS by resting state fMRI. Functional connectivity resulted to be more impaired ipsilateral to the seizure focus in both patient groups when compared to control subjects. This effect was even more pronounced for the left MTLE group. Conclusions The findings presented here suggest that left HS causes more reduction of functional connectivity than right HS in subjects with left hemisphere dominance for language.

  19. Mesial temporal lobe epilepsy lateralization using SPHARM-based features of hippocampus and SVM

    Science.gov (United States)

    Esmaeilzadeh, Mohammad; Soltanian-Zadeh, Hamid; Jafari-Khouzani, Kourosh

    2012-02-01

    This paper improves the Lateralization (identification of the epileptogenic hippocampus) accuracy in Mesial Temporal Lobe Epilepsy (mTLE). In patients with this kind of epilepsy, usually one of the brain's hippocampi is the focus of the epileptic seizures, and resection of the seizure focus is the ultimate treatment to control or reduce the seizures. Moreover, the epileptogenic hippocampus is prone to shrinkage and deformation; therefore, shape analysis of the hippocampus is advantageous in the preoperative assessment for the Lateralization. The method utilized for shape analysis is the Spherical Harmonics (SPHARM). In this method, the shape of interest is decomposed using a set of bases functions and the obtained coefficients of expansion are the features describing the shape. To perform shape comparison and analysis, some pre- and post-processing steps such as "alignment of different subjects' hippocampi" and the "reduction of feature-space dimension" are required. To this end, first order ellipsoid is used for alignment. For dimension reduction, we propose to keep only the SPHARM coefficients with maximum conformity to the hippocampus shape. Then, using these coefficients of normal and epileptic subjects along with 3D invariants, specific lateralization indices are proposed. Consequently, the 1536 SPHARM coefficients of each subject are summarized into 3 indices, where for each index the negative (positive) value shows that the left (right) hippocampus is deformed (diseased). Employing these indices, the best achieved lateralization accuracy for clustering and classification algorithms are 85% and 92%, respectively. This is a significant improvement compared to the conventional volumetric method.

  20. Electrophysiological resting-state biomarker for diagnosing mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Jin, Seung-Hyun; Chung, Chun Kee

    2017-01-01

    The main aim of the present study was to evaluate whether resting-state functional connectivity of magnetoencephalography (MEG) signals can differentiate patients with mesial temporal lobe epilepsy (MTLE) from healthy controls (HC) and can differentiate between right and left MTLE as a diagnostic biomarker. To this end, a support vector machine (SVM) method among various machine learning algorithms was employed. We compared resting-state functional networks between 46 MTLE (right MTLE=23; left MTLE=23) patients with histologically proven HS who were free of seizure after surgery, and 46 HC. The optimal SVM group classifier distinguished MTLE patients with a mean accuracy of 95.1% (sensitivity=95.8%; specificity=94.3%). Increased connectivity including the right posterior cingulate gyrus and decreased connectivity including at least one sensory-related resting-state network were key features reflecting the differences between MTLE patients and HC. The optimal SVM model distinguished between right and left MTLE patients with a mean accuracy of 76.2% (sensitivity=76.0%; specificity=76.5%). We showed the potential of electrophysiological resting-state functional connectivity, which reflects brain network reorganization in MTLE patients, as a possible diagnostic biomarker to differentiate MTLE patients from HC and differentiate between right and left MTLE patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Perspectives on treatment options for mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Palleria, Caterina; Coppola, Antonietta; Citraro, Rita; Del Gaudio, Luigi; Striano, Salvatore; De Sarro, Giovambattista; Russo, Emilio

    2015-01-01

    Mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS) is a syndrome that is often refractory to drug treatment. The effects on specific syndromes are not currently available from the pre-marketing clinical development of new AEDs; this does not allow the prediction of whether new drugs will be more effective in the treatment of some patients. We have reviewed all the existing literature relevant to the understanding of a potential effectiveness in MTLE-HS patients for the latest AEDs, namely brivaracetam, eslicarbazepine, lacosamide, perampanel and retigabine also including the most relevant clinical data and a brief description of their pharmacological profile. Records were identified using predefined search criteria using electronic databases (e.g., PubMed, Cochrane Library Database of Systematic Reviews). Primary peer-reviewed articles published up to the 15 June 2015 were included. All the drugs considered have the potential to be effective in the treatment of MTLE-HS; in fact, they possess proven efficacy in animal models; currently considered valuable tools for predicting drug efficacy in TLE. Furthermore, for some of these (e.g., lacosamide and eslicarbazepine) data are already available from post-marketing studies while brivaracetam acting on SV2A like levetiracetam might have the same potential effectiveness with the possibility to be more efficacious considering its ability to inhibit voltage gated sodium channels; finally, perampanel and retigabine are very effective drugs in animal models of TLE.

  2. Differential gene expression in dentate granule cells in mesial temporal lobe epilepsy with and without hippocampal sclerosis.

    Science.gov (United States)

    Griffin, Nicole G; Wang, Yu; Hulette, Christine M; Halvorsen, Matt; Cronin, Kenneth D; Walley, Nicole M; Haglund, Michael M; Radtke, Rodney A; Skene, J H Pate; Sinha, Saurabh R; Heinzen, Erin L

    2016-03-01

    Hippocampal sclerosis is the most common neuropathologic finding in cases of medically intractable mesial temporal lobe epilepsy. In this study, we analyzed the gene expression profiles of dentate granule cells of patients with mesial temporal lobe epilepsy with and without hippocampal sclerosis to show that next-generation sequencing methods can produce interpretable genomic data from RNA collected from small homogenous cell populations, and to shed light on the transcriptional changes associated with hippocampal sclerosis. RNA was extracted, and complementary DNA (cDNA) was prepared and amplified from dentate granule cells that had been harvested by laser capture microdissection from surgically resected hippocampi from patients with mesial temporal lobe epilepsy with and without hippocampal sclerosis. Sequencing libraries were sequenced, and the resulting sequencing reads were aligned to the reference genome. Differential expression analysis was used to ascertain expression differences between patients with and without hippocampal sclerosis. Greater than 90% of the RNA-Seq reads aligned to the reference. There was high concordance between transcriptional profiles obtained for duplicate samples. Principal component analysis revealed that the presence or absence of hippocampal sclerosis was the main determinant of the variance within the data. Among the genes up-regulated in the hippocampal sclerosis samples, there was significant enrichment for genes involved in oxidative phosphorylation. By analyzing the gene expression profiles of dentate granule cells from surgically resected hippocampal specimens from patients with mesial temporal lobe epilepsy with and without hippocampal sclerosis, we have demonstrated the utility of next-generation sequencing methods for producing biologically relevant results from small populations of homogeneous cells, and have provided insight on the transcriptional changes associated with this pathology. Wiley Periodicals, Inc. © 2016

  3. Morphometric MRI features are associated with surgical outcome in mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Garcia, Maria Teresa Fernandes Castilho; Gaça, Larissa Botelho; Sandim, Gabriel Barbosa; Assunção Leme, Idaiane Batista; Carrete, Henrique; Centeno, Ricardo Silva; Sato, João Ricardo; Yacubian, Elza Márcia Targas

    2017-05-01

    Corticoamygdalohippocampectomy (CAH) improves seizure control, quality of life, and decreases mortality for refractory mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). One-third of patients continue having seizures, and it is pivotal to determine structural abnormalities that might influence the postoperative outcome. Studies indicate that nonhippocampal regions may play a role in the epileptogenic network in MTLE-HS and could generate seizures postoperatively. The aim of this study is to analyze areas of atrophy, not always detected on routine MRI, comparing patients who became seizure free (SF) with those non seizure free (NSF) after CAH, in an attempt to establish possible predictors of surgical outcome. 105 patients with refractory MTLE-HS submitted to CAH (59 left MTLE; 46 males) and 47 controls were enrolled. FreeSurfer was performed for cortical thickness and volume estimation comparing patients to controls and SF versus NSF patients. The final sample after post processing procedures resulted in 99 patients. Cortical thickness analyses showed reductions in left insula in NSF patients compared to those SF. Significant volume reductions in SF patients were present in bilateral thalami, hippocampi and pars opercularis, left parahippocampal gyrus and right temporal pole. In NSF patients reductions were present bilaterally in thalami, hippocampi, entorhinal cortices, superior frontal and supramarginal gyri; on the left: superior and middle temporal gyri, temporal pole, parahippocampal gyrus, pars opercularis and middle frontal gyrus; and on the right: precentral, superior, middle and inferior temporal gyri. Comparison between SF and NSF patients showed ipsilateral gray matter reductions in the right entorhinal cortex (p=0.003) and contralateral parahippocampal gyrus (p=0.05) in right MTLE-HS. Patients NSF had a longer duration of epilepsy than those SF (p=0.028). NSF patients exhibited more extensive areas of atrophy than SF ones. As entorhinal

  4. Clinico-pathological factors influencing surgical outcome in drug resistant epilepsy secondary to mesial temporal sclerosis.

    Science.gov (United States)

    Savitr Sastri, B V; Arivazhagan, A; Sinha, Sanjib; Mahadevan, Anita; Bharath, R D; Saini, J; Jamuna, R; Kumar, J Keshav; Rao, S L; Chandramouli, B A; Shankar, S K; Satishchandra, P

    2014-05-15

    Mesial temporal sclerosis (MTS) is the most common cause of drug resistant epilepsy amenable for surgical treatment and seizure control. This study analyzed the outcome of patients with MTS following anterior temporal lobectomy and amygdalohippocampectomy (ATL-AH) over 10 years and correlated the electrophysiological and radiological factors with the post operative seizure outcome. Eighty seven patients were included in the study. Sixty seven (77.2%) patients had an Engel Class 1 outcome, 9 (11.4%) had Class 2 outcome. Engel's class 1 outcome was achieved in 89.9% at 1 year, while it reduced slightly to 81.9% at 2 years and 76.2% at 5 year follow up. Seventy seven (88.5%) patients had evidence of hippocampal sclerosis on histopathology. Dual pathology was observed in 19 of 77 specimens with hippocampal sclerosis, but did not influence the outcome. Factors associated with an unfavorable outcome included male gender (p=0.04), and a higher frequency of pre-operative seizures (p=0.005), whereas the presence of febrile seizures (p=0.048) and loss of hippocampal neurons in CA4 region on histopathology (p=0.040) were associated with favorable outcome. The effect of CA4 loss on outcome is probably influenced by neuronal loss in other subfields as well since isolated CA4 loss was rare. Abnormal post operative EEG at the end of 1 week was found to be a significant factor predicting unfavorable outcome (p=0.005). On multivariate analysis, the pre-operative seizure frequency was the only significant factor affecting outcome. The present study observed excellent seizure free outcome in a carefully selected cohort of patients with MTS with refractory epilepsy. The presence of dual pathology did not influence the outcome. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Large-scale brain networks are distinctly affected in right and left mesial temporal lobe epilepsy.

    Science.gov (United States)

    de Campos, Brunno Machado; Coan, Ana Carolina; Lin Yasuda, Clarissa; Casseb, Raphael Fernandes; Cendes, Fernando

    2016-09-01

    Mesial temporal lobe epilepsy (MTLE) with hippocampus sclerosis (HS) is associated with functional and structural alterations extending beyond the temporal regions and abnormal pattern of brain resting state networks (RSNs) connectivity. We hypothesized that the interaction of large-scale RSNs is differently affected in patients with right- and left-MTLE with HS compared to controls. We aimed to determine and characterize these alterations through the analysis of 12 RSNs, functionally parceled in 70 regions of interest (ROIs), from resting-state functional-MRIs of 99 subjects (52 controls, 26 right- and 21 left-MTLE patients with HS). Image preprocessing and statistical analysis were performed using UF(2) C-toolbox, which provided ROI-wise results for intranetwork and internetwork connectivity. Intranetwork abnormalities were observed in the dorsal default mode network (DMN) in both groups of patients and in the posterior salience network in right-MTLE. Both groups showed abnormal correlation between the dorsal-DMN and the posterior salience, as well as between the dorsal-DMN and the executive-control network. Patients with left-MTLE also showed reduced correlation between the dorsal-DMN and visuospatial network and increased correlation between bilateral thalamus and the posterior salience network. The ipsilateral hippocampus stood out as a central area of abnormalities. Alterations on left-MTLE expressed a low cluster coefficient, whereas the altered connections on right-MTLE showed low cluster coefficient in the DMN but high in the posterior salience regions. Both right- and left-MTLE patients with HS have widespread abnormal interactions of large-scale brain networks; however, all parameters evaluated indicate that left-MTLE has a more intricate bihemispheric dysfunction compared to right-MTLE. Hum Brain Mapp 37:3137-3152, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. © 2016 The Authors Human Brain Mapping Published by

  6. Imaging of odor perception delineates functional disintegration of the limbic circuits in mesial temporal lobe epilepsy.

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    Ciumas, Carolina; Lindström, Per; Aoun, Bernard; Savic, Ivanka

    2008-01-15

    Metabolic and neuro-receptor abnormalities within the extrafocal limbic circuits are established in mesial temporal lobe epilepsy (MTLE). However, very little is known about how these circuits process external stimuli. We tested whether odor activation can help delineate limbic functional disintegration in MTLE, and measured cerebral blood flow with PET during birhinal smelling of familiar and unfamiliar odors, using smelling of odorless air as the baseline condition. Patients with MTLE (13 left-sided, 10 right-sided) and 21 controls were investigated. In addition to odor activation, the analysis included functional connectivity, using right and left piriform cortex as seed regions. Healthy controls activated the amygdala, piriform, anterior insular, and cingulate cortices on both sides. Smelling of familiar odors engaged, in addition, the right parahippocampus, and the left Brodmann Area (BA) 44, 45, 47. Patients failed to activate the amygdala, piriform and the anterior insular cortex in the epileptogenic hemisphere. Furthermore, those with left MTLE did not activate the left BA 44, 45 and 47 with familiar odors, which they perceived as less familiar than controls. Congruent with the activation data each seed region was in patients functionally disconnected with the contralateral amygdala+piriform+insular cortex. The functional disintegration in patients exceeded the reduced activation, and included the contralateral temporal neocortex, and in subjects with right MTLE also the right orbitofrontal cortex. Imaging of odor perception may be used to delineate functional disintegration of the limbic networks in MTLE. It shows an altered response in several regions, which may underlie some interictal behavioral problems associated with this condition.

  7. Right fronto-limbic atrophy is associated with reduced empathy in refractory unilateral mesial temporal lobe epilepsy.

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    Toller, Gianina; Adhimoolam, Babu; Rankin, Katherine P; Huppertz, Hans-Jürgen; Kurthen, Martin; Jokeit, Hennric

    2015-11-01

    Refractory mesial temporal lobe epilepsy (MTLE) is the most frequent focal epilepsy and is often accompanied by deficits in social cognition including emotion recognition, theory of mind, and empathy. Consistent with the neuronal networks that are crucial for normal social-cognitive processing, these impairments have been associated with functional changes in fronto-temporal regions. However, although atrophy in unilateral MTLE also affects regions of the temporal and frontal lobes that underlie social cognition, little is known about the structural correlates of social-cognitive deficits in refractory MTLE. In the present study, a psychometrically validated empathy questionnaire was combined with whole-brain voxel-based morphometry (VBM) to investigate the relationship between self-reported affective and cognitive empathy and gray matter volume in 55 subjects (13 patients with right MTLE, 9 patients with left MTLE, and 33 healthy controls). Consistent with the brain regions underlying social cognition, our results show that lower affective and cognitive empathy was associated with smaller volume in predominantly right fronto-limbic regions, including the right hippocampus, parahippocampal gyrus, thalamus, fusiform gyrus, inferior temporal gyrus, dorsomedial and dorsolateral prefrontal cortices, and in the bilateral midbrain. The only region that was associated with both affective and cognitive empathy was the right mesial temporal lobe. These findings indicate that patients with right MTLE are at increased risk for reduced empathy towards others' internal states and they shed new light on the structural correlates of impaired social cognition frequently accompanying refractory MTLE. In line with previous evidence from patients with neurodegenerative disease and stroke, the present study suggests that empathy depends upon the integrity of right fronto-limbic and brainstem regions and highlights the importance of the right mesial temporal lobe and midbrain

  8. Hippocampal CA3 transcriptome signature correlates with initial precipitating injury in refractory mesial temporal lobe epilepsy.

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    Silvia Y Bando

    Full Text Available BACKGROUND: Prolonged febrile seizures constitute an initial precipitating injury (IPI commonly associated with refractory mesial temporal lobe epilepsy (RMTLE. In order to investigate IPI influence on the transcriptional phenotype underlying RMTLE we comparatively analyzed the transcriptomic signatures of CA3 explants surgically obtained from RMTLE patients with (FS or without (NFS febrile seizure history. Texture analyses on MRI images of dentate gyrus were conducted in a subset of surgically removed sclerotic hippocampi for identifying IPI-associated histo-radiological alterations. METHODOLOGY/PRINCIPAL FINDINGS: DNA microarray analysis revealed that CA3 global gene expression differed significantly between FS and NFS subgroups. An integrative functional genomics methodology was used for characterizing the relations between GO biological processes themes and constructing transcriptional interaction networks defining the FS and NFS transcriptomic signatures and its major gene-gene links (hubs. Co-expression network analysis showed that: i CA3 transcriptomic profiles differ according to the IPI; ii FS distinctive hubs are mostly linked to glutamatergic signalization while NFS hubs predominantly involve GABAergic pathways and neurotransmission modulation. Both networks have relevant hubs related to nervous system development, what is consistent with cell genesis activity in the hippocampus of RMTLE patients. Moreover, two candidate genes for therapeutic targeting came out from this analysis: SSTR1, a relevant common hub in febrile and afebrile transcriptomes, and CHRM3, due to its putative role in epilepsy susceptibility development. MRI texture analysis allowed an overall accuracy of 90% for pixels correctly classified as belonging to FS or NFS groups. Histological examination revealed that granule cell loss was significantly higher in FS hippocampi. CONCLUSIONS/SIGNIFICANCE: CA3 transcriptional signatures and dentate gyrus morphology fairly

  9. Multivariate pattern analysis reveals anatomical connectivity differences between the left and right mesial temporal lobe epilepsy

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    Peng Fang

    2015-01-01

    Full Text Available Previous studies have demonstrated differences of clinical signs and functional brain network organizations between the left and right mesial temporal lobe epilepsy (mTLE, but the anatomical connectivity differences underlying functional variance between the left and right mTLE remain uncharacterized. We examined 43 (22 left, 21 right mTLE patients with hippocampal sclerosis and 39 healthy controls using diffusion tensor imaging. After the whole-brain anatomical networks were constructed for each subject, multivariate pattern analysis was applied to classify the left mTLE from the right mTLE and extract the anatomical connectivity differences between the left and right mTLE patients. The classification results reveal 93.0% accuracy for the left mTLE versus the right mTLE, 93.4% accuracy for the left mTLE versus controls and 90.0% accuracy for the right mTLE versus controls. Compared with the right mTLE, the left mTLE exhibited a different connectivity pattern in the cortical-limbic network and cerebellum. The majority of the most discriminating anatomical connections were located within or across the cortical-limbic network and cerebellum, thereby indicating that these disease-related anatomical network alterations may give rise to a portion of the complex of emotional and memory deficit between the left and right mTLE. Moreover, the orbitofrontal gyrus, cingulate cortex, hippocampus and parahippocampal gyrus, which exhibit high discriminative power in classification, may play critical roles in the pathophysiology of mTLE. The current study demonstrated that anatomical connectivity differences between the left mTLE and the right mTLE may have the potential to serve as a neuroimaging biomarker to guide personalized diagnosis of the left and right mTLE.

  10. Low and High Frequency Hippocampal Stimulation for Drug-Resistant Mesial Temporal Lobe Epilepsy.

    Science.gov (United States)

    Lim, Siew-Na; Lee, Ching-Yi; Lee, Shih-Tseng; Tu, Po-Hsun; Chang, Bao-Luen; Lee, Chih-Hong; Cheng, Mei-Yun; Chang, Chun-Wei; Tseng, Wei-En Johnny; Hsieh, Hsiang-Yao; Chiang, Hsing-I; Wu, Tony

    2016-06-01

    Electrical stimulation of the hippocampus offers the possibility to treat patients with mesial temporal lobe epilepsy (MTLE) who are not surgical candidates. We report long-term follow-up results in five patients receiving low or high frequency hippocampal stimulation for drug-resistant MTLE. The patients underwent stereotactic implantation of quadripolar stimulating electrodes in the hippocampus. Two of the patients received unilateral electrode implantation, while the other three received bilateral implantation. Stimulation of the hippocampal electrodes was turned ON immediately after the implantation of an implantable pulse generator, with initial stimulation parameters: 1 V, 90-150 μs, 5 or 145 Hz. The frequency of seizures was monitored and compared with preimplantation baseline data. Two men and three women, aged 27-61 years were studied, with a mean follow-up period of 38.4 months (range, 30-42 months). The baseline seizure frequency was 2.0-15.3/month. The five patients had an average 45% (range 22-72%) reduction in the frequency of seizures after hippocampal stimulation over the study period. Low frequency hippocampal stimulation decreased the frequency of seizures in two patients (by 54% and 72%, respectively). No implantation- or stimulation-related side effects were reported. Electrical stimulation of the hippocampus is a minimally invasive and reversible method that can improve seizure outcomes in patients with drug-resistant MTLE. The optimal frequency of stimulation varied from patient to patient and therefore required individual setting. These experimental results warrant further controlled studies with a large patient population to evaluate the long-term effect of hippocampal stimulation with different stimulation parameters. © 2016 The Authors. Neuromodulation: Technology at the Neural Interface published by Wiley Periodicals, Inc. on behalf of International Neuromodulation Society.

  11. Familial mesial temporal lobe epilepsy and the borderland of déjà vu.

    Science.gov (United States)

    Perucca, Piero; Crompton, Douglas E; Bellows, Susannah T; McIntosh, Anne M; Kalincik, Tomas; Newton, Mark R; Vajda, Frank J E; Scheffer, Ingrid E; Kwan, Patrick; O'Brien, Terence J; Tan, K Meng; Berkovic, Samuel F

    2017-08-01

    The cause of mesial temporal lobe epilepsy (MTLE) is often unknown. We ascertained to what extent newly diagnosed nonlesional MTLE actually represents familial MTLE (FMTLE). We identified all consecutive patients presenting to the Austin Health First Seizure Clinic with MTLE and normal magnetic resonance imaging (MRI) or MRI evidence of hippocampal sclerosis over a 10-year period. Patients' first-degree relatives and pairwise age- and sex-matched controls underwent a comprehensive epilepsy interview. Each interview transcript was reviewed independently by 2 epileptologists, blinded to relative or control status. Reviewers classified each subject as follows: epilepsy, specifying if MTLE; manifestations suspicious for epilepsy; or unaffected. Physiological déjà vu was noted. Forty-four patients were included. At the Clinic, MTLE had been recognized to be familial in 2 patients only. Among 242 subjects interviewed, MTLE was diagnosed in 9 of 121 relatives versus 0 of 121 controls (p = 0.008). All affected relatives had seizures with intense déjà vu and accompanying features; 6 relatives had not been previously diagnosed. Déjà vu experiences that were suspicious, but not diagnostic, of MTLE occurred in 6 additional relatives versus none of the controls (p = 0.04). Physiological déjà vu was common, and did not differ significantly between relatives and controls. After completing the relatives' interviews, FMTLE was diagnosed in 8 of 44 patients (18.2%). FMTLE accounts for almost one-fifth of newly diagnosed nonlesional MTLE, and it is largely unrecognized without direct questioning of relatives. Relatives of patients with MTLE may experience déjà vu phenomena that clinically lie in the "borderland" between epileptic seizures and physiological déjà vu. Ann Neurol 2017;82:166-176. © 2017 American Neurological Association.

  12. Multivariate pattern analysis reveals anatomical connectivity differences between the left and right mesial temporal lobe epilepsy.

    Science.gov (United States)

    Fang, Peng; An, Jie; Zeng, Ling-Li; Shen, Hui; Chen, Fanglin; Wang, Wensheng; Qiu, Shijun; Hu, Dewen

    2015-01-01

    Previous studies have demonstrated differences of clinical signs and functional brain network organizations between the left and right mesial temporal lobe epilepsy (mTLE), but the anatomical connectivity differences underlying functional variance between the left and right mTLE remain uncharacterized. We examined 43 (22 left, 21 right) mTLE patients with hippocampal sclerosis and 39 healthy controls using diffusion tensor imaging. After the whole-brain anatomical networks were constructed for each subject, multivariate pattern analysis was applied to classify the left mTLE from the right mTLE and extract the anatomical connectivity differences between the left and right mTLE patients. The classification results reveal 93.0% accuracy for the left mTLE versus the right mTLE, 93.4% accuracy for the left mTLE versus controls and 90.0% accuracy for the right mTLE versus controls. Compared with the right mTLE, the left mTLE exhibited a different connectivity pattern in the cortical-limbic network and cerebellum. The majority of the most discriminating anatomical connections were located within or across the cortical-limbic network and cerebellum, thereby indicating that these disease-related anatomical network alterations may give rise to a portion of the complex of emotional and memory deficit between the left and right mTLE. Moreover, the orbitofrontal gyrus, cingulate cortex, hippocampus and parahippocampal gyrus, which exhibit high discriminative power in classification, may play critical roles in the pathophysiology of mTLE. The current study demonstrated that anatomical connectivity differences between the left mTLE and the right mTLE may have the potential to serve as a neuroimaging biomarker to guide personalized diagnosis of the left and right mTLE.

  13. Immunogenetic predisposing factors for mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Leal, Bárbara; Chaves, João; Carvalho, Cláudia; Bettencourt, Andreia; Brito, Cláudia; Boleixa, Daniela; Freitas, Joel; Brás, Sandra; Lopes, João; Ramalheira, João; Costa, Paulo P; da Silva, Berta Martins; da Silva, António Martins

    2018-04-01

    Neuroinflammation appears as an important epileptogenic mechanism. Experimental and clinical studies have demonstrated an upregulation of pro-inflammatory cytokines such as IL-1β and TNF-α, in mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). Expression of these cytokines can be modulated by polymorphisms such as rs16944 and rs1800629, respectively, both of which have been associated with febrile seizures (FS) and MTLE-HS development. The human leukocyte antigen (HLA) system has also been implicated in diverse epileptic entities, suggesting a variable role of this system in epilepsy. Our aim was to analyse the association between immunogenetic factors and MTLE-HS development. For that rs16944 (-511 T>C, IL-1β), rs1800629 (-308 G>A, TNF-α) polymorphisms and HLA-DRB1 locus were genotyped in a Portuguese Population. We studied 196 MTLE-HS patients (108 females, 88 males, 44.7 ± 12.0 years, age of onset = 13.6 ± 10.3 years, 104 with FS antecedents) and 282 healthy controls in a case-control study. The frequency of rs16944 TT genotype was higher in MTLE-HS patients compared to controls (14.9% in MTLE-HS vs. 7.7% in controls, p = 0.021, OR [95% CI] = 2.20 [1.13-4.30]). This association was independent of FS antecedents. No association was observed between rs1800629 genotypes or HLA-DRB1 alleles and MTLE-HS susceptibility. Also, no correlation was observed between the studied polymorphisms and disease age of onset. The rs16944 TT genotype is associated with MTLE-HS development what may be explained by the higher IL-1β levels produced by this genotype. High IL-1β levels may have neurotoxic effects or imbalance neurotransmission leading to seizures.

  14. Comparative effectiveness of antiepileptic drugs in patients with mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Androsova, Ganna; Krause, Roland; Borghei, Mojgansadat; Wassenaar, Merel; Auce, Pauls; Avbersek, Andreja; Becker, Felicitas; Berghuis, Bianca; Campbell, Ellen; Coppola, Antonietta; Francis, Ben; Wolking, Stefan; Cavalleri, Gianpiero L; Craig, John; Delanty, Norman; Koeleman, Bobby P C; Kunz, Wolfram S; Lerche, Holger; Marson, Anthony G; Sander, Josemir W; Sills, Graeme J; Striano, Pasquale; Zara, Federico; Sisodiya, Sanjay M; Depondt, Chantal

    2017-10-01

    Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is a common epilepsy syndrome that is often poorly controlled by antiepileptic drug (AED) treatment. Comparative AED effectiveness studies in this condition are lacking. We report retention, efficacy, and tolerability in a cohort of patients with MTLE-HS. Clinical data were collected from a European database of patients with epilepsy. We estimated retention, 12-month seizure freedom, and adverse drug reaction (ADR) rates for the 10 most commonly used AEDs in patients with MTLE-HS. Seven hundred sixty-seven patients with a total of 3,249 AED trials were included. The highest 12-month retention rates were observed with carbamazepine (85.9%), valproate (85%), and clobazam (79%). Twelve-month seizure freedom rates varied from 1.2% for gabapentin and vigabatrin to 11% for carbamazepine. Response rates were highest for AEDs that were prescribed as initial treatment and lowest for AEDs that were used in a third or higher instance. ADRs were reported in 47.6% of patients, with the highest rates observed with oxcarbazepine (35.7%), topiramate (30.9%), and pregabalin (27.4%), and the lowest rates with clobazam (6.5%), gabapentin (8.9%), and lamotrigine (16.6%). The most commonly reported ADRs were lethargy and drowsiness, dizziness, vertigo and ataxia, and blurred vision and diplopia. Our results did not demonstrate any clear advantage of newer versus older AEDs. Our results provide useful insights into AED retention, efficacy, and ADR rates in patients with MTLE-HS. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  15. Abnormalities of hippocampal signal intensity in patients with familial mesial temporal lobe epilepsy

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    Coan A.C.

    2004-01-01

    Full Text Available Mesial temporal lobe epilepsy (MTLE is associated with hippocampal atrophy and hippocampal signal abnormalities. In our series of familial MTLE (FMTLE, we found a high proportion of hippocampal abnormalities. To quantify signal abnormalities in patients with FMTLE we studied 152 individuals (46 of them asymptomatic with FMTLE. We used NIH-Image® for volumetry and signal quantification in coronal T1 inversion recovery and T2 for all cross-sections of the hippocampus. Values diverging by 2 or more SD from the control mean were considered abnormal. T2 hippocampal signal abnormalities were found in 52% of all individuals: 54% of affected subjects and 48% of asymptomatic subjects. T1 hippocampal signal changes were found in 34% of all individuals: 42.5% of affected subjects and 15% of asymptomatic subjects. Analysis of the hippocampal head (first three slices revealed T2 abnormalities in 73% of all individuals (74% of affected subjects and 72% of asymptomatic subjects and T1 abnormalities in 59% (67% of affected subjects and 41% of asymptomatic subjects. Affected individuals had smaller volumes than controls (P < 0.0001. There was no difference in hippocampal volumes between asymptomatic subjects and controls, although 39% of asymptomatic patients had hippocampal atrophy. Patients with an abnormal hippocampal signal (133 individuals had smaller ipsilateral volume, but no linear correlation could be determined. Hippocampal signal abnormalities in FMTLE were more frequently found in the hippocampal head in both affected and asymptomatic family members, including those with normal volumes. These results indicate that subtle abnormalities leading to an abnormal hippocampal signal in FMTLE are not necessarily related to seizures and may be determined by genetic factors.

  16. Correlation of neuropsychological and metabolic changes after epilepsy surgery in patients with left mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Güvenç, Canan; Dupont, Patrick; Van den Stock, Jan; Seynaeve, Laura; Porke, Kathleen; Dries, Eva; Van Bouwel, Karen; van Loon, Johannes; Theys, Tom; Goffin, Karolien E; Van Paesschen, Wim

    2018-04-12

    Epilepsy surgery often causes changes in cognition and cerebral glucose metabolism. Our aim was to explore relationships between pre- and postoperative cerebral metabolism as measured with 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) and neuropsychological test scores in patients with left mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), who were rendered seizure-free after epilepsy surgery. Thirteen patients were included. All had neuropsychological testing and an interictal FDG-PET scan of the brain pre- and postoperative. Correlations between changes in neuropsychological test scores and metabolism were examined using statistical parametric mapping (SPM). There were no significant changes in the neuropsychological test scores pre- and postoperatively at the group level. Decreased metabolism was observed in the left mesial temporal regions and occipital lobe. Increased metabolism was observed in the bi-frontal and right parietal lobes, temporal lobes, occipital lobes, thalamus, cerebellum, and vermis. In these regions, we did not find a correlation between changes in metabolism and neuropsychological test scores. A significant negative correlation, however, was found between metabolic changes in the precuneus and Boston Naming Test (BNT) scores. There are significant metabolic decreases in the left mesial temporal regions and increases in the bi-frontal lobes; right parietal, temporal, and occipital lobes; right thalamus; cerebellum; and vermis in patients with left MTLE-HS who were rendered seizure-free after epilepsy surgery. We could not confirm that these changes translate into significant cognitive changes. A significant negative correlation was found between changes in confrontation naming and changes in metabolism in the precuneus. We speculate that the precuneus may play a compensatory role in patients with postoperative naming difficulties after left TLE surgery. Understanding of these neural mechanisms may aid in

  17. Age at onset in patients with medically refractory temporal lobe epilepsy and mesial temporal sclerosis: impact on clinical manifestations and postsurgical outcome.

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    Asadi-Pooya, Ali A; Sperling, Michael R

    2015-08-01

    To evaluate the demographic and clinical manifestations and postsurgical outcome of childhood-onset mesial temporal sclerosis and temporal lobe epilepsy (MTS-TLE) and establishing the potential differences as compared to the patients with adult-onset MTS-TLE. In this retrospective study all patients with a clinical diagnosis of medically refractory TLE due to mesial temporal sclerosis, who underwent epilepsy surgery at Jefferson comprehensive epilepsy center, were recruited. Patients were prospectively registered in a database from 1986 through 2014. Postsurgical outcome was classified into two groups; seizure-free or relapsed. Clinical manifestations and outcome were compared between patients with childhood-onset MTS-TLE (i.e., age at onset of the first afebrile habitual seizure below 10 years) and those with adult-onset MTS-TLE (i.e., age at onset of the first afebrile habitual seizure 20 years or above). One hundred and twelve patients had childhood-onset MTS-TLE and 76 had adult-onset MTS-TLE. Demographic, clinical, EEG and MRI characteristics of these two groups were similar. Postoperative outcome was not statistically different between these two groups of patients (P=0.9). Temporal lobe epilepsy due to mesial temporal sclerosis is a common cause of epilepsy that can start from early childhood to late adulthood. The etiology of MTS-TLE may be different in various age groups, but it seems that when mesial temporal sclerosis is the pathological substrate of TLE, clinical manifestations and response to surgical treatment of patients are very similar in patients with childhood-onset MTS-TLE compared to those with adult-onset disease. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. Persistent Interictal Musical Hallucination in a Patient With Mesial Temporal Sclerosis-Related Epilepsy: First Case Report and Etiopathological Hypothesis.

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    Borelli, Paolo; Vedovello, Marcella; Braga, Massimiliano; Pederzoli, Massimo; Beretta, Sandro

    2016-12-01

    Musical hallucination is a disorder of complex sound processing of instrumental music, songs, choirs, chants, etc. The underlying pathologies include moderate to severe acquired hearing loss (the auditory equivalent of Charles Bonnet syndrome), psychiatric illnesses (depression, schizophrenia), drug intoxication (benzodiazepines, salicylate, pentoxifylline, propranolol), traumatic lesions along the acoustic pathways, and epilepsy. The hallucinations are most likely to begin late in life; 70% of patients are women. Musical hallucination has no known specific therapy. Treating the underlying cause is the most effective approach; neuroleptic and antidepressant medications have only rarely succeeded.Musical hallucination in epilepsy typically presents as simple partial seizures originating in the lateral temporal cortex. To our knowledge, no formal report of musical hallucination in the interictal state has been published before. In contrast, other interictal psychotic features are a relatively common complication, especially in patients with long-standing drug-resistant epilepsy.We describe a 62-year-old woman with a long history of mesial temporal lobe epilepsy whose musical hallucination was solely interictal. We speculate on the possible link between temporal epilepsy and her hallucination. We hypothesize that, as a result of her epileptic activity-induced damage, an imbalance developed between the excitatory and inhibitory projections connecting the mesial temporal cortex to the other auditory structures. These structures may have generated hyperactivity in the lateral temporal cortex through a "release" mechanism that eventually resulted in musical hallucination.

  19. Magnetic resonance in the diagnostic imaging study of mesial temporal sclerosis

    International Nuclear Information System (INIS)

    Pastor, E.; Sanchez, J. C.; Rodriguez, I.; Altuzarra, A.; Machado, F.; Aguilar, D.

    2001-01-01

    Mesial temporal sclerosis (MTS) consists of hippocampal atrophy and gliosis and is the most common cause of temporal lobe epilepsy. The objective of the authors was to establish a magnetic resonance imaging (MRI) protocol for its diagnosis. A prospective study was carried out in 72 patients with drug resistant complex partial seizures (42 women and 30 men ranging in age from 6 to 66 year: mean: 30 years). Using a 1.5-Tesla magnet, paracoronal sections were made in hippocampi for T1-weighted inversion-recovery images and volume measurements, fluid-attenuated inversion-recovery (FLAIR) and T2 relaxometry. A control group of 30 health volunteers was included in the study. MTS was considered to be indicated by the presence of atrophy and hyperintensity in hippocampi on T2-weighted images. There were no differences among the hippocampi of the healthy individuals. The confidence intervals (mean± 1.96 SD) were 4169 mm''3-5911 mm''3 for volume of right side, 4097 mm''3-5940 mm''3 for volume of left side and 98-113 ms for T2 relaxation time. MTS was detected in 40 patients (55.5%): 23 cases involving the left side, 13 involving the right and 4 cases of bilateral asymmetric involvement. The 95% confidence intervals for the diagnostic validity of the results (sensitivity/specificity) were (88.8%-97.2%)/(87.6%-96.4%) for T1 volumetry, (88.8%-97.2%)(95.7%-100.3%) for FLAIR and (85.4%-96.6%)/(85.4%-96.6%) for T2 relaxometry. In 5 cases of MTS, astrophy of other extra hippocampal structures was also observed, and MTS was associated with an extra hippocampal lesion (dual pathology), especially neurona migration disorders, in 8 patients. Seventeen patients (23.5%) presented lesions without MTS (tumors, cortical dysplasias and heterotopias) and there was no MRI evidence of anomalies in 15 (21%). Twenty-five patients underwent surgical treatment: 20 with MTS (19 diagnosed according to MRI and one in whom there had been no abnormal findings), 4 with tumors and 1 with a ballooned cell

  20. Remote infarct of the temporal lobe with coexistent hippocampal sclerosis in mesial temporal lobe epilepsy.

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    Gales, Jordan M; Prayson, Richard A

    2016-02-01

    In patients undergoing surgery for temporal lobe epilepsy, hippocampal sclerosis remains the most commonly observed pathology. In addition to hippocampal sclerosis, 5% to 30% of these resections on magnetic resonance imaging contain a second independently epileptogenic lesion, commonly referred to as dual pathology. A second etiology of seizure activity, as seen in dual pathology, may serve as an important cause of treatment failure in striving for post-operative seizure control. Dual pathology, consisting of hippocampal sclerosis and a remote infarct of the adjacent cortex, has been rarely reported. Cases of pathologically confirmed hippocampal sclerosis diagnosed between January 2000 and December 2012 (n = 349) were reviewed, and 7 cases of coexistent infarct (2%) formed the study group. Seven individuals (mean age, 29years; range, 5-47 years) with a mean epilepsy duration of 12.5years (3.3-25 years) and a mean pre-surgery frequency of 15 seizures per week (range, 0.5-56 seizures/week) were followed up postoperatively for a mean duration of 64months (range, 3-137 months). Pathologically, the most common form of hippocampal sclerosis observed was International League against Epilepsy type Ib or severe variant (n = 4). Four of the six individuals with post-surgery follow-up were seizure free at last encounter. The reported incidence of dual pathology, including hippocampal sclerosis and remote infarct, is low (2% in the present study) but may indicate a slightly increased risk of developing hippocampal sclerosis in the setting of a remote infarct. Surgical intervention for such cases anecdotally appears effective in achieving seizure control. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Declarative long-term memory and the mesial temporal lobe: Insights from a 5-year postsurgery follow-up study on refractory temporal lobe epilepsy.

    Science.gov (United States)

    Salvato, Gerardo; Scarpa, Pina; Francione, Stefano; Mai, Roberto; Tassi, Laura; Scarano, Elisa; Lo Russo, Giorgio; Bottini, Gabriella

    2016-11-01

    It is largely recognized that the mesial temporal lobe and its substructure support declarative long-term memory (LTM). So far, different theories have been suggested, and the organization of declarative verbal LTM in the brain is still a matter of debate. In the current study, we retrospectively selected 151 right-handed patients with temporal lobe epilepsy with and without hippocampal sclerosis, with a homogeneous (seizure-free) clinical outcome. We analyzed verbal memory performance within a normalized scores context, by means of prose recall and word paired-associate learning tasks. Patients were tested at presurgical baseline, 6months, 2 and 5years after anteromesial temporal lobe surgery, using parallel versions of the neuropsychological tests. Our main finding revealed a key involvement of the left temporal lobe and, in particular, of the left hippocampus in prose recall rather than word paired-associate task. We also confirmed that shorter duration of epilepsy, younger age, and withdrawal of antiepileptic drugs would predict a better memory outcome. When individual memory performance was taken into account, data showed that females affected by left temporal lobe epilepsy for longer duration were more at risk of presenting a clinically pathologic LTM at 5years after surgery. Taken together, these findings shed new light on verbal declarative memory in the mesial temporal lobe and on the behavioral signature of the functional reorganization after the surgical treatment of temporal lobe epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Unilateral mesial temporal atrophy after a systemic insult as a possible etiology of refractory temporal lobe epilepsy: case report Esclerose mesial temporal unilateral após insulto sistêmico como possível etiologia de epilepsia refratária do lobo temporal: relato de caso

    Directory of Open Access Journals (Sweden)

    Arthur Cukiert

    1997-09-01

    Full Text Available Mesial temporal sclerosis is the main pathological substrate present in refractory temporal lobe epilepsy and its presence is often related to the occurrence of febrile seizures in infancy. There is an on-going discussion on the nature of mesial temporal sclerosis as it related to epilepsy: cause or consequence. A previously normal child developed hyperosmolar coma after abdominal surgery at the age of 6. Three months afterwards he developed simple and complex partial seizures with an increasing frequency and refractory to multiple mono-and polytherapic drug regimens. He was evaluated for surgery at the age of 13. Ictal and interictal recordings showed left temporal lobe abnormalities. Early CT scaning suggested left temporal atrophy. MRI showed mesial temporal sclerosis. Neuropsichological testing showed verbal memory deficits and he passed a left carotid artery amytal injection. He was submitted to a cortico-amygdalo-hippocampectomy and has been seizure-free since then. The clinical data obtained from this patient suggest that at least in this case mesial temporal sclerosis would be related to the cause of epilepsy and not resultant from repeated seizure activity.A esclerose mesial temporal é o principal substrato anatomo-patológico envolvido na epilepsia refratária do lobo temporal e está frequentemente associada à ocorrência de convulsões febris na infância. Persiste até o momento intensa discussão se a esclerose mesial seria causa ou consequência da síndrome epiléptica. Uma criança previamente normal, desenvolveu coma hiperosmolar após intercorrência em cirurgia abdominal aos 6 anos de idade. Após 3 meses iniciaram-se crises parciais simples e complexas em frequência ascendente e refratárias a múltiplos esquemas terapêuticos em mono- e politerapia. Ele realizou investigação pré-operatória para epilepsia aos 13 anos de idade. Registros eletrencefalográficos de superfície ictais e interictais mostraram anormalidades

  3. Sign of the Cross (Signum Crucis): observation of an uncommon ictal manifestation of mesial temporal lobe epilepsy.

    Science.gov (United States)

    Lin, Katia; Marx, Catherine; Caboclo, Luis O S F; Centeno, Ricardo S; Sakamoto, Américo C; Yacubian, Elza M T

    2009-02-01

    The objective of the study was to describe the clinical characteristics and determine the lateralizing value of ictal Sign of the Cross (SC) as a complex hand automatism (CHA) in patients evaluated by video/EEG monitoring in a comprehensive epilepsy unit. We reviewed video/EEG data of 530 patients with epilepsy recorded in a tertiary epilepsy center from 2002 to 2008. Four patients were found to have manifested a CHA similar to the SC at least once during their complex partial seizures. All patients had unilateral right mesial temporal lobe epilepsy (TLE) refractory to medical treatment. The limbic system is often suggested as the critical site of religious experience. Moreover, it may be localized predominantly to the temporal regions of the right hemisphere. However, this rare and peculiar ictal manifestation may be related not only to the neural substrate and personality characteristics of TLE, but also to the general religious convictions of Brazilians.

  4. Interictal SPECT in the pre surgical evaluation in epileptic patients with normal MRI or bilateral mesial temporal sclerosis

    International Nuclear Information System (INIS)

    Marques, Lucia H.N.; Ferraz-Filho, Jose R.L.; Lins-Filho, Mario L.M.

    2009-01-01

    The aim of this study was to evaluate the sensitivity of interictal compared to ictal SPECT in the lateralization of the epileptogenic focus in refractory temporal lobe epilepsy (TLE) patients that present with normal magnetic resonance imaging (MRI) or bilateral mesial temporal sclerosis (MTS). Thirty patients with TLE, for whom MRI examinations were normal or who presented with bilateral MTS, were retrospectively studied. Using a confidence interval of 95% and a level of significance for p-value <0.05, an estimated agreement rate of 73% with a minimum agreement rate of 57% was calculated comparing interictal and ictal SPECTs. In conclusion the interictal SPECT is only useful when associated with the ictal SPECT and does not substitute it in the localization of epileptogenic areas in patients with normal MRI or bilateral MTS. (author)

  5. Interictal SPECT in the pre surgical evaluation in epileptic patients with normal MRI or bilateral mesial temporal sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Marques, Lucia H.N. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil). Dept. de Neurologia. Centro Cirurgico de Epilepsia; Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil); Ferraz-Filho, Jose R.L. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil); Lins-Filho, Mario L.M. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil). Dept. de Radiologia; Maciel, Marina G.; Yoshitake, Rafael; Filetti, Sarah V. [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil)

    2009-07-01

    The aim of this study was to evaluate the sensitivity of interictal compared to ictal SPECT in the lateralization of the epileptogenic focus in refractory temporal lobe epilepsy (TLE) patients that present with normal magnetic resonance imaging (MRI) or bilateral mesial temporal sclerosis (MTS). Thirty patients with TLE, for whom MRI examinations were normal or who presented with bilateral MTS, were retrospectively studied. Using a confidence interval of 95% and a level of significance for p-value <0.05, an estimated agreement rate of 73% with a minimum agreement rate of 57% was calculated comparing interictal and ictal SPECTs. In conclusion the interictal SPECT is only useful when associated with the ictal SPECT and does not substitute it in the localization of epileptogenic areas in patients with normal MRI or bilateral MTS. (author)

  6. Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy.

    Science.gov (United States)

    Malikova, Hana; Kramska, Lenka; Vojtech, Zdenek; Sroubek, Jan; Lukavsky, Jiri; Liscak, Roman

    2015-01-01

    Mesial temporal structures play an important role in human memory. In mesial temporal lobe epilepsy (MTLE), seizure activity is generated from the same structures. Surgery is the definitive treatment for medically intractable MTLE. In addition to standard temporal lobe microsurgical resection, stereotactic radiofrequency amygdalohippocampectomy (SAHE) is used as an alternative MTLE treatment. While memory impairments after standard epilepsy surgery are well known, it has been shown that memory decline is not a feature of SAHE. The aim of the present study was to correlate the volume of the remnant hippocampus and amygdala in patients treated by SAHE with changes in memory parameters. Thirty-seven MTLE patients treated by SAHE (ten right, 27 left) were included. Patients underwent magnetic resonance imaging examinations including hippocampal and amygdalar volumetry and neuropsychological evaluation preoperatively and 1 year after surgery. Using Spearman correlation analyses, larger left-sided hippocampal reductions were associated with lower verbal memory performance (ρ=-0.46; P=0.02). On the contrary, improvement of global memory quotient (MQ) was positively correlated with larger right-sided hippocampal reduction (ρ=0.66; P=0.04). Similarly, positive correlations between the extent of right amygdalar reduction and verbal MQ (ρ=0.74; P=0.02) and global MQ change (ρ=0.69; P=0.03) were found. Thus, larger right hippocampal and amygdalar reduction was associated with higher global and verbal MQ change after SAHE. Larger left-sided hippocampal reductions were associated with lower verbal memory performance. This finding is in accordance with the material-specific model of human memory, which states that the dominant hemisphere is specialized for the learning and recall of verbal information. We hypothesize that larger right-sided ablations enable the left temporal lobe to support memory more effectively, perhaps as a consequence of epileptiform discharges spreading

  7. The role of histopathologic subtype in the setting of hippocampal sclerosis-associated mesial temporal lobe epilepsy.

    Science.gov (United States)

    Gales, Jordan M; Jehi, Lara; Nowacki, Amy; Prayson, Richard A

    2017-05-01

    Hippocampal sclerosis (HS) and focal cortical dysplasia (FCD) are among the most common neuropathological findings in those undergoing surgery for refractory mesial temporal lobe epilepsy. Existing data regarding differences among the most recent International League Against Epilepsy (ILAE) HS subtypes remain limited. This study sought to characterize the roles of HS subtype and coexistent FCD. Epilepsy surgery pathologic specimens in 307 cases of temporal lobe epilepsy with HS were reviewed (mean age±SD, 37±15years; 56% women). HS and coexistent FCD were classified according to ILAE guidelines. Medical records were reviewed for data on seizure recurrence and seizure burden (clinical follow-up mean duration ± SD, 5±4years). Cases of typical HS (ILAE type I) predominated (ILAE type Ia: 41%, Ib: 47%, II: 11%, and III: 0.7%]. The HS subtypes shared similar demographic and etiologic characteristics, as well as associated pathology and postoperative seizure outcomes. Individuals with type Ib HS were more likely to remain seizure free at long-term follow-up when compared with other subtypes, and they had a later age of seizure onset. Two hundred forty-three cases (79%) demonstrated FCD within the adjacent temporal lobe. Its presence was associated with a significantly decreased risk of seizure recurrence (P=.02). When present, FCD was predominantly type I (98%). HS subtype does not appear to affect epilepsy surgery outcomes despite some clinical differences between the subgroups. FCD is often observed in association with HS in mesial temporal lobe epilepsy; the finding of FCD was associated with better postoperative outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Confiabilidade de medidas volumétricas de estruturas temporais mesiais Reliability of mesial temporal lobe volumetric measures

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    Renato L. Marchetti

    2002-06-01

    Full Text Available MOTIVO DO ESTUDO: O desenvolvimento de técnicas confiáveis para a realização de medidas volumétricas de estruturas temporais mesiais (amígdala, hipocampo e giro para-hipocampal em exames de ressonância magnética (RM pode fornecer dados para o estudo de vários transtornos neuropsiquiátricos, particularmente epilepsia do lobo temporal, doença de Alzheimer e esquizofrenia. MÉTODO: Investigamos essas técnicas realizando estudo de confiabilidade intra-observador (IO e entre-observador (EO, envolvendo controles normais, pacientes com epilepsia e pacientes com doença de Alzheimer, através do coeficiente de correlação intra-classe (CCI. RESULTADOS: A confiabilidade IO para as estruturas analisadas variou de 0,93 a 0,99 (pRATIONALE: The development of reliable techniques for volumetric measurement of mesial temporal structures (amygdala, hypocampus and parahypocampal gyrus on magnetic resonance imaging (MRI can provide data for the study of neuropsychiatric disorders, mainly temporal lobe epilepsy, Alzheimer´s disease and schizophrenia. METHOD: We investigated these techniques performing intraobserver and interobserver reliability study concerning normal controls, epilepsy and Alzheimer's disease patients using the intra-class correlation coefficient. RESULTS: Intra-observer reliability of evaluated structures ranged from 0.93 to 0.99 (p<0.001. Inter-observer reliability ranged from 0.70 to 0.95 (p <= 0.001. CONCLUSION: The results suggest that the technique of MRI morphometry of mesial temporal regions can be considered a reliable tool which may help in the investigation of neuropsychiatric disorders, since used by adequately trained clinicians and researchers.

  9. Facial paresis in patients with mesial temporal sclerosis: clinical and quantitative MRI-based evidence of widespread disease.

    Science.gov (United States)

    Lin, Katia; Carrete, Henrique; Lin, Jaime; de Oliveira, Pedro Alessandro Leite; Caboclo, Luis Otávio Sales Ferreira; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas

    2007-08-01

    To assess the frequency and significance of facial paresis (FP) in a well-defined cohort of mesial temporal lobe epilepsy (MTLE) patients. One hundred consecutive patients with MRI findings consistent with mesial temporal sclerosis (MTS) and concordant electroclinical data underwent facial motor examination at rest, with voluntary expression, and with spontaneous smiling. Hippocampal, amygdaloid, and temporopolar (TP) volumetric measures were acquired. Thirty healthy subjects, matched according to age and sex, were taken as controls. Central-type FP was found in 46 patients. In 41 (89%) of 46, it was visualized at rest, with voluntary and emotional expression characterizing true facial motor paresis. In 33 (72%) of 46 patients, FP was contralateral to the side of MTS. By using a 2-SD cutoff from the mean of normal controls, we found reduction in TP volume ipsilateral to MTS in 61% of patients with FP and in 33% of those without (p = 0.01). Febrile seizures as initial precipitating injury (IPI) were observed in 34% of the patients and were classified as complex in 12 (26%) of 46 of those with FP and in five (9%) of 54 of those without (p = 0.02). The presence of FP was significantly associated with a shorter latent period and younger age at onset of habitual seizures, in particular, with secondarily generalized tonic-clonic seizures. Facial paresis is a reliable lateralizing sign in MTLE and was associated with history of complex febrile seizures as IPI, younger age at onset of disease, and atrophy of temporal pole ipsilateral to MTS, indicating more widespread disease.

  10. Application of T2 relaxometry in lateralization and localization of mesial temporal lobe epilepsy and corresponding comparison with MR volumetry.

    Science.gov (United States)

    Chen, Hui; Yu, Guilian; Wang, Jiangtao; Li, Feng; Li, Guangming

    2016-09-01

    Magnetic resonance (MR) volumetry is insensitive to subtle mesial temporal sclerosis (MTS), while T2 relaxometry is potential useful in detecting MTS, especially MTS in early course. To explore and compare the feasibility of T2 relaxometry and MR volumetry in evaluation of mesial temporal lobe epilepsy (MTLE) and lateralization of the epileptogenic zone, so as to optimize and enhance lesion depiction. For the 17 unilateral MTLE patients and 14 normal participants, the hippocampus and amygdala were contoured on axial T2-weighted (T2W) images and then co-registered onto T2 relaxation maps. Abnormal is defined as an elevated asymmetric ratio of larger than 2 SD. Visual and quantitative volumetric assessment were combined as outcomes of MR volumetry to distinguish MR-positive and MR-negative lesions. Operative and pathological findings were used as gold standard. T2 values of lesions were significantly elevated. In lateralizing the epileptogenic zones, T2 relaxometry yielded an overall accuracy of 94.1% (sensitivity 92.6%, specificity 100%), and MR volumetry yielded an overall accuracy of 82.4% (sensitivity 88.9%, specificity 57.1%), meaning a better performance of T2 relaxometry (P volumetry. MR volumetry wrongly discerned three normal regions as MTS, while one MR-negative sclerotic hippocampus was detected by T2 relaxometry. T2 relaxometry is feasible in non-invasive lateralization of epileptogenic zone, and more advantaged than MR volumetry in detecting MR-negative lesions, facilitating prompt diagnosis and longitudinal disease monitoring. © The Foundation Acta Radiologica 2015.

  11. Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Malikova H

    2015-11-01

    Full Text Available Hana Malikova,1,2,* Lenka Kramska,3,* Zdenek Vojtech,4,5 Jan Sroubek,6 Jiri Lukavsky,7 Roman Liscak8 1Department of Radiology, Na Homolce Hospital, 2Institute of Anatomy, Second Medical Faculty, Charles University in Prague, 3Department of Clinical Psychology, Na Homolce Hospital, 4Department of Neurology, Na Homolce Hospital, 5Department of Neurology, 3rd Medical Faculty, Charles University in Prague, 6Department of Neurosurgery, Na Homolce Hospital, 7Institute of Psychology, Academy of Sciences of the Czech Republic, 8Department of Radiation and Stereotactic Neurosurgery, Na Homolce Hospital, Prague, Czech Republic *These authors contributed equally to this work Background and purpose: Mesial temporal structures play an important role in human memory. In mesial temporal lobe epilepsy (MTLE, seizure activity is generated from the same structures. Surgery is the definitive treatment for medically intractable MTLE. In addition to standard temporal lobe microsurgical resection, stereotactic radiofrequency amygdalohippocampectomy (SAHE is used as an alternative MTLE treatment. While memory impairments after standard epilepsy surgery are well known, it has been shown that memory decline is not a feature of SAHE. The aim of the present study was to correlate the volume of the remnant hippocampus and amygdala in patients treated by SAHE with changes in memory parameters.Materials and methods: Thirty-seven MTLE patients treated by SAHE (ten right, 27 left were included. Patients underwent magnetic resonance imaging examinations including hippocampal and amygdalar volumetry and neuropsychological evaluation preoperatively and 1 year after surgery.Results: Using Spearman correlation analyses, larger left-sided hippocampal reductions were associated with lower verbal memory performance (ρ=-0.46; P=0.02. On the contrary, improvement of global memory quotient (MQ was positively correlated with larger right-sided hippocampal reduction (ρ=0.66; P=0

  12. Crossed cerebellar hyperperfusion on ictal Tc-99m HMPAO brain SPECT: clinical significance for differentiation of mesial or lateral temporal lobe epilepsy and related factors for development

    International Nuclear Information System (INIS)

    Park, Soon Ah; Sohn, Myung Hee; Lim, Seok Tae; Lee, Dong Soo; Lee, Sang Gun; Kim, Seok Ki; Jang, Myoung Jin; Chung, June Key; Lee, Myung Chul

    2000-01-01

    The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; 27.4±7.8 years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class 1, 2). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec (32.6±19.5 sec) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propatation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=3D0.01) and age (p=3D0.02) were related to the development of CCH. Crossed cerebellar hyperperfusion in ictal brain SPECT did not help differentiate mesial from lateral remporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.=20

  13. Crossed cerebellar hyperperfusion on ictal Tc-99m HMPAO brain SPECT: clinical significance for differentiation of mesial or lateral temporal lobe epilepsy and related factors for development

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soon Ah; Sohn, Myung Hee; Lim, Seok Tae [Chonbuk National Univ. School of Medicine, Chonju (Korea, Republic of); Lee, Dong Soo; Lee, Sang Gun; Kim, Seok Ki; Jang, Myoung Jin; Chung, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2000-08-01

    The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; 27.4{+-}7.8 years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class 1, 2). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec (32.6{+-}19.5 sec) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propatation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=3D0.01) and age (p=3D0.02) were related to the development of CCH. Crossed cerebellar hyperperfusion in ictal brain SPECT did not help differentiate mesial from lateral remporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.

  14. Relationship between fluid-attenuated inversion-recovery (FLAIR) signal intensity and inflammatory mediator's levels in the hippocampus of patients with temporal lobe epilepsy and mesial temporal sclerosis.

    Science.gov (United States)

    Varella, Pedro Paulo Vasconcellos; Santiago, Joselita Ferreira Carvalho; Carrete, Henrique; Higa, Elisa Mieko Suemitsu; Yacubian, Elza Márcia Targas; Centeno, Ricardo Silva; Caboclo, Luís Otávio Sales Ferreira; Castro Neto, Eduardo Ferreira de; Canzian, Mauro; Amado, Débora; Cavalheiro, Esper Abrão; Naffah-Mazzacoratti, Maria da Graça

    2011-02-01

    We investigated a relationship between the FLAIR signal found in mesial temporal sclerosis (MTS) and inflammation. Twenty nine patients were selected through clinical and MRI analysis and submitted to cortico-amygdalo-hippocampectomy to seizure control. Glutamate, TNFα, IL1, nitric oxide (NO) levels and immunostaining against IL1β and CD45 was performed. Control tissues (n=10) were obtained after autopsy of patients without neurological disorders. The glutamate was decreased in the temporal lobe epilepsy (TLE) -MTS group (p<0.001), suggesting increased release of this neurotransmitter. The IL1β and TNFα were increased in the hippocampus (p<0.05) demonstrating an active inflammatory process. A positive linear correlation between FLAIR signal and NO and IL1β levels and a negative linear correlation between FLAIR signal and glutamate concentration was found. Lymphocytes infiltrates were present in hippocampi of TLE patients. These data showed an association between hippocampal signal alteration and increased inflammatory markers in TLE-MTS.

  15. Historical Risk Factors Associated with Seizure Outcome After Surgery for Drug-Resistant Mesial Temporal Lobe Epilepsy.

    Science.gov (United States)

    Asadi-Pooya, Ali A; Nei, Maromi; Sharan, Ashwini; Sperling, Michael R

    2016-05-01

    To investigate the possible influence of risk factors on seizure outcome after surgery for drug-resistant temporal lobe epilepsy (TLE) and mesial temporal sclerosis (MTS). This retrospective study recruited patients with drug-resistant MTS-TLE who underwent epilepsy surgery at Jefferson Comprehensive Epilepsy Center and were followed for a minimum of 1 year. Patients had been prospectively registered in a database from 1986 through 2014. After surgery outcome was classified into 2 groups: seizure-free or relapsed. The possible risk factors influencing long-term outcome after surgery were investigated. A total of 275 patients with MTS-TLE were studied. Two thirds of the patients had Engel's class 1 outcome and 48.4% of the patients had sustained seizure freedom, with no seizures since surgery. Patients with a history of tonic-clonic seizures in the year preceding surgery were more likely to experience seizure recurrence (odds ratio, 2.4; 95% confidence interval 1.19-4.80; P = 0.01). Gender, race, family history of epilepsy, history of febrile seizure, history of status epilepticus, duration of disease before surgery, intelligence quotient, and seizure frequency were not predictors of outcome. Many patients with drug-resistant MTS-TLE respond favorably to surgery. It is critical to distinguish among different types and etiologies of TLE when predicting outcome after surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Distinctive Structural and Effective Connectivity Changes of Semantic Cognition Network across Left and Right Mesial Temporal Lobe Epilepsy Patients

    Directory of Open Access Journals (Sweden)

    Xiaotong Fan

    2016-01-01

    Full Text Available Occurrence of language impairment in mesial temporal lobe epilepsy (mTLE patients is common and left mTLE patients always exhibit a primary problem with access to names. To explore different neuropsychological profiles between left and right mTLE patients, the study investigated both structural and effective functional connectivity changes within the semantic cognition network between these two groups and those from normal controls. We found that gray matter atrophy of left mTLE patients was more severe than that of right mTLE patients in the whole brain and especially within the semantic cognition network in their contralateral hemisphere. It suggested that seizure attacks were rather targeted than random for patients with hippocampal sclerosis (HS in the dominant hemisphere. Functional connectivity analysis during resting state fMRI revealed that subregions of the anterior temporal lobe (ATL in the left HS patients were no longer effectively connected. Further, we found that, unlike in right HS patients, increased causal linking between ipsilateral regions in the left HS epilepsy patients cannot make up for their decreased contralateral interaction. It suggested that weakened contralateral connection and disrupted effective interaction between subregions of the unitary, transmodal hub of the ATL may be the primary cause of anomia in the left HS patients.

  17. Distinctive Structural and Effective Connectivity Changes of Semantic Cognition Network across Left and Right Mesial Temporal Lobe Epilepsy Patients

    Science.gov (United States)

    Fan, Xiaotong; Shang, Kun; Wang, Xiaocui; Wang, Peipei; Shan, Yongzhi; Lu, Jie

    2016-01-01

    Occurrence of language impairment in mesial temporal lobe epilepsy (mTLE) patients is common and left mTLE patients always exhibit a primary problem with access to names. To explore different neuropsychological profiles between left and right mTLE patients, the study investigated both structural and effective functional connectivity changes within the semantic cognition network between these two groups and those from normal controls. We found that gray matter atrophy of left mTLE patients was more severe than that of right mTLE patients in the whole brain and especially within the semantic cognition network in their contralateral hemisphere. It suggested that seizure attacks were rather targeted than random for patients with hippocampal sclerosis (HS) in the dominant hemisphere. Functional connectivity analysis during resting state fMRI revealed that subregions of the anterior temporal lobe (ATL) in the left HS patients were no longer effectively connected. Further, we found that, unlike in right HS patients, increased causal linking between ipsilateral regions in the left HS epilepsy patients cannot make up for their decreased contralateral interaction. It suggested that weakened contralateral connection and disrupted effective interaction between subregions of the unitary, transmodal hub of the ATL may be the primary cause of anomia in the left HS patients. PMID:28018680

  18. Decline in word-finding: The objective cognitive finding most relevant to patients after mesial temporal lobe epilepsy surgery.

    Science.gov (United States)

    Pauli, Carla; de Oliveira Thais, Maria Emilia Rodrigues; Guarnieri, Ricardo; Schwarzbold, Marcelo Liborio; Diaz, Alexandre Paim; Ben, Juliana; Linhares, Marcelo Neves; Markowitsch, Hans Joachim; Wolf, Peter; Wiebe, Samuel; Lin, Katia; Walz, Roger

    2017-10-01

    The purpose of this study was to investigate the following: i) the objective impairment in neuropsychological tests that were associated with the subjective perception of cognitive function decline in Brazilian patients who underwent mesial temporal lobe epilepsy (MTLE) surgery and ii) the predictive variables for those impaired objective neuropsychological tests. Forty-eight adults with MTLE (27 right HS and 23 male) were divided according to their perception of changes (Decline or No-decline) of cognitive function domain of the QOLIE-31 questionnaire applied before and 1year after the ATL. The mean (SD) of changes in the raw score difference of the neuropsychological tests before and after the ATL was compared between Decline and No-decline groups. Receiver Operating Characteristic curves, sensitivity, specificity, and predictive values were used to assess the optimum cutoff points of neuropsychological test score changes to predict patient-reported subjective cognitive decline. Six (12.5%) patients reported a perception of cognitive function decline after ATL. Among the 25 cognitive tests analyzed, only changes in the Boston Naming Test (BNT) were associated with subjective cognitive decline reported by patients. A reduction of ≥8 points in the raw score of BNT after surgery had 91% of sensitivity and 45% specificity for predicting subjective perception of cognitive function decline by the patient. Left side surgery and age older than 40years were more associated with an important BNT reduction with overall accuracy of 91.7%, 95% predictive ability for no impairment, and 75% for impairment of cognitive function. Impairment in word-finding seems to be the objective cognitive finding most relevant to Brazilian patients after mesial temporal lobe epilepsy surgery. Similar to American patients, the side of surgery and age are good predictors for no decline in the BNT, but shows a lower accuracy to predict its decline. If replicated in other populations, the

  19. Trans-middle temporal gyrus selective amygdalohippocampectomy for medically intractable mesial temporal lobe epilepsy in adults: seizure response rates, complications, and neuropsychological outcomes.

    Science.gov (United States)

    Bandt, S Kathleen; Werner, Nicole; Dines, Jennifer; Rashid, Samiya; Eisenman, Lawrence N; Hogan, R Edward; Leuthardt, Eric C; Dowling, Joshua

    2013-07-01

    Selective amygdalohippocampectomy (AHC) has evolved to encompass a variety of techniques to resect the mesial temporal lobe. To date, there have been few large-scale evaluations of trans-middle temporal gyrus selective AHC. The authors examine a large series of patients who have undergone the trans-middle temporal gyrus AHC and assess its clinical and neuropsychological impact. A series of 76 adult patients underwent selective AHC via the trans-middle temporal gyrus approach over a 10-year period, 19 of whom underwent pre- and postoperative neuropsychological evaluations. Favorable seizure response rates were achieved (92% Engel class I or II), with very low surgical morbidity and no mortality. Postoperative neuropsychological assessment revealed a decline in verbal memory for the left AHC group. No postoperative memory decline was identified for the right AHC group, but rather some improvements were noted within this group. The trans-middle temporal gyrus selective AHC is a safe and effective choice for management of medically refractory epilepsy in adults. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Different Surgical Approaches for Mesial Temporal Epilepsy: Resection Extent, Seizure, and Neuropsychological Outcomes

    Czech Academy of Sciences Publication Activity Database

    Malíková, H.; Krámská, L.; Vojtěch, Z.; Liščák, R.; Šroubek, J.; Lukavský, Jiří; Druga, R.

    2014-01-01

    Roč. 92, č. 6 (2014), s. 372-380 ISSN 1011-6125 Institutional support: RVO:68081740 Keywords : temporal lobe epilepsy * stereotactic surgery * neuropsychology outcome Subject RIV: AN - Psychology Impact factor: 2.019, year: 2014

  1. Parahippocampal Involvement in Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis: A Proof of Concept from Memory-Guided Saccades

    Directory of Open Access Journals (Sweden)

    Silvia Colnaghi

    2017-11-01

    Full Text Available ObjectiveMesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS may involve extrahippocampal areas of structural damage and dysfunction. The accuracy of medium-term spatial memory can be tested by memory-guided saccades (MGS to evaluate a functional impairment of the parahippocampal cortex (PHC, while voxel-based morphometry (VBM analysis can be used to detect a structural damage of the latter region.MethodsMGS with 3- and 30-s memorization delays were compared between 7 patients affected by right MTLE-HS (r-MTLE-HS, 6 patients affected by left MTLE-HS, and 13 healthy controls. The same subjects underwent brain MRI for a VBM analysis. Correlation analysis was performed between the results of VBM and MGS and with patients’ clinical data.ResultsRight MTLE-HS patients showed impaired accuracy of leftward MGS with a 30-s memorization delay; their gray-matter volume was reduced in the right hippocampus and inferior temporal gyrus, and bilaterally in the cerebellum. Left MTLE-HS patients had normal MGS accuracy; their gray-matter volume was reduced in the left hippocampus, in the right-inferior temporal gyrus and corpus callosus, and bilaterally in the insular cortex and in the cerebellum. The difference between right and left parahippocampal volumes correlated with MGS accuracy, while right and left hippocampal volumes did not. Hippocampal and parahippocampal volume did not correlate with clinical variables such as febrile seizures, age at disease onset, disease duration, and seizure frequency.ConclusionMGS abnormalities suggested the functional involvement of the right PHC in patients with r-MTLE-HS, supporting a right lateralization of spatial memory control and showing a relation between functional impairment and degree of atrophy.

  2. Major vault protein (MVP) gene polymorphisms and drug resistance in mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Balan, Shabeesh; Radhab, Saradalekshmi Koramannil; Radha, Koramannil; Sathyan, Sanish; Vijai, Joseph; Banerjee, Moinak; Radhakrishnan, Kurupath

    2013-09-10

    The human major vault protein (MVP) has been implicated in the development of drug resistance in cancer cells. Over expression of MVP has also been reported in brain tissue samples from antiepileptic drug (AED)-resistant human focal epilepsies. To investigate the relationship between single nucleotide polymorphisms (SNPs) involving the MVP gene and AED-resistance, we compared the distribution of three SNPs in the MVP gene, rs4788187, rs3815824 and rs3815823, among 220 patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) (prototype of AED-resistant epilepsy syndrome), 201 patients with juvenile myoclonic epilepsy (JME) (prototype of AED-responsive epilepsy syndrome) and 213 ethnically matched non-epilepsy controls. All the patients and controls were residents of the South Indian state of Kerala for more than three generations. We did not find any significant difference in allele and genotypic frequencies of the studied SNPs between AED-resistant and AED-responsive cohorts, and between AED-resistant and AED-responsive cohorts independently and pooled together when compared with the controls. We conclude that rs4788187, rs3815824, rs3815823 variants of the MVP gene are associated neither with predisposition for epilepsy nor with AED-resistance in the population that we have studied. Our results suggest the need for further research into the link between MVP and AED-resistance. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Ripples on spikes show increased phase-amplitude coupling in mesial temporal lobe epilepsy seizure onset zones

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    Weiss, Shennan A; Orosz, Iren; Salamon, Noriko; Moy, Stephanie; Wei, Linqing; Van ’t Klooster, Maryse A; Knight, Robert T; Harper, Ronald M; Bragin, Anatol; Fried, Itzhak; Engel, Jerome; Staba, Richard J

    2016-01-01

    Objective Ripples (80–150 Hz) recorded from clinical macroelectrodes have been shown to be an accurate biomarker of epileptogenic brain tissue. We investigated coupling between epileptiform spike phase and ripple amplitude to better understand the mechanisms that generate this type of pathological ripple (pRipple) event. Methods We quantified phase amplitude coupling (PAC) between epileptiform EEG spike phase and ripple amplitude recorded from intracranial depth macroelectrodes during episodes of sleep in 12 patients with mesial temporal lobe epilepsy. PAC was determined by 1) a phasor transform that corresponds to the strength and rate of ripples coupled with spikes, and a 2) ripple-triggered average to measure the strength, morphology, and spectral frequency of the modulating and modulated signals. Coupling strength was evaluated in relation to recording sites within and outside the seizure onset zone (SOZ). Results Both the phasor transform and ripple-triggered averaging methods showed ripple amplitude was often robustly coupled with epileptiform EEG spike phase. Coupling was more regularly found inside than outside the SOZ, and coupling strength correlated with the likelihood a macroelectrode’s location was within the SOZ (pripples coupled with EEG spikes inside the SOZ to rates of coupled ripples in non-SOZ was greater than the ratio of rates of ripples on spikes detected irrespective of coupling (pripple amplitude (pripple spectral frequency (pripple amplitude. The changes in excitability reflected as epileptiform spikes may also cause clusters of pathologically interconnected bursting neurons to grow and synchronize into aberrantly large neuronal assemblies. PMID:27723936

  4. Five-Year Neuropsychological Outcome after Stereotactic Radiofrequency Amygdalohippocampectomy for Mesial Temporal Lobe Epilepsy: Longitudinal Study

    Czech Academy of Sciences Publication Activity Database

    Krámská, L.; Vojtěch, Z.; Lukavský, Jiří; Stará, M.; Malíková, H.

    2017-01-01

    Roč. 95, č. 3 (2017), s. 149-157 ISSN 1011-6125 Institutional support: RVO:68081740 Keywords : Cognitive outcome * Memory * Temporal lobe epilepsy * Stereotactic surgery Subject RIV: FH - Neurology OBOR OECD: Psychology (including human - machine relations) Impact factor: 1.692, year: 2016

  5. Clinical value of scatter correction for interictal brain 99m Tc-HMPAO SPECT in mesial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Sanchez Catasus, C.; Morales, L.; Aguila, A.

    2002-01-01

    Aim: It is well known that some patients with temporal lobe epilepsy (TLE) show normal perfusion during interictal SPECT study. The aim of this research was to evaluate if the scatter radiation has some influence on this kind of result. Materials and Methods: We studied 15 patients with TLE by clinical diagnosis and by video-EEG monitoring with surface electrodes (11 left TLE, 4 right TLE), which showed normal perfusion during interictal brain 99m Tc-HMPAO SPECT. The SPECT data were reconstructed by filtered backprojection without scatter correction (A). The same SPECT data were reconstructed after the projections were corrected by dual energy window method of scatter correction (B). Attenuation was corrected in all cases using first order Chang Method. For A and B images groups, cerebellum perfusion ratios were calculated on irregular regions of interest (ROI) drawn on anterior (ATL), lateral (LTL), mesial (MTL) and whole temporal lobe (WTL). To evaluate the influence of scatter radiation, the cerebellum perfusion ratios of each subject were compared with a normal database of 10 normal subjects, with and without scatter correction, using z-score analysis. Results: In group A, the z-score was less than 2 in all cases. In group B, the z-score was more than 2 in 6 cases, 4 in MTL (3 left, 1 right) and 2 in left LTL, which were coincident with the EEG localization. All images of group B showed better contrast than images of group A. Conclusions: These results suggest that scatter correction could improve the sensitivity of interictal brain SPECT to identify epileptic focus in patients with TLE

  6. Clinical and electrophysiological findings in mesial temporal lobe epilepsy with hippocampal sclerosis, based on the recent histopathological classifications.

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    Tezer, F Irsel; Xasiyev, Farid; Soylemezoglu, Figen; Bilginer, Burcak; Oguz, Kader Karli; Saygi, Serap

    2016-11-01

    Hippocampal sclerosis (HS) is a common pathology in MTLE, patients may show different surgical outcomes and clinical features. The 2013 ILAE classification subdivides HS into 3 types (HS type 1: severe neuronal loss and gliosis predominantly in CA1 and CA4 regions; - HS type 2: CA1 predominant; HS type 3: CA4 predominant) and includes "gliosis only, as no-HS". The association of clinical and electrophysiological findings with different HS types has not been reported previously in detail. 48 patients who had undergone temporal lobectomy with amygdalohippocampectomy due to mesial TLE-HS between February 2014 and February 2016 were included. The patients were divided into five groups: patients with HS ILAE type 1, HS ILAE type 2, HS ILAE type 3, FCD type IIIa, or gliosis/no HS. The correlation between HS ILAE types and clinical/EEG findings in patients with MTLE due to HS was investigated. Of the 48 patients 30 were male. In 23 patients, the resection was on the left side (48%). Three patients had only gliosis, 25 patients had HS ILAE type 1, 7 had HS ILAE type 2, and 4 had HS ILAE type 3. Nine of the 48 patients had cortical lamination abnormalities in the temporal lobe associated with HS (FCD type IIIa). All patients were seizure free for early follow up. There was no association between type of HS in terms of duration of epilepsy, onset age of epilepsy, lateralized or localized semiological findings, or interictal/ictal EEG findings. Family history of epilepsy or SGTCSs were statistically more frequent in patients with types 2 and 3 HS and status epilepticus was more frequent in patients with HS-FCD type IIIa. The patients with HS types 2 and 3 have more frequent SGTCS or status epilepticus as well as increased family history of epilepsy. These findings can be helpful in understanding the epileptogenicity-prognoses of HS. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Automated volumetry of hippocampus is useful to confirm unilateral mesial temporal sclerosis in patients with radiologically positive findings.

    Science.gov (United States)

    Silva, Guilherme; Martins, Cristina; Moreira da Silva, Nádia; Vieira, Duarte; Costa, Dias; Rego, Ricardo; Fonseca, José; Silva Cunha, João Paulo

    2017-08-01

    Background and purpose We evaluated two methods to identify mesial temporal sclerosis (MTS): visual inspection by experienced epilepsy neuroradiologists based on structural magnetic resonance imaging sequences and automated hippocampal volumetry provided by a processing pipeline based on the FMRIB Software Library. Methods This retrospective study included patients from the epilepsy monitoring unit database of our institution. All patients underwent brain magnetic resonance imaging in 1.5T and 3T scanners with protocols that included thin coronal T2, T1 and fluid-attenuated inversion recovery and isometric T1 acquisitions. Two neuroradiologists with experience in epilepsy and blinded to clinical data evaluated magnetic resonance images for the diagnosis of MTS. The diagnosis of MTS based on an automated method included the calculation of a volumetric asymmetry index between the two hippocampi of each patient and a threshold value to define the presence of MTS obtained through statistical tests (receiver operating characteristics curve). Hippocampi were segmented for volumetric quantification using the FIRST tool and fslstats from the FMRIB Software Library. Results The final cohort included 19 patients with unilateral MTS (14 left side): 14 women and a mean age of 43.4 ± 10.4 years. Neuroradiologists had a sensitivity of 100% and specificity of 73.3% to detect MTS (gold standard, k = 0.755). Automated hippocampal volumetry had a sensitivity of 84.2% and specificity of 86.7% (k = 0.704). Combined, these methods had a sensitivity of 84.2% and a specificity of 100% (k = 0.825). Conclusions Automated volumetry of the hippocampus could play an important role in temporal lobe epilepsy evaluation, namely on confirmation of unilateral MTS diagnosis in patients with radiological suggestive findings.

  8. Cavernomas de la región temporal mesial: Anatomía microquirúrgica y abordajes

    Science.gov (United States)

    Campero, Alvaro

    2015-01-01

    Objetivo: Describir la anatomía microquirúrgica y los abordajes a la región temporal mesial (RTM), en relación a cavernomas de dicho sector. Materiales y Método: Cinco cabezas de cadáveres adultos, fijadas en formol e inyectadas con silicona coloreada, fueron estudiadas. Además, desde enero de 2007 a junio de 2014, 7 pacientes con cavernomas localizados en la RTM fueron operados por el autor. Resultados: Anatomia: La RTM fue dividida en 3 sectores: Anterior, medio y posterior. Pacientes: 7 enfermos con cavernomas de la RTM fueron operados por el autor. De acuerdo a la ubicacion en la RTM, 4 cavernomas se ubicaron en el sector anterior, 2 cavernomas se localizaron en el sector medio y 1 cavernoma se ubico en el sector posterior. Para el sector anterior de la RTM se utilizo un abordaje transsilviano-transinsular; para el sector medio de la RTM se utilizo un abordaje transtemporal (lobectomia temporal anterior); y para el sector posterior de la RTM se utilizo un abordaje supracerebeloso-transtentorial. Conclusión: Dividir la RTM en 3 sectores nos permite adecuar el abordaje en función a la localización de la lesión. Así, el sector anterior es bien abordable a través de la fisura silviana; el sector medio a través de una vía transtemporal; y el sector posterior por un abordaje supracerebeloso. PMID:26600986

  9. Correlation between temporal pole MRI abnormalities and surface ictal EEG patterns in patients with unilateral mesial temporal lobe epilepsy.

    Science.gov (United States)

    Caboclo, Luís Otávio S F; Garzon, Eliana; Oliveira, Pedro A L; Carrete, Henrique; Centeno, Ricardo S; Bianchin, Marino M; Yacubian, Elza Márcia T; Sakamoto, Américo C

    2007-01-01

    The objective of this retrospective study is to analyze ictal patterns observed during continuous Video-EEG monitoring in patients with temporal lobe epilepsy (TLE) due to unilateral hippocampal sclerosis (HS), and to correlate these EEG patterns to temporal pole abnormalities observed on magnetic resonance imaging exams. We analyzed 147 seizures from 35 patients with TLE and unilateral HS. Ictal patterns were classified and correlated to signal abnormalities and volumetric measures of the temporal poles. Volume differences over 10% were considered abnormal. The most frequent type of ictal pattern was rhythmic theta activity (RTA), encountered in 65.5% of the seizures. Rhythmic beta activity (RBA) was observed in 11% of the seizures, localized attenuation in 8%, interruption of epileptiform discharges in 6%, repetitive discharges in 5.5%, and rhythmic delta activity (RDA) in 4%. Sixty-six percent of the patients presented signal abnormalities in the temporal pole that were always ipsilateral to the HS. Sixty percent presented significant asymmetry of the temporal poles consisting of reduced volume that was also always ipsilateral to HS. Although patients with RTA as the predominant ictal pattern tended to present asymmetry of temporal poles (p=0.305), the ictal EEG pattern did not correlate with temporal pole asymmetry or signal abnormalities. RTA is the most frequent initial ictal pattern in patients with TLE due to unilateral HS. Temporal pole signal changes and volumetric reduction were commonly found in this group of patients, both abnormalities appearing always ipsilateral to the HS. However, neither temporal pole volume reduction nor signal abnormalities correlated with the predominant ictal pattern, suggesting that the temporal poles are not crucially involved in the process of epileptogenesis.

  10. Long-term outcome characteristics in mesial temporal lobe epilepsy with and without associated cortical dysplasia.

    Science.gov (United States)

    Schmeiser, B; Hammen, T; Steinhoff, B J; Zentner, J; Schulze-Bonhage, A

    2016-10-01

    The intention of our study was to identify predictive characteristics for long-term seizure control and running down phenomenon after surgical treatment of pharmacoresistant mesiotemporal lobe epilepsy (mTLE) with and without associated cortical dysplasia. Our study comprises a consecutive series of 458 patients who underwent surgical treatment for intractable mTLE at the Epilepsy Center Freiburg. Data evaluated included semiology, duration and frequency of seizures, results of presurgical diagnostics including video-EEG monitoring, MRI, PET and SPECT as well as postoperative seizure outcome. Results were evaluated forming two groups: Group A consisted of isolated mesiotemporal lesions. Group B comprised patients with mTLE and additional focal cortical dysplasia (FCD). Statistical evaluation was based on the Kaplan Meier survival analysis, using log-rank-tests and a multivariate regression model. Postoperative running down phenomenon was defined as seizure freedom after a period of gradual reduction of postoperative seizure frequency. This was compared to patients with ongoing epilepsy. Complete seizure freedom was achieved in 65.0% of investigated patients at 1year and in 56.5% at long-term follow-up of ≥5 years after surgery. Corresponding results were 64.2% and 56.8% at 1 and ≥5 years, respectively in group A and 66.4% and 56.0%, respectively in group B. Predictive for favorable postoperative outcome in the total group were younger age at surgery, shorter duration of epilepsy, absence of secondarily generalized tonic-clonic seizures (SGTCS), presence of strictly ipsilateral temporal interictal epileptiform discharges (IEDs), complete resection of the lesion as well as absence of postoperative epileptiform activity and of early postoperative seizures. In subgroup analyses, patients of group A demonstrated longer postoperative seizure-free intervals with adolescent age at surgery, short duration of epilepsy before surgery and absence of SGTCS, whereas in

  11. A structural MRI study: gray matter changes in mesial temporal lobe epilepsy patients with different seizure types

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    Jun-hao XIAO

    2018-04-01

    Full Text Available Objective To observe gray matter volume changes and evaluate the relation between gray matter changes and duration of mesial temporal lobe epilepsy (mTLE patients with different seizure types. Methods A total of 40 patients with mTLE, including 20 with partial seizures (mTLE-PS group and 20 with secondarily generalized seizures (mTLE-sGS group, and 20 sex- and age-matched healthy volunteers (control group were recruited. T1-three-dimensional magnetization-prepared rapid gradient echo (T1-3D-MPRAGE was scanned for voxel.based morphometry (VBM. Bilateral frontal lobes and thalami were selected as regions of interest (ROIs to compare gray matter volume of brain regions among 3 groups. Spearman rank correlation analysis was used to evaluate the correlation between gray matter volume of brain regions and duration. Results There were significant differences in gray matter volumes in bilateral superior frontal gyri, right middle frontal gyrus, right medial frontal gyrus, right angular gyrus, right middle temproral gyrus, right hippocampus, bilateral thalami and bilateral cerebellar hemispheres among 3 groups (P < 0.01, for all; FWE correction. Compared with control group, gray matter volumes in bilateral superior frontal gyri, bilateral cerebellar hemispheres, right middle temproral gyrus, right hippocampus and right thalamus in mTLE-PS group were significantly decreased (P < 0.01, for all; FWE correction. Compared with control group, gray matter volumes in bilateral superior frontal gyri, bilateral thalami, bilateral cerebellar hemispheres, right angular gyrus, right middle temporal gyrus and right hippocampus in mTLE-sGS group were significantly decreased (P < 0.01, for all; FWE correction. Compared with mTLE-PS group, gray matter volumes in bilateral superior frontal gyri, bilateral thalami, right medial frontal gyrus and right gyrus rectus in mTLE-sGS group were significantly reduced (P < 0.01, for all; FWE correction. Gray matter volumes in left

  12. Social cognition in neuropsychiatric populations: a comparison of theory of mind in schizophrenia and mesial temporal lobe epilepsy.

    Science.gov (United States)

    Okruszek, Łukasz; Bala, Aleksandra; Wordecha, Małgorzata; Jarkiewicz, Michał; Wysokiński, Adam; Szczepocka, Ewa; Piejka, Aleksandra; Zaborowska, Oliwia; Szantroch, Marta; Rysz, Andrzej; Marchel, Andrzej

    2017-03-28

    Social cognition deficits are observed both in patients with schizophrenia (SCZ) and in patients with mesial temporal lobe epilepsy (MTLE). This may be due to dysfunction of the amygdala network, which is a common feature of both diseases. In this study, SCZ (n = 48) or MTLE (n = 31) and healthy controls (HC, n = 47) completed assessments of mentalising (Reading Mind in the Eyes Test, RMET) and basic cognitive processing, e.g., working memory, executive functions and psychomotor speed (Trail-Making Test B and Digit Symbol). SCZ were also assessed with the Positive And Negative Syndrome Scale (PANSS). We found that the RMET scores of the two clinical groups were similar (p > 0.05) and lower than in the HCs (SCZ: p < 0.05; MTLE: p < 0.001). In the next step, SCZ were split into two groups with respect to the level of symptoms. Analysis of the RMET scores revealed no differences between the HC (M = 25.7 ± 4.1) and POS-LO (M = 25.3 ± 4.8); both groups outperformed the POS-HI group (M = 21.3 ± 5.2) and the MTLE group (M = 20.8 ± 4.6). No differences were found for the median-split with regard to negative symptoms. In SCZ, the mind-reading deficit appears to be associated with the level of positive symptoms. Both POS-HI and MTLE patients present significant mentalising deficits compared to healthy controls.

  13. Hippocampal atrophy on MRI is predictive of histopathological patterns and surgical prognosis in mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Jardim, Anaclara Prada; Corso, Jeana Torres; Garcia, Maria Teresa Fernandes Castilho; Gaça, Larissa Botelho; Comper, Sandra Mara; Lancellotti, Carmen Lúcia Penteado; Centeno, Ricardo Silva; Carrete, Henrique; Cavalheiro, Esper Abrão; Scorza, Carla Alessandra; Yacubian, Elza Márcia Targas

    2016-12-01

    To correlate hippocampal volumes obtained from brain structural imaging with histopathological patterns of hippocampal sclerosis (HS), in order to predict surgical outcome. Patients with mesial temporal lobe epilepsy (MTLE) with HS were selected. Clinical data were assessed pre-operatively and surgical outcome in the first year post surgery. One block of mid hippocampal body was selected for HS classification according to ILAE criteria. NeuN-immunoreactive cell bodies were counted within hippocampal subfields, in four randomly visual fields, and cell densities were transformed into z-score values. FreeSurfer processing of 1.5T brain structural images was used for subcortical and cortical volumetric estimation of the ipsilateral hippocampus. Univariate analysis of variance and Pearson's correlation test were applied for statistical analyses. Sixty-two cases (31 female, 32 right HS) were included. ILAE type 1 HS was identified in 48 patients, type 2 in eight, type 3 in two, and four had no-HS. Better results regarding seizure control, i.e. ILAE 1, were achieved by patients with type 1 HS (58.3%). Patients with types 1 and 2 had smaller hippocampal volumes compared to those with no-HS (p<0.001 and p=0.004, respectively). Positive correlation was encountered between hippocampal volumes and CA1, CA3, CA4, and total estimated neuronal densities. CA2 was the only sector which did not correlate its neuronal density with hippocampal volume (p=0.390). This is the first study correlating hippocampal volume on MRI submitted to FreeSurfer processing with ILAE patterns of HS and neuronal loss within each hippocampal subfield, a fundamental finding to anticipate surgical prognosis for patients with drug-resistant MTLE and HS. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Features of amygdala in patients with mesial temporal lobe epilepsy and hippocampal sclerosis: An MRI volumetric and histopathological study.

    Science.gov (United States)

    Nakayama, Yoko; Masuda, Hiroshi; Shirozu, Hiroshi; Ito, Yosuke; Higashijima, Takefumi; Kitaura, Hiroki; Fujii, Yukihiko; Kakita, Akiyoshi; Fukuda, Masafumi

    2017-09-01

    It is well-known that there is a correlation between the neuropathological grade of hippocampal sclerosis (HS) and neuroradiological atrophy of the hippocampus in mesial temporal lobe epilepsy (mTLE) patients. However, there is no strict definition or criterion regarding neuron loss and atrophy of the amygdala neighboring the hippocampus. We examined the relationship between HS and neuronal loss in the amygdala. Nineteen mTLE patients with neuropathological proof of HS were assigned to Group A, while seven mTLE patients without HS were assigned to Group B. We used FreeSurfer software to measure amygdala volume automatically based on pre-operation magnetic resonance images. Neurons observed using Klüver-Barrera (KB) staining in resected amygdala tissue were counted. and the extent of immunostaining with stress marker antibodies was semiquantitatively evaluated. There was no significant difference in amygdala volume between the two groups (Group A: 1.41±0.24; Group B: 1.41±0.29cm 3 ; p=0.98), nor in the neuron cellularity of resected amygdala specimens (Group A: 3.98±0.97; Group B: 3.67±0.67 10× -4 number of neurons/μm 2 ; p=0.40). However, the HSP70 level, representing acute stress against epilepsy, in Group A patients was significantly larger than that in Group B. There was no significant difference in the level of Bcl-2, which is known as a protein that inhibits cell death, between the two groups. Neuronal loss and volume loss in the amygdala may not necessarily follow hippocampal sclerosis. From the analysis of stress proteins, epileptic attacks are as likely to damage the amygdala as the hippocampus but do not lead to neuronal death in the amygdala. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Impact of hippocampal subfield histopathology in episodic memory impairment in mesial temporal lobe epilepsy and hippocampal sclerosis.

    Science.gov (United States)

    Comper, Sandra Mara; Jardim, Anaclara Prada; Corso, Jeana Torres; Gaça, Larissa Botelho; Noffs, Maria Helena Silva; Lancellotti, Carmen Lúcia Penteado; Cavalheiro, Esper Abrão; Centeno, Ricardo Silva; Yacubian, Elza Márcia Targas

    2017-10-01

    The objective of the study was to analyze preoperative visual and verbal episodic memories in a homogeneous series of patients with mesial temporal lobe epilepsy (MTLE) and unilateral hippocampal sclerosis (HS) submitted to corticoamygdalohippocampectomy and its association with neuronal cell density of each hippocampal subfield. The hippocampi of 72 right-handed patients were collected and prepared for histopathological examination. Hippocampal sclerosis patterns were determined, and neuronal cell density was calculated. Preoperatively, two verbal and two visual memory tests (immediate and delayed recalls) were applied, and patients were divided into two groups, left and right MTLE (36/36). There were no statistical differences between groups regarding demographic and clinical data. Cornu Ammonis 4 (CA4) neuronal density was significantly lower in the right hippocampus compared with the left (p=0.048). The groups with HS presented different memory performance - the right HS were worse in visual memory test [Complex Rey Figure, immediate (p=0.001) and delayed (p=0.009)], but better in one verbal task [RAVLT delayed (p=0.005)]. Multiple regression analysis suggested that the verbal memory performance of the group with left HS was explained by CA1 neuronal density since both tasks were significantly influenced by CA1 [Logical Memory immediate recall (p=0.050) and Logical Memory and RAVLT delayed recalls (p=0.004 and p=0.001, respectively)]. For patients with right HS, both CA1 subfield integrity (p=0.006) and epilepsy duration (p=0.012) explained Complex Rey Figure immediate recall performance. Ultimately, epilepsy duration also explained the performance in the Complex Rey Figure delayed recall (pepilepsy duration were associated with visual memory performance in patients with right HS. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. MicroRNA hsa-miR-134 is a circulating biomarker for mesial temporal lobe epilepsy.

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    Simoni H Avansini

    Full Text Available Epilepsy is misdiagnosed in up to 25% of patients, leading to serious and long-lasting consequences. Recently, circulating microRNAs have emerged as potential biomarkers in a number of clinical scenarios. The purpose of this study was to identify and to validate circulating microRNAs that could be used as biomarkers in the diagnosis of epilepsy. Quantitative real-time PCR was used to measure plasma levels of three candidate microRNAs in two phases of study: an initial discovery phase with 14 patients with mesial temporal lobe epilepsy (MTLE, 13 with focal cortical dysplasia (FCD and 16 controls; and a validation cohort constituted of an independent cohort of 65 patients with MTLE and 83 controls. We found hsa-miR-134 downregulated in patients with MTLE (p = 0.018 but not in patients with FCD, when compared to controls. Furthermore, hsa-miR-134 expression could be used to discriminate MTLE patients with an area under the curve (AUC of 0.75. To further assess the robustness of hsa-miR-134 as a biomarker for MTLE, we studied an independent cohort of 65 patients with MTLE, 27 of whom MTLE patients were responsive to pharmacotherapy, and 38 patients were pharmacoresistant and 83 controls. We confirmed that hsa-miR-134 was significantly downregulated in the plasma of patients with MTLE when compared with controls (p < 0.001. In addition, hsa-miR-134 identified patients with MTLE regardless of their response to pharmacotherapy or the presence of MRI signs of hippocampal sclerosis. We revealed that decreased expression of hsa-miR-134 could be a potential non-invasive biomarker to support the diagnosis of patients with MTLE.

  17. Validation of suitable reference genes for expression studies in different pilocarpine-induced models of mesial temporal lobe epilepsy.

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    Thalita Ewellyn Batista Sales Marques

    Full Text Available It is well recognized that the reference gene in a RT-qPCR should be properly validated to ensure that gene expression is unaffected by the experimental condition. We investigated eight potential reference genes in two different pilocarpine PILO-models of mesial temporal lobe epilepsy (MTLE performing a stability expression analysis using geNorm, NormFinder and BestKepeer softwares. Then, as a validation strategy, we conducted a relative expression analysis of the Gfap gene. Our results indicate that in the systemic PILO-model Actb, Gapdh, Rplp1, Tubb2a and Polr1a mRNAs were highly stable in hippocampus of rats from all experimental and control groups, whereas Gusb revealed to be the most variable one. In fact, we observed that using Gusb for normalization, the relative mRNA levels of the Gfap gene differed from those obtained with stable genes. On the contrary, in the intrahippocampal PILO-model, all softwares included Gusb as a stable gene, whereas B2m was indicated as the worst candidate gene. The results obtained for the other reference genes were comparable to those observed for the systemic Pilo-model. The validation of these data by the analysis of the relative expression of Gfap showed that the upregulation of the Gfap gene in the hippocampus of rats sacrificed 24 hours after status epilepticus (SE was undetected only when B2m was used as the normalizer. These findings emphasize that a gene that is stable in one pathology model may not be stable in a different experimental condition related to the same pathology and therefore, the choice of reference genes depends on study design.

  18. Relationship between fluid-attenuated inversion-recovery (FLAIR signal intensity and inflammatory mediator's levels in the hippocampus of patients with temporal lobe epilepsy and mesial temporal sclerosis

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    Pedro Paulo Vasconcellos Varella

    2011-02-01

    Full Text Available We investigated a relationship between the FLAIR signal found in mesial temporal sclerosis (MTS and inflammation. Twenty nine patients were selected through clinical and MRI analysis and submitted to cortico-amygdalo-hippocampectomy to seizure control. Glutamate, TNFα, IL1, nitric oxide (NO levels and immunostaining against IL1β and CD45 was performed. Control tissues (n=10 were obtained after autopsy of patients without neurological disorders. The glutamate was decreased in the temporal lobe epilepsy (TLE -MTS group (p<0.001, suggesting increased release of this neurotransmitter. The IL1β and TNFα were increased in the hippocampus (p<0.05 demonstrating an active inflammatory process. A positive linear correlation between FLAIR signal and NO and IL1β levels and a negative linear correlation between FLAIR signal and glutamate concentration was found. Lymphocytes infiltrates were present in hippocampi of TLE patients. These data showed an association between hippocampal signal alteration and increased inflammatory markers in TLE-MTS.

  19. {sup 1}H MR spectroscopy of mesial temporal lobe epilepsies treated with Gamma knife

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    Hajek, Milan; Dezortova, Monika [MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague (Czech Republic); Center for Cell Therapy and Tissue Repair, V Uvalu 84, 150 00 Prague (Czech Republic); Liscak, Roman; Vymazal, Josef; Vladyka, Vilibald [Department of Stereotactic and Radiation Neurosurgery, Hospital Na Homolce, 151 19, Prague (Czech Republic)

    2003-05-01

    Proton MR spectroscopy was used to observe long-term post-irradiation metabolic changes in epileptogenic tissue and in the contralateral parts of the brain which are not available with conventional imaging methods. We studied these changes in the temporal lobe in six patients, following radiosurgery on the amygdala and hippocampus. {sup 1}H MR spectroscopy at 1.5 T with short and long echo times (TE=10 and 135 ms) were used together with standard MR imaging sequences (T1-, T2-weighted). The treatment was performed by Leksell Gamma Knife with a dose of 50 Gy to the center and a 50% isodose to the margin of the target, represented by the mean volume of approximately 7.5 ml. Magnetic resonance imaging and MR spectroscopy examinations were performed at least once per year for 3 years. The most significant changes in spectra were observed approximately 1 year after the irradiation when edema in irradiated area was observed and strong signal of lipids was identified. Later, edema and lipid signals disappeared and follow-up was characterized by a decrease of NAA, Cr, and Cho concentrations in the ipsilateral region of the brain to the irradiation (LCModel calculation from voxel of interest 3.8-4.5 ml positioned into the centrum of target volume). The concentration of NAA, Cr, and Cho after radiosurgery was significantly different from control values (p<0.05) and also from concentrations in the contralateral part of the brain (p<0.05). In the contralateral part, the concentration of NAA was significantly increased (p<0.05) (NAA: before treatment 8.81, after treatment 11.33 mM). No radiotoxic changes were observed in the contralateral part of the brain or behind the area of target volume. The MR spectroscopy findings precluded MRI observation and MRS results completed data about the development of radiotoxic changes in the target volume. (orig.)

  20. Can intraoperative electrocorticography patterns predict surgical outcome in patients with temporal lobe epilepsy secondary to unilateral mesial temporal sclerosis?

    Science.gov (United States)

    Oliveira, Pedro A L; Garzon, Eliana; Caboclo, Luís O S F; Sousa, Patrícia S; Carrete, Henrique; Centeno, Ricardo S; Costa, José M P; Machado, Hélio R; Yacubian, Elza M T; Bianchin, Marino M; Sakamoto, Américo C

    2006-10-01

    Intraoperative electrocorticography (ECoG) can be performed in cases of temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS). However, its significance and correlation with surgical outcome are still controversial. To analyze the electrophysiological characteristics of temporal lobe structures during ECoG of patients with TLE-HS, with emphasis on the comparison between pre- and post-resection recordings and surgical outcome. Seventeen patients with refractory TLE-HS submitted to corticoamigdalohipocampectomy were included in the study. Clinical variables included age at the onset, duration of epilepsy and seizure outcome. The post-operative follow-up ranged from 24 to 36 months. According to outcome subjects were divided in two subgroups: (A) individuals free of seizures (Engel 1A), and (B) individuals not-free of seizures (Engel 1B-IV). Four patterns of ECoG findings were identified: isolated discharges; high frequency spikes (HFS); continuous discharges; combination of isolated discharges and HFS. According to predominant topography ECoG was classified as mediobasal, lateral (or neocortical), mediobasal and lateral. The progressive removal of the temporal pole and the hippocampus was associated with significant decrease of neocortical spikes. No correlation between clinical variables and seizure outcome was observed. Patients who only had isolated spikes on intraoperative ECoG presented a statistical trend for excellent surgical control. Patients who presented temporal pole blurring on MRI also had better post-surgical seizure outcome. This study showed that out of diverse clinical and laboratory variables, only isolated discharges on intraoperative ECoG and temporal pole blurring on MRI predicted excellent post-surgical seizure outcome. However, other studies with larger number of patients are still necessary to confirm these findings.

  1. Mesial temporal lobe morphology in intractable pediatric epilepsy: so-called hippocampal malrotation, associated findings, and relevance to presurgical assessment.

    Science.gov (United States)

    Leach, James L; Awwad, Reem; Greiner, Hansel M; Vannest, Jennifer J; Miles, Lili; Mangano, Francesco T

    2016-06-01

    OBJECTIVE Diagnostic criteria for hippocampal malrotation (HIMAL) on brain MRI typically include a rounded hippocampus, vertical collateral sulcus, and architectural blurring. Relationship to epileptogenesis remains speculative, and usefulness for surgical guidance is unknown. The study was performed to determine the prevalence of hippocampal rotational anomalies in a cohort of pediatric patients with intractable epilepsy undergoing evaluation for surgery and to determine the significance of this finding in the context of surgical planning. METHODS Forty-eight surgically treated children with intractable epilepsy were compared with matched healthy subjects; reviewers were blinded to surgical side. Each temporal lobe was evaluated for rounded hippocampus, blurring, vertical collateral sulcus, wide choroidal fissure, enlarged temporal horn, low fornix, hippocampal signal, and findings of hippocampal sclerosis. A mesial temporal lobe (MTL) score was calculated by summing the number of features, and the collateral sulcus angle (CSA) was measured in each temporal lobe. Surgical side, pathological diagnosis, and imaging findings elsewhere in the brain were tabulated. Presence of HIMAL, associated imaging features, and MTL score were compared between sides, between epilepsy and control groups, in relationship to side of surgery, and in relationship to postoperative outcome. RESULTS Only 3 epilepsy patients (6.2%) and no controls exhibited all 3 features of HIMAL (p = 0.12). Eight of 48 (16.7%) epilepsy versus 2 of 48 (4.6%) control subjects had both a rounded hippocampus and vertical collateral sulcus (suggesting HIMAL) (p = 0.045). In control and epilepsy subjects, most findings were more prevalent on the left, and the left CSA was more vertical (p Epilepsy subjects had higher MTL scores (z = -2.95, p = 0.002) and more acute CSAs (p = 0.04) than controls. Only lateralizing raw MTL score had a significant association with surgical side (p = 0.03, OR 7.33); however, this

  2. Mesial temporal sclerosis

    African Journals Online (AJOL)

    Kurt

    2005-07-29

    Jul 29, 2005 ... The case under discussion involved a 42-year-old woman. She had had numerous previous admis- sions related to her alcoholism, but presented on this occasion with new onset partial complex seizures and secondary generalisation. On clinical examination she had impaired short- term memory, however ...

  3. MicroRNA and mesial temporal lobe epilepsy with hippocampal sclerosis: Whole miRNome profiling of human hippocampus.

    Science.gov (United States)

    Bencurova, Petra; Baloun, Jiri; Musilova, Katerina; Radova, Lenka; Tichy, Boris; Pail, Martin; Zeman, Martin; Brichtova, Eva; Hermanova, Marketa; Pospisilova, Sarka; Mraz, Marek; Brazdil, Milan

    2017-10-01

    Mesial temporal lobe epilepsy (mTLE) is a severe neurological disorder characterized by recurrent seizures. mTLE is frequently accompanied by neurodegeneration in the hippocampus resulting in hippocampal sclerosis (HS), the most common morphological correlate of drug resistance in mTLE patients. Incomplete knowledge of pathological changes in mTLE+HS complicates its therapy. The pathological mechanism underlying mTLE+HS may involve abnormal gene expression regulation, including posttranscriptional networks involving microRNAs (miRNAs). miRNA expression deregulation has been reported in various disorders, including epilepsy. However, the miRNA profile of mTLE+HS is not completely known and needs to be addressed. Here, we have focused on hippocampal miRNA profiling in 33 mTLE+HS patients and nine postmortem controls to reveal abnormally expressed miRNAs. In this study, we significantly reduced technology-related bias (the most common source of false positivity in miRNA profiling data) by combining two different miRNA profiling methods, namely next generation sequencing and miRNA-specific quantitative real-time polymerase chain reaction. These methods combined have identified and validated 20 miRNAs with altered expression in the human epileptic hippocampus; 19 miRNAs were up-regulated and one down-regulated in mTLE+HS patients. Nine of these miRNAs have not been previously associated with epilepsy, and 19 aberrantly expressed miRNAs potentially regulate the targets and pathways linked with epilepsy (such as potassium channels, γ-aminobutyric acid, neurotrophin signaling, and axon guidance). This study extends current knowledge of miRNA-mediated gene expression regulation in mTLE+HS by identifying miRNAs with altered expression in mTLE+HS, including nine novel abnormally expressed miRNAs and their putative targets. These observations further encourage the potential of microRNA-based biomarkers or therapies. Wiley Periodicals, Inc. © 2017 International League Against

  4. Functional substrate for memory function differences between patients with left and right mesial temporal lobe epilepsy associated with hippocampal sclerosis.

    Science.gov (United States)

    Jin, Seung-Hyun; Chung, Chun Kee

    2015-10-01

    Little is known about the functional substrate for memory function differences in patients with left or right mesial temporal lobe epilepsy (mTLE) associated with hippocampal sclerosis (HS) from an electrophysiological perspective. To characterize these differences, we hypothesized that hippocampal theta connectivity in the resting-state might be different between patients with left and right mTLE with HS and be correlated with memory performance. Resting-state hippocampal theta connectivity, identified via whole-brain magnetoencephalography, was evaluated. Connectivity and memory function in 41 patients with mTLE with HS (left mTLE=22; right mTLE=19) were compared with those in 46 age-matched healthy controls and 28 patients with focal cortical dysplasia (FCD) but without HS. Connectivity between the right hippocampus and the left middle frontal gyrus was significantly stronger in patients with right mTLE than in patients with left mTLE. Moreover, this connectivity was positively correlated with delayed verbal recall and recognition scores in patients with mTLE. Patients with left mTLE had greater delayed recall impairment than patients with right mTLE and FCD. Similarly, delayed recognition performance was worse in patients with left mTLE than in patients with right mTLE and FCD. No significant differences in memory function between patients with right mTLE and FCD were detected. Patients with right mTLE showed significantly stronger hippocampal theta connectivity between the right hippocampus and left middle frontal gyrus than patients with FCD and left mTLE. Our results suggest that right hippocampal-left middle frontal theta connectivity could be a functional substrate that can account for differences in memory function between patients with left and right mTLE. This functional substrate might be related to different compensatory mechanisms against the structural hippocampal lesions in left and right mTLE groups. Given the positive correlation between

  5. Aberrant expression of miR-218 and miR-204 in human mesial temporal lobe epilepsy and hippocampal sclerosis-Convergence on axonal guidance

    DEFF Research Database (Denmark)

    Kaalund, Sanne S; Venø, Morten T; Bak, Mads

    2014-01-01

    OBJECTIVE: Mesial temporal lobe epilepsy (MTLE) is one of the most common types of the intractable epilepsies and is most often associated with hippocampal sclerosis (HS), which is characterized by pronounced loss of hippocampal pyramidal neurons. microRNAs (miRNAs) have been shown...... to be dysregulated in epilepsy and neurodegenerative diseases, and we hypothesized that miRNAs could be involved in the pathogenesis of MTLE and HS. METHODS: miRNA expression was quantified in hippocampal specimens from human patients using miRNA microarray and quantitative real-time polymerase chain reaction RT...

  6. Pre-surgical predictors for psychiatric disorders following epilepsy surgery in patients with refractory temporal lobe epilepsy and mesial temporal sclerosis.

    Science.gov (United States)

    Filho, Gerardo Maria de Araújo; Mazetto, Lenon; Gomes, Francinaldo Lobato; Marinho, Murilo Martinez; Tavares, Igor Melo; Caboclo, Luís Otávio Sales Ferreira; Centeno, Ricardo Silva; Yacubian, Elza Márcia Targas

    2012-11-01

    Psychiatric outcomes of patients submitted to epilepsy surgery have gained particular interest given the high prevalence of pre-surgical psychiatric disorders (PD) in this population. The present study aimed to verify the possible pre-surgical predictors for psychiatric disorders following epilepsy surgery in a homogeneous series of patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS). Data from 115 TLE-MTS patients (65 females; 56.5%) who underwent cortico-amygdalohippocampectomy were included. Pre- and post-surgical psychiatric evaluations were performed using DSM-IV criteria. Pre-surgical PD - particularly mood, anxiety and psychotic disorders - were diagnosed in 47 patients (40.8%). Twenty-seven patients (54% of those with pre-surgical PD) demonstrated a remission of psychiatric symptoms on post-surgical psychiatric evaluation. Eleven patients (9.6%) developed de novo PD. The presence of pre-surgical depression (OR=3.32; p=0.008), pre-surgical interictal psychosis (OR=4.39; p=0.009) and epileptiform discharges contralateral to the epileptogenic zone (OR=2.73; p=0.01) were risk factors associated with post-surgical PD. Although epilepsy surgery is considered to be the best treatment option for patients with refractory TLE-MTS, the relatively high psychiatric comorbidities observed in surgical candidates and their possible negative impact on post-surgical outcomes require a careful pre-surgical evaluation of clinical, sociodemographic and psychiatric factors. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. Major depressive disorder as a predictor of a worse seizure outcome one year after surgery in patients with temporal lobe epilepsy and mesial temporal sclerosis.

    Science.gov (United States)

    de Araújo Filho, Gerardo Maria; Gomes, Francinaldo Lobato; Mazetto, Lenon; Marinho, Murilo Martinez; Tavares, Igor Melo; Caboclo, Luís Otávio Sales Ferreira; Yacubian, Elza Márcia Targas; Centeno, Ricardo Silva

    2012-10-01

    The association between pre-surgical psychiatric disorders (PDs) and worse seizure outcome in patients with refractory epilepsy submitted to surgery has been increasingly recognized in the literature. The present study aimed to verify the impact of pre- and post-surgical PD on seizure outcome in a series of patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS). Data from 115 TLE-MTS patients (65 females; 56.5%) who underwent cortico-amygdalohippocampectomy (CAH) were analyzed. Pre- and post-surgical psychiatric evaluations were performed using DSM-IV and ILAE criteria. The outcome subcategory Engel IA was considered as corresponding to a favorable prognosis. A multivariate logistic regression model was applied to identify possible risk factors associated with a worse seizure outcome. Pre-surgical PDs, particularly major depressive disorder (MDD), anxiety and psychotic disorders, were common, being found in 47 patients (40.8%). Fifty-six patients (48.7%) were classified as having achieved an Engel IA one year after CAH. According to the logistic regression model, the presence of pre-surgical MDD (OR=5.23; p=0.003) appeared as the most important risk factor associated with a non-favorable seizure outcome. Although epilepsy surgery may be the best treatment option for patients with refractory TLE-MTS, our findings emphasize the importance of performing a detailed psychiatric examination as part of the pre-surgical evaluation protocol. Copyright © 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  8. Clinical and eeg analysis of mesial and lateral temporal lobe seizures Análise clínica e eletrencefalográfica de crises epilépticas temporais de origem mesial e lateral

    Directory of Open Access Journals (Sweden)

    FÁBIO GALVÃO DANTAS

    1998-09-01

    Full Text Available The analysis of the temporal lobe seizures through video-EEG systems shows that they often consist of a sequence of clinical and EEG features which may suggest the localization and the lateralization of the epileptogenic lobe. We analyzed clinical and EEG features of 50 temporal lobe seizures which were separated in group 1 with 25 patients (related to mesial temporal sclerosis and group 2 with 25 patients (other neocortical temporal lesions. Among the auras, the epigastric type was the most frequent and predominated in group 1. There were differences between the two groups, considering dystonic and tonic posturing and versive head and eye movements. Dystonic posturing was always contralateral to the ictal onset and was considered the most useful lateralizing clinical feature. Ictal speech, spitting and blinking automatisms, prolonged disorientation for place and a greatest percentage of postictal language preservation occurred in right temporal seizures. Postictal aphasia and global disorientation predominated in left temporal seizures. EEG was important for lateralizing the epileptogenic lobe, specially considering rhythmic ictal activity and postictal findings.As crises epilépticas do lobo temporal tendem a seguir uma sequência previsível de eventos clínicos e eletrencefalográficos, cuja análise, preferencialmente através de sistemas de vídeo-EEG, sugere a localização e a lateralização do lobo epileptogênico. Para este estudo, foram analisadas 50 crises epilépticas do lobo temporal, do ponto de vista clínico e eletrencefalográfico, sendo 25 relacionadas a esclerose mesial (grupo 1 e 25 a patologias neocorticais (grupo 2. Auras abdominais foram as mais frequentes, predominando no grupo 1. Houve diferenças entre os dois grupos, quanto à instalação e duração da postura distônica, à postura tônica e à versão oculocefálica. Postura distônica unilateral foi o mais importante fenômeno clínico lateralizatório, sempre

  9. A locus identified on chromosome18p11.31 is associated with hippocampal abnormalities in a family with mesial temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Claudia Vianna Maurer-Morelli

    2012-08-01

    Full Text Available We aimed to identify the region harboring a putative candidate gene associated with hippocampal abnormalities (HAb in a family with mesial temporal lobe epilepsy (MTLE. Genome-wide scan was performed in one large kindred with MTLE using a total of 332 microsatellite markers at ~12cM intervals. An additional 13 markers were genotyped in the candidate region. Phenotypic classes were defined according to the presence of hippocampal atrophy and/or hyperintense hippocampal T2 signal detected on magnetic resonance imaging. We identified a significant positive LOD score on chromosome 18p11.31 with a Zmax of 3.12 at D18S452. Multipoint LOD scores and haplotype analyses localized the candidate locus within a 6cM interval flanked by D18S976 and D18S967. We present here evidence that HAb, which were previously related mainly to environmental risk factors, may be influenced by genetic predisposition. This finding may have major impact in the study of the mechanisms underlying abnormalities in mesial temporal lobe structures and their relationship with MTLE.

  10. Decrease of NAA with aging outside the seizure focus in mesial temporal lobe epilepsy--a proton-MRS study at 3 Tesla.

    Science.gov (United States)

    Riederer, Franz; Bittsanský, Michal; Lehner-Baumgartner, Eva; Baumgartner, Christoph; Mlynárik, Vladimír; Gruber, Stephan; Moser, Ewald; Kaya, Marihan; Serles, Wolfgang

    2007-11-07

    There is evidence that chronic pharmacoresistant temporal lobe epilepsy (TLE) is a progressive disorder accompanied by mental deterioration. We investigated effects of aging on cerebral N-acetyl-aspartate (NAA) concentrations in the temporal lobe of 12 patients with pharmacoresistant mesial TLE (mTLE) and 22 healthy controls by means of proton-magnetic resonance spectroscopy ((1)H-MRS) at 3 T. Furthermore, we calculated correlations between NAA concentrations and measures of verbal and figural memory in patients. In mTLE patients but not in healthy controls the concentration of NAA in the lateral temporal lobe was negatively correlated with age. In patients with mTLE NAA in left lateral temporal voxels correlated with verbal memory. NAA in medial temporal voxels did not correlate with age or neuropsychological measures. Significant decrease of NAA with age in the lateral temporal lobe of patients with mTLE provides evidence for progressive neuronal dysfunction with aging. NAA is a marker of neuronal integrity since it correlates with verbal memory.

  11. Correlação entre atrofia hipocampal e déficit de memória em pacientes com epilepsia de lobo temporal mesial

    OpenAIRE

    Denise Pacagnella

    2012-01-01

    Resumo: A Epilepsia de Lobo Temporal Mesial (ELTM) é a forma mais frequente de epilepsia focal em adultos e geralmente está associada à atrofia hipocampal (AH) identificável pela ressonância magnética (RM) de alta resolução. Consiste em uma síndrome frequentemente refratária ao tratamento clínico e os pacientes podem apresentar déficits de memória devido a danos no sistema hipocampal, porém pouco se sabe a respeito do impacto da frequência de crises sobre a memória. Portanto, os objetivos do ...

  12. Linkage study of voltage-gated potassium channels in familial mesial temporal lobe epilepsy Análise de ligação dos canais de potássio voltagem-dependente na epilepsia de lobo temporal mesial familiar

    Directory of Open Access Journals (Sweden)

    Cláudia Vianna Maurer-Morelli

    2007-03-01

    Full Text Available Voltage-gated potassium channels (VGKCs play a critical role in the regulation of neuronal excitability and have been implicated in some types of epilepsies. Recently, autoimmune limbic encephalitis (LE was associated with antibodies against VGKC. In addition, patients with LE showed partial epilepsy and increased T2 signal abnormalities in limbic structures. We have reported familial mesial temporal lobe epilepsy (FMTLE associated with hippocampal atrophy (HA and other signs of mesial temporal sclerosis detected by magnetic resonance imaging (MRI. In order to investigate whether VGKC may be associated to HA present in FMTLE, we perform linkage study in these candidate genes. Seventy-three microsatellites markers were genotyped in different human autosomal chromosome. Two-point LOD scores did not show evidence for linkage with any of the microsatellite markers genotyped (Zmax ranging from 0.11to-9.53 at theta=0.00. In the present study, linkage data showed no evidence that VGKC are involved in the determination of HA in FMTLE.Canais de potássio voltagem-dependentes (CPVD desempenham importante papel na excitabilidade neuronal e estão associados a determinados tipos de epilepsia. Recentemente, um tipo de encefalite límbica autoimune (EL foi associado com anticorpos contra CPVD. Além disso, há relatos de pacientes com EL e epilepsia parcial, além de hipersinal em regiões límbicas detectadas em imagens de ressonância magnética (IRM. Nós temos descrito a epilepsia de lobo temporal mesial familial (ELTMF associada à atrofia hipocampal (AH e outros sinais de esclerose mesial temporal observadas em IRM. Para investigar se os CPVD podem estar associados com a AH identificada na ELTMF, empregamos o estudo de ligação genética nesses genes candidatos. Setenta e três marcadores microssatélites foram genotipados e o LOD score de dois pontos mostrou Zmax variando de 0.11 a -9.53 para teta=0.00. No presente estudo, os dados obtidos com a an

  13. Clinical Study White Matter Atrophy in Patients with Mesial Temporal Lobe Epilepsy: Voxel-Based Morphometry Analysis of T1- and T2-Weighted MR Images

    International Nuclear Information System (INIS)

    Braga, B.; Yasuda, C.L.; Cendes, F.

    2012-01-01

    Introduction. Mesial temporal lobe epilepsy (MTLE) associated with hippocampal sclerosis is highly refractory to clinical treatment. MRI voxel-based morphometry (VBM) of T1-weighted images has revealed a widespread pattern of gray matter (GM) and white matter (WM) atrophy in MTLE. Few studies have investigated the role of T2-weighted images in revealing WM atrophy using VBM. Objectives. To compare the results of WM atrophy between T1- and T2-weighted images through VBM. Methods. We selected 28 patients with left and 27 with right MTLE and 60 normal controls. We analyzed T1- and T2- weighted images with SPM8, using VBM/DARTEL algorithm to extract maps of GM and WM. The second level of SPM was used to investigate areas of WM atrophy among groups. Results. Both acquisitions showed bilateral widespread WM atrophy. T1-weighted images showed higher sensibility to detect areas of WM atrophy in both groups of MTLE. T2-weighted images also showed areas of WM atrophy in a more restricted pattern, but still bilateral and with a large area of superposition with T1-weighted images. Conclusions. In MTLE, T1-weighted images are more sensitive to detect subtle WM abnormalities using VBM, compared to T2 images, although both present a good superposition of statistical maps. 1. Introduction The mesial temporal lobe epilepsy (MTLE) is highly refractory to pharmacological treatment [1], and it is the main group of epilepsy referred to the tertiary care hospitals for surgical treatment [2]. MTLE shows a good surgical prognosis, with satisfactory seizures control in 60-80% of the patients [3]. In approximately 65%

  14. Bilateral mesial temporal sclerosis: MRI with high-resolution fast spin-echo and fluid-attenuated inversion-recovery sequences

    Energy Technology Data Exchange (ETDEWEB)

    Oppenheim, C.; Dormont, D.; Lehericy, S.; Marsault, C. [Dept. of Neuroradiology, Groupe Hospitalier Pite-Salpetriere, Paris (France); Hasboun, D. [Dept. of Neuroradiology, Groupe Hospitalier Pite-Salpetriere, Paris (France)]|[Dept. of Neurology, Paris VI Univ. (France); Bazin, B.; Samson, S.; Baulac, M. [Dept. of Neurology, Paris VI Univ. (France)

    1999-07-01

    We report a retrospective analysis of MRI in 206 patients with intractable seizures and describe the findings in bilateral mesial temporal sclerosis (MTS) on fast spin-echo (FSE) and fast fluid-attenuated inversion-recovery (fFLAIR) sequences. Criteria for MTS were atrophy, signal change and loss of the digitations of the head of the hippocampus. In patients with bilateral MRI signs of MTS, correlation with clinical electro, volumetric MRI data and neuropsychological tests, when available, was performed. Bilateral MTS was observed in seven patients. Bilateral loss of the digitations and signal change of fFLAIR was seen in all seven. In three, bilateral atrophy was obvious. In two patients, mild bilateral atrophy was observed and in two others, the hippocampi were: asymmetrical, with obvious atrophy on only one side. Volumetric data confirmed bilateral symmetrical atrophy in five patients, and volumes were at the lowest of the normal range in other two. The EEG showed temporal abnormalities in all patients, unilateral in five and bilateral in two. All patients had memory impairment and neuropsychological data confirmed visual and verbal memory deficits; two patients failed the Wada test on both sides. High-resolution T2-weighted FSE and fFLAIR sequences allow diagnosis of bilateral MTS, which has important therapeutic and prognostic implications. (orig.)

  15. Factores de Riesgo para Recurrencia de Convulsiones y Pronóstico a Corto Plazo en Cirugía de Epilepsia para Esclerosis Mesial Temporal.

    Directory of Open Access Journals (Sweden)

    Héctor Jaramillo Betancur

    2009-07-01

    Full Text Available

    Objetivo: Determinar los factores de riesgo para recurrencia de convulsiones y la clasificación posquirúrgica a corto plazo en pacientes operados por esclerosis mesial temporal (EMT.

    Métodos: Estudio de casos y controles anidado en la cohorte de pacientes con EMT diagnosticados por resonancia magnética con dos años de seguimiento posquirúrgico; se excluyeron pacientes con EMT bilateral. Se evaluaron características clínicas prequirúrgicas, foco epileptogénico en video-EEG y variables quirúrgicas con respecto a recurrencia de convulsiones en los primeros dos años posquirúrgicos y clasificación de Engel en el primer y segundo aniversario de la cirugía.

    Resultados: Entre octubre de 2001 y junio de 2008 se han evaluado 144 pacientes con EMT candidatos a cirugía de epilepsia; a junio de 2007, se han operado 89 pacientes, 51.7% con EMT izquierda. 35.8% de los pacientes presentaron recurrencia de convulsiones antes del segundo año posquirúrgico; el factor de riesgo prequirúrgico asociado a recurrencia fue foco bitemporal o temporal único con diseminación contralateral por video-EEG (OR: 6.32; IC95% 1.64-26.41, y posquirúrgico, la presencia de convulsiones durante el primer mes posoperatorio (p:0.0004; no se encontró asociación con recurrencia para: género, convulsiones tónico-clónicas generalizadas prequirúrgicas, lado de la EMT ni tiempo de evolución prequirúrgica de la epilepsia. 66.3% y 75.8% de los pacientes estaban en Engel I al primer y segundo aniversario de la cirugía, respectivamente. 91% de los pacientes intervenidos estaban en buen pronóstico posquirúrgico a los dos años.

    Conclusión: La localización del foco epileptogénico por electrofisiología es factor determinante en el pronóstico posquirúrgico a corto plazo en EMT.

    Palabras clave

    Cirugía de epilepsia, convulsiones, epilepsia del lóbulo temporal

  16. Bilateral mesial temporal sclerosis: MRI with high-resolution fast spin-echo and fluid-attenuated inversion-recovery sequences

    International Nuclear Information System (INIS)

    Oppenheim, C.; Dormont, D.; Lehericy, S.; Marsault, C.; Hasboun, D.; Bazin, B.; Samson, S.; Baulac, M.

    1999-01-01

    We report a retrospective analysis of MRI in 206 patients with intractable seizures and describe the findings in bilateral mesial temporal sclerosis (MTS) on fast spin-echo (FSE) and fast fluid-attenuated inversion-recovery (fFLAIR) sequences. Criteria for MTS were atrophy, signal change and loss of the digitations of the head of the hippocampus. In patients with bilateral MRI signs of MTS, correlation with clinical electro, volumetric MRI data and neuropsychological tests, when available, was performed. Bilateral MTS was observed in seven patients. Bilateral loss of the digitations and signal change of fFLAIR was seen in all seven. In three, bilateral atrophy was obvious. In two patients, mild bilateral atrophy was observed and in two others, the hippocampi were: asymmetrical, with obvious atrophy on only one side. Volumetric data confirmed bilateral symmetrical atrophy in five patients, and volumes were at the lowest of the normal range in other two. The EEG showed temporal abnormalities in all patients, unilateral in five and bilateral in two. All patients had memory impairment and neuropsychological data confirmed visual and verbal memory deficits; two patients failed the Wada test on both sides. High-resolution T2-weighted FSE and fFLAIR sequences allow diagnosis of bilateral MTS, which has important therapeutic and prognostic implications. (orig.)

  17. Limbic encephalitis associated with anti-voltage-gated potassium channel complex antibodies as a cause of adult-onset mesial temporal lobe epilepsy.

    Science.gov (United States)

    Toyota, Tomoko; Akamatsu, Naoki; Tsuji, Sadatoshi; Nishizawa, Shigeru

    2014-06-01

    Recently, some reports have indicated that limbic encephalitis associated with anti-voltage-gated potassium channel complex antibodies (VGKC-Ab) is a cause of adult-onset mesial temporal lobe epilepsy (MTLE). We report a 53-year-old woman who had her first epileptic seizure at the age of 50 years old. Examination by 3-Tesla brain MRI revealed left hippocampal high signal intensity and swelling on fluid-attenuated inversion recovery (FLAIR) and T2-weighted imaging at 2 months after her first seizure. The patient received intravenous methylprednisolone and carbamazepine 300 mg/day. One month later, MRI revealed improvement of her left hippocampal abnormalities. Thereafter, she had no seizures, however, three years after her first seizure, EEG revealed a seizure pattern in the left temporal region. Brain MRI revealed left hippocampal high signal intensity and brain fluorodeoxyglucose positron emission tomography revealed hypermetabolism. Her serum VGKC-Ab levels were 118 pM(normal VGKC-Ab levels decreased to 4.4 pM. Remission of the epileptic seizures was also observed. This MTLE in the middle age was considered as limbic encephalitis associated with anti- VGKC-Ab. In cases of unexplained adult-onset MTLE, limbic encephalitis associated with anti-VGKC-Ab, which responds well to immunotherapy, should be considered in the differential diagnosis.

  18. Microtubule-Associated Proteins in Mesial Temporal Lobe Epilepsy with and without Psychiatric Comorbidities and Their Relation with Granular Cell Layer Dispersion

    Directory of Open Access Journals (Sweden)

    Ludmyla Kandratavicius

    2013-01-01

    Full Text Available Background. Despite strong association between epilepsy and psychiatric comorbidities, biological substrates are unknown. We have previously reported decreased mossy fiber sprouting in mesial temporal lobe epilepsy (MTLE patients with psychosis and increased in those with major depression. Microtubule associated proteins (MAPs are essentially involved in dendritic and synaptic sprouting. Methods. MTLE hippocampi of subjects without psychiatric history, MTLE + major depression, and MTLE + interictal psychosis derived from epilepsy surgery and control necropsies were investigated for neuronal density, granular layer dispersion, and MAP2 and tau immunohistochemistry. Results. Altered MAP2 and tau expression in MTLE and decreased tau expression in MTLE with psychosis were found. Granular layer dispersion correlated inversely with verbal memory scores, and with MAP2 and tau expression in the entorhinal cortex. Patients taking fluoxetine showed increased neuronal density in the granular layer and those taking haloperidol decreased neuronal density in CA3 and subiculum. Conclusions. Our results indicate relations between MAPs, granular layer dispersion, and memory that have not been previously investigated. Differential MAPs expression in human MTLE hippocampi with and without psychiatric comorbidities suggests that psychopathological states in MTLE rely on differential morphological and possibly neurochemical backgrounds. This clinical study was approved by our institution’s Research Ethics Board (HC-FMRP no. 1270/2008 and is registered under the Brazilian National System of Information on Ethics in Human Research (SISNEP no. 0423.0.004.000-07.

  19. SCOPE-mTL: A non-invasive tool for identifying and lateralizing mesial temporal lobe seizures prior to scalp EEG ictal onset.

    Science.gov (United States)

    Lam, Alice D; Maus, Douglas; Zafar, Sahar F; Cole, Andrew J; Cash, Sydney S

    2017-09-01

    In mesial temporal lobe (mTL) epilepsy, seizure onset can precede the appearance of a scalp EEG ictal pattern by many seconds. The ability to identify this early, occult mTL seizure activity could improve lateralization and localization of mTL seizures on scalp EEG. Using scalp EEG spectral features and machine learning approaches on a dataset of combined scalp EEG and foramen ovale electrode recordings in patients with mTL epilepsy, we developed an algorithm, SCOPE-mTL, to detect and lateralize early, occult mTL seizure activity, prior to the appearance of a scalp EEG ictal pattern. Using SCOPE-mTL, 73% of seizures with occult mTL onset were identified as such, and no seizures that lacked an occult mTL onset were identified as having one. Predicted mTL seizure onset times were highly correlated with actual mTL seizure onset times (r=0.69). 50% of seizures with early mTL onset were lateralizable prior to scalp ictal onset, with 94% accuracy. SCOPE-mTL can identify and lateralize mTL seizures prior to scalp EEG ictal onset, with high sensitivity, specificity, and accuracy. Quantitative analysis of scalp EEG can provide important information about mTL seizures, even in the absence of a visible scalp EEG ictal correlate. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  20. Dentate gyrus and hilus transection blocks seizure propagation and granule cell dispersion in a mouse model for mesial temporal lobe epilepsy.

    Science.gov (United States)

    Pallud, Johan; Häussler, Ute; Langlois, Mélanie; Hamelin, Sophie; Devaux, Bertrand; Deransart, Colin; Depaulis, Antoine

    2011-03-01

    Epilepsy-associated changes of the anatomical organization of the dentate gyrus and hilus may play a critical role in the initiation and propagation of seizures in mesial temporal lobe epilepsy (MTLE). This study evaluated the role of longitudinal projections in the propagation of hippocampal paroxysmal discharges (HPD) in dorsal hippocampus by performing a selective transection in a mouse model for MTLE obtained by a single unilateral intrahippocampal injection of kainic acid (KA). Full transections of the dentate gyrus and hilus were performed in the transverse axis at 22 days after KA injection when spontaneous HPD were fully developed. They: (i) significantly reduced the occurrence of HPD; (ii) increased their duration at the KA injection site; (iii) abolished their spread along the longitudinal axis of the hippocampal formation and; (iv) limited granule cell dispersion (GCD) of the dentate gyrus posterior to the transection. These data suggest that: (i) longitudinal projections through the dentate gyrus and hilus are involved in HPD spread; (ii) distant hippocampal circuits participate in the generation and cessation of HPD and; (iii) GCD requires continuous HPD to develop, even when seizures are established. Our data reveal a critical role for longitudinal projections in the generation and spread of hippocampal seizures. Copyright © 2010 Wiley-Liss, Inc.

  1. Parahippocampectomy as a New Surgical Approach to Mesial Temporal Lobe Epilepsy Caused By Hippocampal Sclerosis: A Pilot Randomized Comparative Clinical Trial.

    Science.gov (United States)

    Alonso-Vanegas, Mario Arturo; Freire Carlier, Iván D; San-Juan, Daniel; Martínez, Alma Rosa; Trenado, Carlos

    2018-02-01

    The parahippocampal gyrus plays an important role in the epileptogenic pathways of mesial temporal lobe epilepsy caused by hippocampal sclerosis (mTLE-HS); its resection could prevent epileptic seizures with fewer complications. This study evaluates the initial efficacy and safety of anterior temporal lobectomy (ATL), selective amygdalohipppocampectomy (SAH), and parahippocampectomy (PHC) surgical approaches in mTLE-HS. A randomized comparative pilot clinical trial (2008-2011) was performed that included patients with mTLE-HS who underwent ATL, trans-T3 SAH, and trans-T3 PHC. Their sociodemographic characteristics, visual field profiles, verbal and visual memory profiles, and Engel scale outcome at baseline and at 1 and 5 years are described, using descriptive statistics along with parametric and nonparametric tests. Forty-three patients with a mean age of 35.2 years (18-56 years), 65% female, were analyzed: 14 underwent PHC, 14 ATL, and 15 SAH. The following percentages refer to those patients who were seizure free (Engel class IA) at 1-year and 5-year follow-up, respectively: 42.9% PHC, 71.4% ATL, and 60% SAH (P = 0.304); 28.6% PHC, 50% ATL, and 53.3% SAH (P = 0.353). Postoperative visual field deficits were 0% PHC, 85.7% ATL, and 46.7% SAH (P = 0.001). Verbal and/or visual memory worsening were present in 21.3% PHC, 42.8% ATL, and 33.4% SAH (P = 0.488) and preoperative and postoperative visual memory scores were significantly different in the SAH group only (P = 0.046). PHC, ALT, and SAH show a preliminary similar efficacy in short-term seizure-free rates in patients with mTLE-HS. However, PHC efficacy in the long-term decreases compared with the other surgical techniques. PHC does not produce postoperative visual field deficits. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. PARADIGMA PSICOSSOCIAL

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    Alexsandro Barreto Almeida

    2015-01-01

    Full Text Available Este estudio tuvo como objetivo conocer la percepción y las intervenciones de equipos de apoyo básicos del centro de salud móvil de emergencia en el estado de crisis psíquica. Investigación cualitativa, descriptiva realizada en el estado de Santa Catarina con profesionales de cuatro equipos de Unidades de Soporte Básico del Servicio de Atención Móvil de Urgencias. Los datos fueron recolectados de abril a junio de 2011 mediante entrevista semiestructurada. Se utilizó el Discurso del Sujeto Colectivo para organizar y analizar los datos y para la discusión el Paradigma Psicosocial. De los resultados emergieron tres discursos con las ideas: crisis como alteración del comportamiento e inestabilidad psicológica; se manifiesta con alucinaciones y agresividad; la intervención surge con contención física, medicamentosa e interconsultas. Se concluye que la concepción de la crisis por los profesionales está ligada al positivismo de la psiquiatría y la atención pre-hospitalaria sigue medidas protocolares en el atendimiento a la persona en crisis psíquica, distante de los principios determinados por el paradigma psicosocial.

  3. An fMRI study of mesial temporal lobe epilepsy with different pathological basis using amplitude of low-frequency fluctuation analysis

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    Wei WEI

    2014-12-01

    Full Text Available Objective To study the distinction of abnormal brain activity in mesial temporal lobe epilepsy (mTLE with hippocampal sclerosis (HS or other pathogical basis, and to discuss their underlying pathophysiological mechanism in mTLE.  Methods Thirty mTLE patients with unilateral hippocampal sclerosis (mTLE-HS and 30 mTLE patients with occupying lesion in unilateral temporal lobe (mTLE-OL were investigated by comparing with 30 age- and sex-matched healthy subjects. MRI data were collected using a Siemens 3.0T scanner, and all of the participants were studied using amplitude of low-frequency fluctuation (ALFF analysis of resting state fMRI. A cost-function modification was used for image preprocessing, then the difference of extratemporal mALFF changes between the two groups of mTLE patients were analyzed with two-sample t test, and the correlation between mALFF and epilepsy duration of mTLE were also investigated.  Results In the resting state, mTLE-HS patients and mTLE-OL patients all showed significant changes in mALFF in extratemporal structures, but the distribution patterns of changes in brain were different. Compared with mTLE-HS, the mTLE-OL patients showed increased mALFF in bilateral inferior parietal lobes, precuneus, angular gyrus, middle and posterior cingulate gyrus and contralateral middle temporal gyrus, while mALFF reducing was observed in contralateral postcentral gyrus, bilateral middle occipital gyrus and cerebellum (P < 0.05, AlphaSim corrected, that is to say, the default mode network (DMN in mTLE-HS were inhibited more seriously than in mTLE-OL patients. Correlation analysis showed that no significant correlation was found between mALFF and epilepsy duration in mTLE-HS patients; mALFF in bilateral middle and posterior cingulate gyrus was positively correlated with epilepsy duration in mTLE-OL patients (r = 0.687, P = 0.000, while mALFF in bilateral anterior cingulate gyrus was negatively correlated with epilepsy duration (r

  4. Clinical efficacy of gamma knife and surgery treatment of mesial temporal lobe epilepsy and their effects on EF-Tumt and EF-Tsmt expression.

    Science.gov (United States)

    Wang, X-Q; Zhang, X-D; Han, Y-M; Shi, X-F; Lan, Z-B; Men, X-X; Pan, Y-W

    2017-04-01

    To study the clinical efficacy of gamma knife and surgery treatment of mesial temporal lobe epilepsy (MTLE) and their effects on EF-Tumt and EF-Tsmt expression. The data of 78 cases of MTLE patients treated in our hospital from April 2011 to March 2013 were retrospectively analyzed. The patients were divided into two groups according to the treatment methods: the surgery group (including 41 cases) and the gamma knife group (including 37 cases). The clinical efficacy, the occurrence and recurrence of complications were evaluated, respectively; meanwhile, the expression of the EF-Tumt protein and EF-Tsmt protein in brain tissue were analyzed. The difference between the efficacy rate of the two groups showed no statistical significance (χ2=0.960, p>0.05). The complication rate of the gamma knife group was significantly lower than that of the control group (χ2=6.430, pknife group was significantly lower than that of the patients in the surgery group (p>0.05). Within the two groups, the positive expression granum of EF-Tsmt protein and EF-Tumt protein of the two groups after treatment were significantly lower than that before treatment (pknife group was obviously more than that of the patients in the surgery group (p0.05). Before and after treatment within the group, the positive cell of EF-Tsmt protein and EF-Tumt protein of the two groups of patients after treatment were significantly lower than that before treatment (p0.05). Both surgery and gamma knife could treat MTLE effectively, and the efficacy may be related to the ability to reduce the expression of EF-Tsmt protein and EF-Tumt protein in brain tissue.

  5. Modifications of EEG power spectra in mesial temporal lobe during n-back tasks of increasing difficulty. A sLORETA study.

    Science.gov (United States)

    Imperatori, Claudio; Farina, Benedetto; Brunetti, Riccardo; Gnoni, Valentina; Testani, Elisa; Quintiliani, Maria I; Del Gatto, Claudia; Indraccolo, Allegra; Contardi, Anna; Speranza, Anna M; Della Marca, Giacomo

    2013-01-01

    The n-back task is widely used to investigate the neural basis of Working Memory (WM) processes. The principal aim of this study was to explore and compare the EEG power spectra during two n-back tests with different levels of difficulty (1-back vs. 3-back). Fourteen healthy subjects were enrolled (seven men and seven women, mean age 31.21 ± 7.05 years, range: 23-48). EEG was recorded while performing the N-back test, by means of 19 surface electrodes referred to joint mastoids. EEG analysis were conducted by means of the standardized Low Resolution brain Electric Tomography (sLORETA) software. The statistical comparison between EEG power spectra in the two conditions was performed using paired t-statistics on the coherence values after Fisher's z transformation available in the LORETA program package. The frequency bands considered were: delta (0.5-4 Hz); theta (4.5-7.5 Hz); alpha (8-12.5 Hz); beta (13-30 Hz); gamma (30.5-100 Hz). Significant changes occurred in the delta band: in the 3-back condition an increased delta power was localized in a brain region corresponding to the Brodmann Area (BA) 28 in the left posterior entorhinal cortex (T = 3.112; p < 0.05) and in the BA 35 in the left perirhinal cortex in the parahippocampal gyrus (T = 2.876; p < 0.05). No significant differences were observed in the right hemisphere and in the alpha, theta, beta, and gamma frequency bands. Our results indicate that the most prominent modification induced by the increased complexity of the task occur in the mesial left temporal lobe structures.

  6. How do people with drug-resistant mesial temporal lobe epilepsy sleep? A clinical and video-EEG with EOG and submental EMG for sleep staging study

    Directory of Open Access Journals (Sweden)

    Aline Vieira Scarlatelli-Lima

    2016-09-01

    Full Text Available This study aimed to assess subjective and objective sleep parameters in a homogeneous group of drug-resistant mesial temporal lobe epilepsy (MTLE patients through internationally validated clinical questionnaires, video-electroencephalographic (VEEG and polysomnographic (PSG studies. Fifty-six patients with definite diagnosis of MTLE who were candidates for epilepsy surgery underwent a detailed clinical history, the Pittsburgh Sleep Quality Index (PSQI, Epworth Sleepiness Scale (ESS, Stanford Sleepiness Scale (SSS, neurological examination, 1.5 T brain magnetic resonance imaging, VEEG and PSG. Sixteen percent of patients reported significant daytime sleepiness as measured by ESS and 27% reported low levels of sleep quality as measured by PSQI. Patients with medically resistant epilepsy by MTLE showed increased wakefulness after sleep onset (WASO with mean ± standard deviation of 17.4 ± 15.6, longer non-rapid eye movement (NREM 1 (7.5 ± 4.6% and NREM3 sleep (26.6 ± 11.8%, abnormal rapid eye movement (REM latency in 30/56 patients, shorter REM sleep (16.7 ± 6.6%, and abnormal alpha delta patterns were observed in 41/56 patients. The analysis of interictal epileptic discharges (IEDs evidenced highest spiking rate during NREM3 sleep and higher concordance with imaging data when IEDs were recorded in sleep, mainly during REM sleep. We concluded that patients with MTLE showed disrupted sleep architecture that may result in daytime dysfunction and sleep complaints. Furthermore, NREM sleep activated focal IEDs and them - when recorded during sleep - had higher localizing value.

  7. Usefulness of fluid attenuated inversion recovery(FLAIR) image in mesial temporal sclerosis : comparison with turbo spin-echo T2-weighted image

    Energy Technology Data Exchange (ETDEWEB)

    Son, Seok Hyun; Chang, Seung Kuk; Eun, Choong Ki [Pusan Paik Hospital, Inje Univ. College of Medicine, Kimhae (Korea, Republic of)

    1999-12-01

    To determine the usefulness of fluid attenuated inversion recovery(FLAIR) imaging for the in detection of high signal intensity of hippocampus or amygdala in mesial temporal sclerosis (MTS), compared with that of turbo spin-echo T2-weighted imaging. Two neuroradiologists independently analyzed randomly mixed MR images of 20 lesions of 17 patients in whom MTS had been diagnosed, and ten normal controls. All subjects underwent both who performed both FLAIR and turbo spin-echo T2-weighted imaging, in a blind fashion. In order to determine hippocampal morphology, oblique coronal images perpendicular to the long axis of the hippocampus were obtained. The detection rate of high signal intensity in hippocampus or amygdala, the radiologists' preferred imaging sequence, and intersubject consistency of detection were evaluated. Signal intensity in hippocampus or amygdala was considered high if substantially higher than signal intensity in the cortex of adjacent temporo-parietal lobe. In all normal controls, FLAIR and spin-echo T2-weighted images showed normal signal intensity in hippocampus or amygdala. In MTS, the mean detection rate of high signal intensity in hippocampus or amygdala, as seen on FLAIR images was 93%, compared with 43% on spin-echo T2-weighted images. In all cases in which signal intensity on FLAIR images was normal, signal intensity on spin-echo T2-weighted images was also normal. The radiologists preferred the contrast properties of FLAIR to those of spin-echo T2-weighted images. In the diagnosis of MTS using MRI, FLAIR images are more useful for the detection of high signal intensity of hippocampus or amygdala than are spin-echo T2-weighted images. In the diagnosis of MTS, FLAIR imaging is therefore a suitable alternative to spin-echo T2-weighted imaging.

  8. Usefulness of fluid attenuated inversion recovery(FLAIR) image in mesial temporal sclerosis : comparison with turbo spin-echo T2-weighted image

    International Nuclear Information System (INIS)

    Son, Seok Hyun; Chang, Seung Kuk; Eun, Choong Ki

    1999-01-01

    To determine the usefulness of fluid attenuated inversion recovery(FLAIR) imaging for the in detection of high signal intensity of hippocampus or amygdala in mesial temporal sclerosis (MTS), compared with that of turbo spin-echo T2-weighted imaging. Two neuroradiologists independently analyzed randomly mixed MR images of 20 lesions of 17 patients in whom MTS had been diagnosed, and ten normal controls. All subjects underwent both who performed both FLAIR and turbo spin-echo T2-weighted imaging, in a blind fashion. In order to determine hippocampal morphology, oblique coronal images perpendicular to the long axis of the hippocampus were obtained. The detection rate of high signal intensity in hippocampus or amygdala, the radiologists' preferred imaging sequence, and intersubject consistency of detection were evaluated. Signal intensity in hippocampus or amygdala was considered high if substantially higher than signal intensity in the cortex of adjacent temporo-parietal lobe. In all normal controls, FLAIR and spin-echo T2-weighted images showed normal signal intensity in hippocampus or amygdala. In MTS, the mean detection rate of high signal intensity in hippocampus or amygdala, as seen on FLAIR images was 93%, compared with 43% on spin-echo T2-weighted images. In all cases in which signal intensity on FLAIR images was normal, signal intensity on spin-echo T2-weighted images was also normal. The radiologists preferred the contrast properties of FLAIR to those of spin-echo T2-weighted images. In the diagnosis of MTS using MRI, FLAIR images are more useful for the detection of high signal intensity of hippocampus or amygdala than are spin-echo T2-weighted images. In the diagnosis of MTS, FLAIR imaging is therefore a suitable alternative to spin-echo T2-weighted imaging

  9. Modifications of EEG Power Spectra in Mesial Temporal Lobe during n-back tasks of increasing difficulty. A sLORETA study.

    Directory of Open Access Journals (Sweden)

    Claudio eImperatori

    2013-04-01

    Full Text Available The n-back task is widely used to investigate the neural basis of Working Memory (WM processes. The principal aim of this study was to explore and compare the EEG power spectra during two n-back tests with different levels of difficulty (1-back vs 3-back.Fourteen healthy subjects were enrolled (7 men and 7 women, mean age 31.21±7.05 years, range: 23-48. EEG was recorded while performing the N-back test, by means of 19 surface electrodes referred to joint mastoids. EEG analysis were conducted by means of the standardized LOw Resolution brain Electric Tomography (sLORETA software. The statistical comparison between EEG power spectra in the two conditions was performed using paired t-statistics on the coherence values after Fisher’s z transformation available in the LORETA program package. The frequency bands considered were: delta (0.5-4 Hz; theta (4.5–7.5 Hz; alpha (8–12.5 Hz; beta (13–30 Hz; gamma (30.5–100 Hz. Significant changes occurred in the delta band: in the 3-back condition an increased delta power was localized in a brain region corresponding to the Brodmann Area (BA 28 in the left posterior entorhinal cortex (T = 3.112; p<0.05 and in the BA 35 in the left peririnhal cortex in the parahippocampal gyrus (T = 2.876; p<0.05. No significant differences were observed in the right hemisphere and in the alpha, theta, beta and gamma frequency bands. Our results indicate that the most prominent modification induced by the increased complexity of the task occur in the mesial left temporal lobe structures.

  10. Memória de orientação espacial: avaliação em pacientes com doença de Alzheimer e com epilepsia mesial temporal refratária Spatial orientation memory: evaluation in patents with Alzheimer disease and temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Lisiane Tuon

    2006-06-01

    Full Text Available Estudos experimentais identificaram células piramidais no hipocampo de ratos com participação na memória de orientação espacial (MOE, denominadas células de localização. O objetivo deste estudo foi adaptar um teste baseado nesses experimentos para verificar o desempenho de MOE e a participação do hipocampo na MOE em pacientes com esclerose mesial temporal (EMT. Dividiu-se a pesquisa em dois estudos: no primeiro adaptou-se o teste e visando verificar sua capacidade de investigação de déficits de MOE aplicou-se em grupos de 10 indivíduos, um com doença de Alzheimer (DA e outro de idosos saudáveis (pExperimental studies have identified pyramidal cells in hippocampus in rats with participation in the spatial orientation memory (SOM, which are named location cells. This study had the purpose to adapt a test based in these experiments in order to check the performance of SOM and the participation of hippocampus into SOM in patients with mesial temporal sclerosis (MTS. The research was divided into two studies: the first one the test was adapted, and in order to check its capacity to investigate the deficits of SOM, it has applied in groups of 10 (ten subjects, one group with patients that have Alzheimer disease and the other one with healthy elderly (p<0.001. The second study has evaluated the participation of hippocampus into SOM in 43 patients (23 with mesial temporal sclerosis (MTS and 20 submitted to selective amygdala hippocampectomy (SAH and 23 healthy volunteers with p<0,05 between MTS and SAH and between controled and SAH. It was shown that the test of SOM is suitable to evaluate deficits, but it seems the SOM is not a specific function of human hippocampus.

  11. Gender, apolipoprotein E genotype, and mesial temporal atrophy: 2-year follow-up in patients with stable mild cognitive impairment and with progression from mild cognitive impairment to Alzheimer's disease

    International Nuclear Information System (INIS)

    Spampinato, M.V.; Patrick, K.E.; Collins, H.; Langdon, B.R.; Parker, R.O.; Pravata', E.

    2016-01-01

    This study aimed to examine the relationship between gender, apolipoprotein E (APOE) genotype, and mesial temporal atrophy in mild cognitive impairment (MCI) with and without progression to Alzheimer's disease (AD). We evaluated 236 MCI patients with (n = 121) and without (n = 115) AD progression. Longitudinal MRI-based hippocampal volumes (HV) and entorhinal cortex (ERC) thickness were obtained. The Clinical Dementia Rating Sum of Boxes (CDR-SB) score was used to assess disease severity. We found a significant effect of APOE, gender, and clinical course (stable MCI versus MCI-AD progression) on HV. There was a significant effect of clinical course and APOE, but not gender, on ERC. Baseline HV and APOE4 status predicted MCI-AD progression in women. Baseline ERC and APOE4 status predicted MCI-AD progression in men. There were significant differences in CDR-SB scores between patients with and without MCI-AD progression, but not between males and females, or APOE4 carriers and non-carriers. HV, but not ERC, is strongly influenced by gender in MCI. The effects of gender and APOE4 on neuroimaging biomarkers have potentially important implications in the prediction of MCI-AD progression and should be taken into account in clinical trials. (orig.)

  12. Gender, apolipoprotein E genotype, and mesial temporal atrophy: 2-year follow-up in patients with stable mild cognitive impairment and with progression from mild cognitive impairment to Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Spampinato, M.V.; Patrick, K.E.; Collins, H. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Langdon, B.R. [Medical University of South Carolina, Department of Internal Medicine, Charleston, SC (United States); Parker, R.O. [Vanderbilt University, Department of Anesthesiology, Nashville, TN (United States); Pravata' , E. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Ospedale Regionale di Lugano, Department of Neuroradiology, Neurocenter of Southern Switzerland, Lugano (Switzerland); Collaboration: For the Alzheimer' s Disease Neuroimaging Initiative

    2016-11-15

    This study aimed to examine the relationship between gender, apolipoprotein E (APOE) genotype, and mesial temporal atrophy in mild cognitive impairment (MCI) with and without progression to Alzheimer's disease (AD). We evaluated 236 MCI patients with (n = 121) and without (n = 115) AD progression. Longitudinal MRI-based hippocampal volumes (HV) and entorhinal cortex (ERC) thickness were obtained. The Clinical Dementia Rating Sum of Boxes (CDR-SB) score was used to assess disease severity. We found a significant effect of APOE, gender, and clinical course (stable MCI versus MCI-AD progression) on HV. There was a significant effect of clinical course and APOE, but not gender, on ERC. Baseline HV and APOE4 status predicted MCI-AD progression in women. Baseline ERC and APOE4 status predicted MCI-AD progression in men. There were significant differences in CDR-SB scores between patients with and without MCI-AD progression, but not between males and females, or APOE4 carriers and non-carriers. HV, but not ERC, is strongly influenced by gender in MCI. The effects of gender and APOE4 on neuroimaging biomarkers have potentially important implications in the prediction of MCI-AD progression and should be taken into account in clinical trials. (orig.)

  13. Longitudinal positron emission tomography imaging of glial cell activation in a mouse model of mesial temporal lobe epilepsy: Toward identification of optimal treatment windows.

    Science.gov (United States)

    Nguyen, Duc-Loc; Wimberley, Catriona; Truillet, Charles; Jego, Benoit; Caillé, Fabien; Pottier, Géraldine; Boisgard, Raphaël; Buvat, Irène; Bouilleret, Viviane

    2018-06-01

    Mesiotemporal lobe epilepsy is the most common type of drug-resistant partial epilepsy, with a specific history that often begins with status epilepticus due to various neurological insults followed by a silent period. During this period, before the first seizure occurs, a specific lesion develops, described as unilateral hippocampal sclerosis (HS). It is still challenging to determine which drugs, administered at which time point, will be most effective during the formation of this epileptic process. Neuroinflammation plays an important role in pathophysiological mechanisms in epilepsy, and therefore brain inflammation biomarkers such as translocator protein 18 kDa (TSPO) can be potent epilepsy biomarkers. TSPO is associated with reactive astrocytes and microglia. A unilateral intrahippocampal kainate injection mouse model can reproduce the defining features of human temporal lobe epilepsy with unilateral HS and the pattern of chronic pharmacoresistant temporal seizures. We hypothesized that longitudinal imaging using TSPO positron emission tomography (PET) with 18 F-DPA-714 could identify optimal treatment windows in a mouse model during the formation of HS. The model was induced into the right dorsal hippocampus of male C57/Bl6 mice. Micro-PET/computed tomographic scanning was performed before model induction and along the development of the HS at 7 days, 14 days, 1 month, and 6 months. In vitro autoradiography and immunohistofluorescence were performed on additional mice at each time point. TSPO PET uptake reached peak at 7 days and mostly related to microglial activation, whereas after 14 days, reactive astrocytes were shown to be the main cells expressing TSPO, reflected by a continuing increased PET uptake. TSPO-targeted PET is a highly potent longitudinal biomarker of epilepsy and could be of interest to determine the therapeutic windows in epilepsy and to monitor response to treatment. Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.

  14. Avatares del paradigma conexionista

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    Asier Arias

    2012-02-01

    Full Text Available Hace ahora un año que falleciera David Everett Rumelhart, conexionista pionero y editor junto con James Lloyd McClelland de la llamada “biblia del Procesamiento Distribuido en Paralelo” (PDP. Al mismo tiempo, los dos volúmenes de la referida biblia celebraban su vigésimo quinto cumpleaños. También uno de los padres de la inteligencia artificial, John McCarthy, que bautizara de hecho la disciplina, nos abandonó el pasado mes de octubre a los 84 años. Estas tres efemérides nos sirven de pretexto para un breve recorrido por las derivas y obstáculos a los que se ha enfrentado el llamado paradigma conexionista desde su puesta en escena como alternativa al cognitivismo clásico.

  15. del paradigma comprensivo

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    María Luisa Bacarlett Pérez

    2008-01-01

    Full Text Available A partir de la distinción planteada por von Wright en su texto ya clásico Explicación y comprensión, se analiza la obra de Giambattista Vico (1668-1744 a la luz de su crítica desarrollada hacia Descartes y la distinción que realiza en tre "crítica" y "tópica". No es aventurado decir que en la propuesta viquiana la actividad propia de la tópica, ligada al uso del lenguaje, la retórica y la elocuencia, se acerca más aquello que von Wright ubica dentro del "paradigma comprensivo"; mientras que la crítica, identificada con el método cartesiano, privilegia la abstracción, la deducción lógica y el análisis matemático; es decir, todo aquello ligado al conocimiento de la naturaleza. La gran diferencia en tre tópica y crítica radica, al final, en el criterio de verdad propio de cada perspectiva: mientras la crítica encuentra la verdad en la exterioridad del mundo natural, en algo que los hombres no hacen; en cambio, la única forma de verdad en el terreno de la tópica es como "verdad hecha" o "verum factum"; es decir, la verdad que nosotros mismos hacemos como agentes históricos, lingüísticos, creadores de cultura, de vida política y social.

  16. Paradigma Sosiologi Hukum Keluarga Islam Di Indonesia (Rekonstruksi Paradigma Integratif Kritis)

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    Rosman, Edi

    2015-01-01

    Tulisan ini bermaksud menjelaskan tentang tawaran rekonstruksi paradigma hukum Keluarga Islam di Indonesia. Hukum Keluarga Islam merupakan representasi dari Hukum Islam secara keseluruhan yang telah berkembang dan dikembangkan berdasarkan paradigma klasik yang literalistik. Kemapanan paradigma literalistik sering digoyahkan oleh paradigma kontemporer yang liberalistik. Konflik paradigmatik berimplikasi pada terjadinya disparitas antara hukum normatif dan empiris serta hilangnya aktualitas h...

  17. Justicia Restaurativa: Un paradigma emergente

    OpenAIRE

    García Gumbau, Erica

    2017-01-01

    RESUMEN DE LA TESIS DOCTORAL JUSTICIA RESTAURATIVA: UN PARADIGMA EMERGENTE La tesis profundiza y reflexiona en torno a una nueva concepción de la justicia y su aplicación en la praxis. Actualmente nos encontramos ante una crisis del paradigma retributivo o crisis del modelo de justicia tradicional, dominante hasta ahora en la administración de justicia. Paralelamente, se está empezando a hablar de una nueva filosofía de la administración de justicia. El presente trabajo de i...

  18. KONSTRUKSI TEORI PARADIGMA THOMAS S. KUHN

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    Nurkhalis Nurkhalis

    2012-02-01

    Full Text Available Thomas Kuhn memberikan gambaran bahwa kebenaran sains akan ditemukan berkali-kali ataupun berganti-ganti bentuk ilmiahnya walaupun dari satu objek yang sama. Formulasi teori paradigma yang mencetuskan bahwa sebuah kebenaran sains (legatimed truth identik dalam target teleologis yang didasari pada detection dikenal sebagai final cause (end. Kebenaran sains bukan continuous (lanjutan, improvisasi, evolusi atau kumulatif, melainkan terjadi paradigm shift (pergeseran paradigma atau disebut juga dengan revolusi. Paradigma melalui shift moving (pergerakan pergeseran dipahami sama dengan gestalt switch (perpindahan secara keseluruhan atau tidak sama sekali. Di dalam gestalt switch yang diungkapkan adalah verifikasi terjadi sekaligus atau tidak sama sekali (all at once or not at all. Konsep paradigm shifts membuka kesadaran bersama bahwa para pengkaji sains tidak akan mungkin bekerja dalam suatu suasana objektivitas yang mapan. Paradigma men-design kerangka world view (pandangan dunia atau perspective (cara pandang untuk lebih important, legitimate, and reasonable. Hal ini membuat sebuah detection (target teleologis tidak akan terevolusi atau tereleminir karena kemampuan eksperimentalnya mengakomodir counterinstances (ketahanan berkompetisi teori. Paradigma yang bertahan merupakan winnowing (keunggulan baru dari sebuah discovery, supertitian (temuan besar atau novelty (terbaharukan. Paradigma bertahan akan tumbuh menguasai normal science selama belum eksisnya anomaly (ketimpangan. Paradigma baru memiliki kriteria neater (rapi, more suitable (lebih cocok, simpler (sederhana, or more elegant (lebih elegan. Paradigma akan terusbertransformatif dengan paradigma baru karena sistem bekerja paradigma mengalihkan padigma menuju revolusi ilmiah di mana revolusi ilmiah dengan perubahan fundamental akan meresap dalam metode dan pemahaman.

  19. O resgate de velhos paradigmas

    Directory of Open Access Journals (Sweden)

    Silva, Aloysio Pereira da

    2005-01-01

    Full Text Available Este artigo objetiva mostrar como algumas formas de gestão de ensino, ainda que superadas e inadequadas em sua prática, surgem em momentos históricos particulares portando novas roupagens e utilizando uma retórica pretensamente inovadora, mas, ao contrário, resgata velhos paradigmas. Neste artigo utilizamos a GQT - Gestão da Qualidade Total como referencial ilustrativo e instrumental desse fenômeno

  20. Vida artificial, el nuevo paradigma

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    José Jesús Martínez Páez

    1998-05-01

    Full Text Available Se presenta una síntesis cronológica de los hechos más importantes en el desarrollo teórico y de simulación computacional, que han llevado a la formación de un nuevo paradigma que se conoce como vida artificial; se analizan sus características y sus príncipales líneas de investigación. Finalmente, se hace una descripción de su trabajo en la Universidad Nacional.

  1. Paradigma Lerner versus Konstruksi Gender

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    Mien Hidayat

    2006-06-01

    Full Text Available Asumsi dasar Paradigma Lerner (dalam komunikasi pembangunan menyatakan terbukanya suatu wilayah dari isolasi fisik akan mendorong masyarakat berurbanisasi, yang selanjutnya akan menghasilkan literasi. Kedua variabel ini akan memengaruhi partisipasi media massa. Selanjutnya saling pengaruh dari ketiga variabel itu akan bermuara pada partisipasi pembangunan Konstruksi gender yang berlangsung di masyarakat yang berlatar belakang budaya patriarkhat ternyata mampu memandekkan aplikasi pemikiran Lerner, khususnya pada ibu-ibu rumah tangga. Urbanisasi tidak berjalan karena gender mengonstruksikan ibu-ibu rumah tangga untuk mendiami wilayah domestik. Gender juga menebar faham, pendidikan lebih diprioritaskan untuk anak laki-laki ketimbang anak perempuan dengan alasan laki-laki akan menjadi kepala rumah tangga yang bertanggung jawab terhadap keluarga. Terhambatnya aplikasi kedua konsep ini cenderung memperkecil akses perempuan pada media massa, yang pada akhirnya mengondisikan ibu-ibu rumah tangga (perempuan dihimpit keterbatasan dalam partisipasi pembangunan.

  2. La noción de paradigma

    OpenAIRE

    Luis Fernando Marín Ardila

    2007-01-01

    El artículo reclama la importancia de la noción de paradigma y el conocimiento o reflexión sobre los paradigmas que reproducimos al orientar nuestra acción vital y nuestra comprensión de las distintas facetas de la existencia. Denominamos paradigmatología al estudio de los paradigmas como lógica, semántica e ideológica del conocimiento y la praxis. Dos autores concurren a nutrir este dominio teórico: Thomas S. Kuhn y Edgar Morin; cada uno, desde perspectivas distint...

  3. Temporal Lobe Epilepsy Surgery Failures: A Review

    Science.gov (United States)

    Harroud, Adil; Bouthillier, Alain; Weil, Alexander G.; Nguyen, Dang Khoa

    2012-01-01

    Patients with temporal lobe epilepsy (TLE) are refractory to antiepileptic drugs in about 30% of cases. Surgical treatment has been shown to be beneficial for the selected patients but fails to provide a seizure-free outcome in 20–30% of TLE patients. Several reasons have been identified to explain these surgical failures. This paper will address the five most common causes of TLE surgery failure (a) insufficient resection of epileptogenic mesial temporal structures, (b) relapse on the contralateral mesial temporal lobe, (c) lateral temporal neocortical epilepsy, (d) coexistence of mesial temporal sclerosis and a neocortical lesion (dual pathology); and (e) extratemporal lobe epilepsy mimicking TLE or temporal plus epilepsy. Persistence of epileptogenic mesial structures in the posterior temporal region and failure to distinguish mesial and lateral temporal epilepsy are possible causes of seizure persistence after TLE surgery. In cases of dual pathology, failure to identify a subtle mesial temporal sclerosis or regions of cortical microdysgenesis is a likely explanation for some surgical failures. Extratemporal epilepsy syndromes masquerading as or coexistent with TLE result in incomplete resection of the epileptogenic zone and seizure relapse after surgery. In particular, the insula may be an important cause of surgical failure in patients with TLE. PMID:22934162

  4. La noción de paradigma

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    Luis Fernando Marín Ardila

    2007-01-01

    Full Text Available El artículo reclama la importancia de la noción de paradigma y el conocimiento o reflexión sobre los paradigmas que reproducimos al orientar nuestra acción vital y nuestra comprensión de las distintas facetas de la existencia. Denominamos paradigmatología al estudio de los paradigmas como lógica, semántica e ideológica del conocimiento y la praxis. Dos autores concurren a nutrir este dominio teórico: Thomas S. Kuhn y Edgar Morin; cada uno, desde perspectivas distintas, ha abierto un horizonte de pensamiento que promueve el debate sobre el conocimiento, su estructuración, su historia y su incorporación en la vida académica y en la producción investigativa. Los paradigmas son especies de anteojos o linternas que nos hacen visibles y audibles unos fenómenos y ocultan o dejan otros sobre un trasfondo inconsciente. El artículo concluye con la ilustración de un paradigma imperante en la praxis educativa y pedagógica que posee una potencia tal que se se ha “naturalizado”; se trata del paradigma transmisionista de la educación, en el que se concibe y se vive el lenguaje como un instrumento, el conocimiento como una representación y la pedagogía como transmisión.

  5. Did Fyodor Mikhailovich Dostoevsky suffer from mesial temporal lobe epilepsy?

    Science.gov (United States)

    Baumann, Christian R; Novikov, Vladimir P I; Regard, Marianne; Siegel, Adrian M

    2005-07-01

    Many scientific authors--among them famous names such as Henri Gastaut or Sigmund Freud--dealt with the question from what kind of epilepsy Fyodor Mikhailovitch Dostoevsky (1821-1881) might had suffered. Because of the tight interplay between Dostoevsky's literary work and his own disease we throw light on the author's epilepsy against the background of his epileptic fictional characters. Moreover, we attempt to classify Dostoevsky's epilepsy on the basis of his bibliography, language, and literary work.

  6. Toetsen als Leerinterventie. Samenvatten in het Testing Effect Paradigma [Tests as learning interventions. Summarization in the testing effect paradigma investigated

    NARCIS (Netherlands)

    Dirkx, Kim; Kester, Liesbeth; Kirschner, Paul A.

    2011-01-01

    Dirkx, K. J. H., Kester, L., & Kirschner, P. A. (2011, July). Toetsen als leerinterventie. Samenvatten in het testing effect paradigma onderzocht [Tests as learning interventions. Summarization in the testing effect paradigma investigated]. Presentation for Erasmus University Rotterdam, Rotterdam.

  7. Paradigma En Parodie | Snyman | Stellenbosch Papers in ...

    African Journals Online (AJOL)

    Stellenbosch Papers in Linguistics Plus. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 22 (1992) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Paradigma En Parodie. HHJ Snyman. Abstract.

  8. PARADIGMA TRADICIONAL E PARADIGMA EMERGENTE: ALGUMAS IMPLICAÇÕES NA EDUCAÇÃO

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    Wallace Carvalho Ribeiro

    Full Text Available É intrínseco ao Homem conhecer os objetos e os fenômenos da realidade que o cerca, por meio de um ponto de vista que, por sinal, se refere a um paradigma que traz consigo uma epistemologia. Nesse con texto, o presente artigo objetiva levantar alguns princípios e pressupostos do Paradigma Tradicional e do Paradigma Emergente, como também visa apresentar algumas implicações desses dois paradigmas na Educação. Esse trabalho foi desenvolvido por meio de pesquisa bibliográfica e faz parte da dissertação de Mestrado, defendida no 1° semestre de 2009, pelo seu primeiro autor no Programa de Pós-Graduação em Educação da PUC Minas. Ao final, constatou-se que se vive hoje um período de mudanças paradigmáticas, embora todos nós ainda temos muito do paradigma cartesiano-newtoniano, mas o surgimento de novos problemas oriundos da dinâmica da realidade nos impõe o desafio da transformação no nosso ser e agir, no intento de (reconstruir um conhecimento mais humano e diversificado.

  9. MR imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Fobben, E.S.; Zimmerman, R.A.; Sperling, M.R.; Kohn, M.I.; Atlas, S.W.; Hackney, D.B.; Goldberg, H.I.; Bilaniuk, L.T.; Grossman, R.I.

    1988-01-01

    MR imaging examinations of 31 patients undergoing temporal lobe resection for refractory partial epilepsy were reviewed retrospectively for the presence of signal abnormalities as well as atrophy. High-signal abnormalities were present in only two of the described 31 patients (6.5%). Pathologically, these represented mesial temporal sclerosis and a hamartoma. Of the remaining 29 cases, 13 showed pathologically varying degrees of mesial temporal sclerosis and gliosis and 16 were pathologically normal. Atrophy, as determined by gross asymmetry, sulcal and temporal horn enlargement, and computer volume measurements, was observed in 23 of 31 patients, correlating with the clinically affected side in 20 and the contralateral side in three. In this series, in contrast to others reported, focal MR signal abnormalities were not detected in the vast majority of patients with mesial temporal sclerosis

  10. ¿Paradigmas en psicología? ¿Nuevos paradigmas?

    OpenAIRE

    Peláez Jaramillo, Gloria Patricia

    2012-01-01

    El debate epistemológico de la psicología es una constante a lo largo de su historia; no obstante, en las últimas dos décadas este debate ha perdido vigencia y son pocos los psicólogos que en sus investigaciones se ocupan de él, aunque se escucha la introducción del término paradigma, en lugar de corrientes, pretendiendo matizar la realidad del problema en esta disciplina; y cifrar mágicamente en esta referencia a paradigmas la solución a las inconsistencias epistemológicas verdaderas de s...

  11. La noción de paradigma

    OpenAIRE

    Marín Ardila, Luis Fernando; Pontificia Universidad Javeriana

    2007-01-01

    El artículo reclama la importancia de la noción deparadigma y el conocimiento o reflexión sobre los paradigmasque reproducimos al orientar nuestra acciónvital y nuestra comprensión de las distintas facetasde la existencia. Denominamos paradigmatología alestudio de los paradigmas como lógica, semántica eideológica del conocimiento y la praxis. Dos autoresconcurren a nutrir este dominio teórico: Thomas S.Kuhn y Edgar Morin; cada uno, desde perspectivasdistintas, ha abierto un horizonte de pensa...

  12. Das CARNOTsche Paradigma und seine erkenntnistheoretischen Implikationen

    Science.gov (United States)

    Schöpf, Hans-Georg

    Der vorliegende historisch-kritische Essay führt die Eigentümlichkeiten der klassischen phänomenologischen Thermodynamik auf das von CARNOT geschaffene Paradigma zurück und greift einige damit zusammenhängende Fragen auf.Translated AbstractCARNOT's Paradigm and its Epistemological ImplicationsThe present historic-critical essay traces the pecularities of classical phenomenological thermodynamics back to the paradigm, created by CARNOT, and takes up some questions to which this paradigm gives rise.

  13. Lavado de manos. Un cambio de paradigma

    OpenAIRE

    López Matheu, Carme

    2003-01-01

    El lavado de manos es una de las principales medidas para el control de la infección nosocomial. En la actualidad diversos estudios evidencian que la descontaminación de las manos con una solución de base alcohólica es igual de eficaz, más rápida de utilizar y más fácil. Este hecho representa un cambio de paradigma importante en el control de la trasmisión de las infecciones. El objetivo de esta revisión es presentar y discutir los aspectos más relevantes de las nuevas recomendaciones....

  14. WARGA NEGARA DAN MASALAH KONTEMPORER DALAM PARADIGMA PEMBANGUNAN

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    Yuni Harmawati

    2018-05-01

    Full Text Available Ditengah hingar-bingar globasliasi dan modernisasi dunia yang memperlihatkan kemajuan disegala bidang, tanpa disadari kita tidak melihat sisi gelap modernisasi dan globlaisasi yakni kemiskinan, yang terjadi negara-negara kulit berwarna seperti di Asia dan Afrika. Bagi bangsa berkembang yang baru saja terlepas dari penjajahan kolonial, bebas dari belenggu kemiskinan adalah suatu hal yang sulit dilakukan. Dampak dari penjajahan seperti kebodohan, eksploitasi sumberdaya alam, ketidakberdayaan rakyat, kesehatan masyarakat yang rendah serta kemiskinan itu sendiri merupakan suatu hambatan dalam membangun suatu negara. Di negara-negara berkembang banyak terjadi semacam eksploitasi yang tidak tampak, tapi cukup tajam yakni eksploitasi manusia atas manusia tanpa terkecuali di Indonesia. Bung Karno menyebutnya sebagai ‘exploitation de l‘homme par l‘homme’ dan ‘exploitation de nation par nation’. Paradigma pertumbuhan (growth paradigm hanya menguntungkan sebagian kecil masyarakat karena paradigma ini dalam penerapan belum dapat meningkatkan kesejahteraan secara menyeluruh atau yang kaya makin kaya dan yang miskin makin miskin. Kegagalan dalam paradigma ini memicu munculnya paradigma baru yakni paradigma pemetaan (generalization paradigm. Pemerataan pembangunan ini cenderung menggunakan pendekatan kebijakan top-down. Hingga melahirkan paradigma baru yakni pembangunan yang berpusat pada sumberdaya manusia (people centered development paradigm. Paradigma ini juga dikenal sebagai paradigma pembangunan partisipatif (partisipative approach atau juga disebut buttom-up planing. Pendekatan pembangunan ini menekankan pentingnya, inisiatif, kreatifitas, dan inovasi yang beripijak pada keinginan masyarakat. Dengan mendengar aspirasi dari warga negara untuk disampaikan kepada pemerintah membuat terjalin sinergitas diantara keduanya sehingga persoalan kemiskinan dapat diselesaikan secara bersama-sama.

  15. Quantitative magnetic resonance imaging study on patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Senzaki, Akira; Okubo, Yoshiro; Matsuura, Masato; Toru, Michio; Abe, Tetsuo; Asai, Kunihiko; Moriiwa, Motoi.

    1993-01-01

    In 30 patients with temporal lobe epilepsy who had no visual abnormality on either CT or MRI, cerebral changes especially in the mesial temporal region were examined. The findings were compared with those in 20 normal volunteers. In epileptic patients, the mesial temporal region was significantly smaller and T1-weighted values in this region were significantly higher, as compared with the controls. In the group of epilepsy, atrophy especially in the hippocampal and tonsillar regions and increased water content were suggested. Regarding the bilateral difference in the size of the mesial temporal region, there was no significant difference between the group of epilepsy and the control group. The group of epilepsy seemed to have bilateral changes in the mesial temporal region. In 9 patients with the present or past history of organic delusional (schizophrenia-like) disorder, the coronal section of the third ventricle was significantly large, suggesting the likelihood of structural changes surrounding the third ventricle. (N.K.)

  16. Los paradigmas financieros en tiempos de crisis

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    Guillermo de la Dehesa

    2014-12-01

    Full Text Available La crisis financiera mundial de finales del siglo XX ha puesto en evidencia los problemas de aplicación de los paradigmas financieros sobre los que se basa la actividad inversora de los agentes económicos que intervienen en los mercados de capitales. Esta experiencia ha demostrado, una vez más, que la aplicación de las teorías y de los modelos más consolidados en la ciencia de las finanzas no funciona adecuadamente, bien porque los supuestos sobre los que se basan dejan de darse en situaciones críticas, bien porque no se utilizan de forma correcta. No quiero decir que dichas teorías o modelos no sean coherentes, ya que son los que han permitido el enorme desarrollo de los mercados financieros, pero tienen problemas en los momentos críticos.

  17. PARADIGMAS EMERGENTES, CONHECIMENTO E MEIO AMBIENTE

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    Liane Keitel

    Full Text Available Este artigo tem por objetivo estimular o debate sobre novos modos de se compreender/ tratar o mundo com os recursos científico-epistêmicos. Para tal, o es tudo levanta e analisa novas formas de relacionamento científico com o mundo, com fundamento em paradigmas emergentes em ciências, tais como a teoria dos sistemas de Bertalanfy, a teoria de auto-organização de von Foerster, Ilya Prigogine, Henri Atlan e Edgar Morin, do acaso e necessidade de Monod, de autopoiese de Humberto Maturana e Francisco Varela, com suas emergentes possibilidades epistemológicas e também educacionais. Utiliza-se o método reconstrutivo, ou seja, colocam-se em diálogo teóricos e teorias diferentes que possam fornecer sustentação argumentativa para a tese central defendida.

  18. Novos paradigmas literários

    Directory of Open Access Journals (Sweden)

    Denise Azevedo Duarte Guimarães

    2005-12-01

    Full Text Available O artigo estuda a emergência de novos paradigmas literários, procurando refletir acerca das textualidades contemporâneas. Focaliza os hipertextos informatizados e a poesia multimídia, com o intuito de desvendar como estão sendo criados novos procedimentos expressivos e em que medida eles podem ser identificados com reflexões teóricas anteriores acerca do texto literário impresso. Remete a questões ligadas à leitura dos diferentes tipos de signos e aos modos como eles se integram para a constituição dessas novíssimas linguagens híbridas em novos suportes.El artículo estudia la emergencia de nuevos paradigmas literarios, procurando reflejar acerca de las textualidades contemporáneas. Enfoca los hipertextos informatizados y la poesía multimedia, intentando desvendar cómo están siendo creados nuevos procedimientos expresivos y en qué medida ellos pueden ser identificados a reflexiones teóricas anteriores acerca del texto literario impreso. Remite a cuestiones ligadas a la lectura de los diferentes tipos de signos y a los modos cómo ellos se interaccionan para la constitución de los novísimos lenguajes híbridos en nuevos supuestos.This article investigates the emergence of new literary paradigms as it tries to understand new contemporary textualities. It analyses some hypertexts and multimedia poetry trying to trace how new expressive procedures are being created. How can these new languages be identified and what are their relations to previous theories which dealt with the literary printed text? This study approaches questions linked to the reading of different types of signs and the modes they function towards the fabrication of these new hybrid languages.

  19. Marketing! Onde está o Paradigma?

    Directory of Open Access Journals (Sweden)

    Deosir Flávio Lobo de Castro Júnior

    2015-09-01

    Full Text Available O debate quantitativo-qualitativo, não é uma discussão recente. O objetivo desse trabalho, portanto, é verificar por meio do conceito de paradigma, novas perspectivas de compreender as pesquisas acadêmicas em marketing, a evolução do pensamento de marketing e as metodologias utilizadas nos estudos da qualidade de serviço. Sem a pretensão de esgotar este assunto e apresentar uma conclusão final, são apresentadas pesquisas que apontam para a necessidade e a importância da pesquisa qualitativa, uma vez que auxilia ao pesquisador uma melhor compreensão da natureza complexa do mundo social em que vivemos. Segundo Santana e Gomes (2007, após análise da discussão de Hegel e Kant, concluem que a razão e a própria epistemologia são construções históricas e evoluem a partir de contradições. O presente artigo está dividido em cinco momentos. Na primeira parte apresenta-se além da introdução a constituição dos objetivos desse ensaio teórico. Na segunda parte apresenta-se uma breve discussão a respeito do conceito de paradigma e o marketing. Na terceira parte apresenta-se uma retrospectiva histórica do marketing e sua evolução de suas escolas a partir dos estudos de Miranda e Arruda (2004. Na quarta parte, são apresentadas as metodologias dos estudos sobre qualidade de serviços e finalmente na quinta parte apresenta-se as considerações finais.

  20. El paradigma chino en el escenario global

    Directory of Open Access Journals (Sweden)

    Mar Llera

    2016-01-01

    Full Text Available El presente artículo examina la evolución más reciente del Gigante Asiático en lo que concierne a su proyección internacional y su influencia global, sirviéndose de datos contrastados y fuentes académicas de referencia. Tras recabar las cifras que han otorgado a China su actual posición de liderazgo en los mercados internacionales, repasaremos las directrices del régimen en materia de política exterior, hasta pergeñar lo que se está publicitando como un nuevo paradigma de desarrollo que hoy afecta transversalmente a todos los países del mundo, comenzando por los menos avanzados. Los interrogantes que plantea este modelo están, sin embargo, a la vista de todos, pues no solo conciernen a cuestiones éticas en torno a los derechos y las libertades, sino ahora también a su eficiencia y viabilidad. China se enfrenta a la necesidad de unas reformas que chocan contra la inercia y los intereses creados de los beneficiarios del régimen.

  1. [Cancer and nutrition - a paradigma shift].

    Science.gov (United States)

    Imoberdorf, R; Rühlin, M; Ballmer, P E

    2017-08-01

    Substantial international differences in the prevalence of cancer disease suppose that nutrition may be an important factor in the development of cancer. Many experts believe, that nutritional factors may contribute up to 35 % to the development of malignant tumors. Many patients have lost substantial body weight already at the time of the diagnosis of the disease as consequence of undernutrition and malnutrition, respectively. During the course of the disease the nutritional status often is deteriorating further. Caused by both the cancer disease itself and the treatment, loss of appetite, changes in taste, nausea and vomiting may additionally contribute to undernutrition. Undernutrition is a relevant factor for the outcome of the disease and for the tolerance of the treatment as well. Therefore, supporting the heavily impaired patients in nutritional intake is of paramount importance and an urgent task for physicians and nurses. In view of physiology, pathophysiology, genetics and molecular biology, metabolic processes in cancer are highly complex regulated and there is increasing evidence that a diet rich in fat and protein is favourable. This, however, implies a paradigma shift away from the "healthy" balanced diet rich in fruit, vegetable and complex carbohydrates. So far, the evidence based data of this new concept is, however, a controversial issue. Georg Thieme Verlag KG Stuttgart · New York.

  2. Differentiation of medial or lateral temporal lobe epilepsy by F-18-fluorodeoxyglucose positron emission tomography: comparative study with magnetic resonance imaging in 113 surgically and pathologically proven patients

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Lee, Sang Kun; Chang, Ki Hyun; Chung, Chun Kee; Choi, Ki Young; Chung, June Key; Lee, Myung Chul

    1999-01-01

    As mesial temporal lobe epilepsy (TLE) shows hypometabolism of medial and lateral temporal lobe, we investigated whether symmetric uptake of F-18-FDG in medial temporal lobes can differentiate mesial from lateral TLE. In 113 patients (83 mesial TLE, 30 lateral TLE) who underwent anterior temporal lobectomy and/or corticectomy with good surgical outcome, we performed F-18-FDG PET and compared F-18-FDG uptake of medial and lateral temporal lobes. All the patients with mesial TLE had hippocampal sclerosis except one congenital abnormal hippocampus. Patients with lateral TLE revealed cerebromalacia, microdysgenesis, arteriovenous malformation, old contusion, and cortical dysplasia. Sensitivity of F-18-FDG PET and MR for mesial TLE was 84% (70/83) and 73% (62/83), respectively. Sensitivity of F-18-FDG PET and MR for lateral TLE was 90% (27/30) and 66% (20/30), respectively. Twelve patients were normal on F-18-FDG PET. 101 patients had hypometabolism of lateral temporal lobe. Among 88 patients who showed hypometabolism of medial temporal lobe as well as lateral temporal lobe, 70 were mesial TLE patients and 18 were lateral TLE on pathologic examination. Positive predictive value of medial temporal hypometabolism for mesial TLE was 80%. Among 13 patients who showed hypometabolism of only lateral temporal lobe, 4 were mesial TLE and 9 were lateral TLE. Positive predictive value of hypometabolism of lateral temporal lobe for the diagnosis of lateral TLE was 69% (9/ 13). Normal MR findings stood against medial TLE, whose negative predictive value was 66%. Lateral temporal lobe epilepsy should be suspected when there is decreased F-18-FDG uptake in lateral temporal lobe with normal uptake in medial temporal lobe

  3. Psicología y discapacidad: un encuentro desde el paradigma social

    OpenAIRE

    Lucrecia Alfaro-Rojas

    2013-01-01

    El tema de la discapacidad ha sido abordado desde diversos paradigmas o modelos que han dictado el modo de brindar atención a personas con esta condición. Aunque en la literatura se encuentran diversas denominaciones para estos paradigmas, el presente artículo se refiere a los tres paradigmas que engloban las posturas más habituales hacia el tema de la discapacidad: el paradigma tradicional, el paradigma médico-biológico y el paradigma social. Es dentro de este último que se concibe a la p...

  4. Microsurgical techniques in temporal lobe epilepsy.

    Science.gov (United States)

    Alonso Vanegas, Mario A; Lew, Sean M; Morino, Michiharu; Sarmento, Stenio A

    2017-04-01

    Temporal lobe resection is the most prevalent epilepsy surgery procedure. However, there is no consensus on the best surgical approach to treat temporal lobe epilepsy. Complication rates are low and efficacy is very high regarding seizures after such procedures. However, there is still ample controversy regarding the best surgical approach to warrant maximum seizure control with minimal functional deficits. We describe the most frequently used microsurgical techniques for removal of both the lateral and mesial temporal lobe structures in the treatment of medically intractable temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (corticoamygdalohippocampectomy and selective amygdalohippocampectomy). The choice of surgical technique appears to remain a surgeon's preference for the near future. Meticulous surgical technique and thorough three-dimensional microsurgical knowledge are essentials for obtaining the best results. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  5. PERKEMBANGAN PARADIGMA EPISTEMOLOGI DALAM FILSAFAT ISLAM

    Directory of Open Access Journals (Sweden)

    Fathul Mufid

    2013-06-01

    Full Text Available Abstract:    Based on historical reports, Islamic epistemology paradigm has evolved from time to time bringing different schools each other. This paper aims at revealing such differences. Methods employed are philosophical Literary Review where compiled data are analyzed inductively to formulate theoretical constructions. Research findings reveal that peripatetic philosophers highlight their mind as a dominant tool to gain knowledge using demonstrative method (burhānī.Whilst illuminative philosophers, ‘irfāniyyīn, and Sufis believe that knowledge can only be derived from mystical intuition after purification of the heart (qalb trough practices (riyā╨ah. Different schools such as ones held by Mulla Sadra and Abed al-Jabiri are based on those distinctive principles.Abstrak:      Paradigma epistemologi pemikiran Islam menurut laporan sejarah mengalami perkembangan dari zaman ke zaman, yang berbeda prinsip antara aliran yang satu dengan yang lain. Tulisan ini bertujuan untuk menguak letak perbedaan antara aliran-aliran tersebut. Metode kepustakaan filsafat dilakukan dengan analisa data induktif untuk merumuskan konstruksi teoritik.  Temuan penelitian ini adalah, bahwa para filosof Muslim Paripatetik mengedepankan akal atau rasio sebagai alat yang paling dominan untuk memperoleh pengetahuan yang benar dengan menggunakan metode demonstratif (burhānī. Sementara filosof iluminasi, kaum ‘irfānī, dan kaum sufi berprinsip bahwa pengetahuan hakiki hanya dapat diperoleh melalui intuisi-mistik, setelah melalui proses penyucian hati (qalb dengan berbagai bentuk latihan (riyā╨ah. Sementara epistemologi Mulla Sadra menggunakan tipe “hikmah”, yaitu pemaduan antara visi rasional dengan visi mistik, yang kemudian diselaraskan dengan syari’at. Epistemolog kontemporer, Abed al-Jabiri memilih epistemologi burhānī yang meyakini bahwa sumber pengetahuan adalah rasio, bukan teks atau intuisi.

  6. Conocer y ser en el paradigma constructivista

    Directory of Open Access Journals (Sweden)

    Jose Antonio Camargo Rodriguez

    2014-03-01

    Full Text Available Toda teoría acerca del aprendizaje se fundamenta en una interpretación del conocimiento, la cual se encuentra, a su vez, ligada a una cierta concepción de «ser». No será posible asimilar verdaderamente cualquiera de tales teorías si se ignoran, o no se consideran con el debido detenimiento, las ideas de conocer y «ser» que le sirven de base. Sc pone de presente que el constructivismo, en contraste con la teoría transmisionista de la enseñanza y el aprendizaje, predominante en la pedagogía tradicional, tiene su fundamento en la interpretación según la cual el conocer es una actividad humana en la que, a medida quo conoce, el hombre construye el «ser». Antes de todo conocimiento, las cosas no tienen un «ser»; están ahí, pero no se sabe lo que son. El «ser», quo constituye el objeto de todo conocer, aquello que el sujeto persigue a través de su conocimiento, no toes dada de antemano, ni le viene de fuera, sino quo es una elaboración quo el mismo realiza a través de su actividad cognoscitiva, un contenido de su propia conciencia. Hay, pues, una cierta paradoja entre las ideas de conocer y «ser» que sirven de fundamento al constructivismo, cuya reflexión se propone en aras de ganar una mejor comprensión, de encontrarle a este paradigma un sentido más allá de la pedagogía y la didáctica.

  7. DESDE EL PARADIGMA DE LA COMPLEJIDAD

    Directory of Open Access Journals (Sweden)

    Silvia Alvarado Cordero

    2015-01-01

    Full Text Available Este trabajo busca brindar un aporte a la disciplina de Orientación al proponer una forma de incorporar el paradigma de la complejidad al quehacer profesional. Se incluye una revisión de la injerencia de diferentes teorías en el desarrollo histórico de esta disciplina y se ejemplifica la aplicación de los principios de auto organización, interdependencia y sustentabilidad a la práctica de la Orientación. Sustentada en estos fundamentos teóricos, se diseñó e implementó una propuesta pedagógica en un centro educativo de Educación Primaria. Se realizó un trabajo de campo con 22 docentes y 380 estudiantes de una escuela pública en donde, durante un mes, se generaron espacios de participación y expresión creativa, con acciones a nivel de aula y de institución. En las acciones realizadas se subrayó constantemente la importancia de iniciar con el cambio individual en pequeños actos, como el ahorro energético, el manejo de desechos, la armonía en las relaciones interpersonales, se desplegó un abanico de posibilidades que emergió de las personas participantes. Los resultados y conclusiones evidencian importantes alcances y aportes que realiza la Orientación a la calidad de vida personal y social desde el contexto educativo, desde donde se convierte en una experiencia pedagógica exitosa, que puede ser homologada en otros contextos.

  8. Middle mesial canals in mandibular molars: incidence and related factors.

    Science.gov (United States)

    Nosrat, Ali; Deschenes, Raney J; Tordik, Patricia A; Hicks, M Lamar; Fouad, Ashraf F

    2015-01-01

    Although the internal anatomy of mandibular molars has been extensively studied, information about middle mesial (MM) canals is limited. The primary aim of this retrospective study was to evaluate the incidence of MM canals in mandibular first and second molars. The secondary aim was to correlate the incidence of MM canals with variables of molar type, sex, age, ethnicity, and presence of a second distal canal. All mature permanent first and second mandibular molars treated from August 2012 to May 2014 were included in the analysis. After completion of root canal instrumentation in all main canals, the clinician inspected the isthmus area of the mesial root using the dental operating microscope. If there was a catch point in this area with a file or explorer, the operator spent more time attempting to negotiate an MM canal. Seventy-five mandibular first and second molars were treated during the specified period. Fifteen (20%) teeth had negotiable MM canals. The incidence of MM canals was 32.1% in patients ≤ 20 years old, 23.8% in patients 21-40 years old, and 3.8% in patients > 40 years. Analysis of data revealed a significant difference in the distribution of MM canals among different age groups (P molar type, and presence of a second distal canal were not significant. The incidence of negotiable MM canals overall and their frequency of identification in younger patients were higher than in previous reports. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  9. Mandibular second molar with 3 mesial canals and a radix paramolaris

    Directory of Open Access Journals (Sweden)

    N Ragavendran

    2014-01-01

    Full Text Available Mandibular first molar commonly has two roots, the mesial and the distal root. Surprisingly in some mandibular first molar has an unusual extra third root in between mesial and distal root. This extra root is the most commonly seen in lingual side and is called as radix entomolaris. If this extra root is seen on the buccal side, it is termed as radix paramolaris (RP, which is a very rare phenomenon. Recently, various case report studies has shown the presence of third canal in the mesial and distal roots of mandibular molars. They are named as middle mesial and middle distal canal, respectively. Here, we present a case report of mandibular second molar showing three canals in the mesial root and a RP.

  10. Teoria feminista: o desafio de tornar-se um paradigma

    Directory of Open Access Journals (Sweden)

    Mirian Santos Paiva

    1997-12-01

    Full Text Available Partindo da crise do paradigma tradicional e tendo como epicentro a crítica feminista, este trabalho tenta mostrar o desafio que enfrenta a teoria feminista para tornar-se um novo paradigma e para tanto realiza-se uma pesquisa bibliográfica, consubstanciada na literatura pertinente ao tema. Evidencia-se que o desafio de ser um paradigma em ascensão faz com que esta teoria enfrente problemas teóricos, conceituais e metodológicos que precisam de um esforço conjunto para serem aprofundados e resolvidos. Todavia, o desenvolvimento desta teoria não depende apenas do mundo acadêmico, mas está também atrelado a mudanças na estrutura social, pois, de uma sociedade mais igualitária, mais facilmente emergirá um conhecimento sem dominação de gênero.

  11. Astrocyte uncoupling as a cause of human temporal lobe epilepsy.

    Science.gov (United States)

    Bedner, Peter; Dupper, Alexander; Hüttmann, Kerstin; Müller, Julia; Herde, Michel K; Dublin, Pavel; Deshpande, Tushar; Schramm, Johannes; Häussler, Ute; Haas, Carola A; Henneberger, Christian; Theis, Martin; Steinhäuser, Christian

    2015-05-01

    Glial cells are now recognized as active communication partners in the central nervous system, and this new perspective has rekindled the question of their role in pathology. In the present study we analysed functional properties of astrocytes in hippocampal specimens from patients with mesial temporal lobe epilepsy without (n = 44) and with sclerosis (n = 75) combining patch clamp recording, K(+) concentration analysis, electroencephalography/video-monitoring, and fate mapping analysis. We found that the hippocampus of patients with mesial temporal lobe epilepsy with sclerosis is completely devoid of bona fide astrocytes and gap junction coupling, whereas coupled astrocytes were abundantly present in non-sclerotic specimens. To decide whether these glial changes represent cause or effect of mesial temporal lobe epilepsy with sclerosis, we developed a mouse model that reproduced key features of human mesial temporal lobe epilepsy with sclerosis. In this model, uncoupling impaired K(+) buffering and temporally preceded apoptotic neuronal death and the generation of spontaneous seizures. Uncoupling was induced through intraperitoneal injection of lipopolysaccharide, prevented in Toll-like receptor4 knockout mice and reproduced in situ through acute cytokine or lipopolysaccharide incubation. Fate mapping confirmed that in the course of mesial temporal lobe epilepsy with sclerosis, astrocytes acquire an atypical functional phenotype and lose coupling. These data suggest that astrocyte dysfunction might be a prime cause of mesial temporal lobe epilepsy with sclerosis and identify novel targets for anti-epileptogenic therapeutic intervention. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Aplicación del paradigma de calidad de vida

    OpenAIRE

    Seminario de actualización metodológica en investigación sobre discapacidad Said (7º, 2010, Salamanca)

    2010-01-01

    [ES]El libro está compuesto por nueve capítulos en los que se desgranan los primeros resultados de las investigaciones que se están llevando a cabo en el proyecto "Aplicación del paradigma de calidad de vida a la intervención con personas con discapacidad desde una perspectiva integral", financiado por la Junta de Castilla y León al Grupo de Investigación de Excelencia GR197, que dirige Miguel Ángel Verdugo. En él se abordan temas relacionados con el cambio y la aplicación del paradigma de...

  13. Paradigmas en progressie in die teologie: *n Perspektief op die ...

    African Journals Online (AJOL)

    Die metodologie as besinningsterrein word egter al belangriker. Gedurende die tweede week van April 1988 het teoloë van dwarsoor Suid-. Afrika by die nuwe gebou van die Raad vir Geesteswetenskaplike Navorsing in. Pretoria byeen gekom vir 'n kongres van amper drie dae met die tema Paradigma.'> 476. ISSN 0259 ...

  14. Visualisatie van het Objectgeoriënteerde Paradigma

    NARCIS (Netherlands)

    Rensink, Arend

    2002-01-01

    Programmeeronderwijs maakt een wezenlijk deel uit van elke informatica-opleiding. Veel opleidingen kiezen ervoor dit onderwijs te schoeien op objectgeoriënteerde leest. Voor studenten die voor het eerst met dit paradigma geconfronteerd worden blijkt het vaak lastig te zijn zich een voorstelling te

  15. Õppiv organisatsioon ja juhtimise uus paradigma / Harry Roots

    Index Scriptorium Estoniae

    Roots, Harry, 1950-2010

    2004-01-01

    Juhtimise uus paradigma tähendab varasemaga võrreldes märgatavalt soodsama õpikeskkonna loomist. Nii nagu igapäevane juhtimispraktika kujundab organisatsioonis domineerivat kultuuritüüpi, samamoodi see ka kas soodustab või tõkestab õppiva organisatsiooni kujunemist, leiab autor. Tabelid. Skeemid

  16. Temporal lobe epilepsy in patients with nonlesional MRI and normal memory: an SEEG study.

    Science.gov (United States)

    Suresh, Suraj; Sweet, Jennifer; Fastenau, Philip S; Lüders, Hans; Landazuri, Patrick; Miller, Jonathan

    2015-12-01

    Temporal lobe epilepsy (TLE) in the absence of MRI abnormalities and memory deficits is often presumed to have an extramesial or even extratemporal source. In this paper the authors report the results of a comprehensive stereoelectroencephalography (SEEG) analysis in patients with TLE with normal MRI images and memory scores. Eighteen patients with medically refractory epilepsy who also had unremarkable MR images and normal verbal and visual memory scores on neuropsychological testing were included in the study. All patients had seizure semiology and video electroencephalography (EEG) findings suggestive of TLE. A standardized SEEG investigation was performed for each patient with electrodes implanted into the mesial and lateral temporal lobe, temporal tip, posterior temporal neocortex, orbitomesiobasal frontal lobe, posterior cingulate gyrus, and insula. This information was used to plan subsequent surgical management. Interictal SEEG abnormalities were observed in the mesial temporal structures in 17 patients (94%) and in the temporal tip in 6 (33%). Seizure onset was exclusively from mesial structures in 13 (72%), exclusively from lateral temporal cortex and/or temporal tip structures in 2 (11%), and independently from mesial and neocortical foci in 3 (17%). No seizure activity was observed arising from any extratemporal location. All patients underwent surgical intervention targeting the temporal lobe and tailored to the SEEG findings, and all experienced significant improvement in seizure frequency with a postoperative follow-up observation period of at least 1 year. This study demonstrates 3 important findings: 1) normal memory does not preclude mesial temporal seizure onset; 2) onset of seizures exclusively from mesial temporal structures without early neocortical involvement is common, even in the absence of memory deficits; and 3) extratemporal seizure onset is rare when video EEG and semiology are consistent with focal TLE.

  17. A mandibular third molar with three mesial roots: a case report.

    Science.gov (United States)

    Plotino, Gianluca

    2008-02-01

    Although its most common configuration is 2 roots and 3 root canals, mandibular molars might have many different combinations. A case of unusual root canal morphology is presented to demonstrate anatomic variations in mandibular molars. Endodontic therapy was performed in a mandibular third molar with 3 separate mesial roots. The appearance of the pulp chamber floor revealed 4 separate canal orifices. Radiographically the 4 root canals ended in their own distinct foramen. Many reports deal with 3 orifices or 3 independent canals in the mesial root, but none described 3 mesial canals in 3 separate mesial roots, indicating a rare anatomic configuration. This report points out the importance of looking for additional canals and unusual canal morphology, because knowledge of their existence might occasionally enable clinicians to treat a case successfully that otherwise might have ended in failure.

  18. La Persona como Eje Fundamental del Paradigma Humanista

    Directory of Open Access Journals (Sweden)

    Monserrat Georgina Aizpuru Cruces

    2012-02-01

    Full Text Available Para el desarrollo de una educación humanista es necesario centrar el paradigma pedagógico en la persona y que ésta sea concebida de una manera integral, como una totalidad. En este paradigma se desenvuelven aprendizajes significativos vivenciales, partiendo de la experiencia misma del educando, utilizando métodos activos de aprendizaje y conceptualizando a la educación como una experiencia creadora. Así mismo, es indispensable que existan programas flexibles, multi y transdisciplinarios. Por otra parte, la autoevaluación es un proceso reflexivo permanente que puede trasladarse a todos los aspectos de su vida y no sólo quedarse en el aula. Por último, los valores más importantes que promueve el modelo son el respeto, la tolerancia, la libertad, todos ellos básicos para la convivencia humana.

  19. Middle Temporal Gyrus Versus Inferior Temporal Gyrus Transcortical Approaches to High-Grade Astrocytomas in the Mediobasal Temporal Lobe: A Comparison of Outcomes, Functional Restoration, and Surgical Considerations.

    Science.gov (United States)

    Quinones-Hinojosa, Alfredo; Raza, Shaan M; Ahmed, Ishrat; Rincon-Torroella, Jordina; Chaichana, Kaisorn; Olivi, Alessandro

    2017-01-01

    High-grade astrocytomas of the mesial temporal lobe may pose surgical challenges. Several approaches (trans-sylvian, subtemporal, and transcortical) have been designed to circumnavigate the critical neurovascular structures and white fiber tracts that surround this area. Considering the paucity of literature on the transcortical approach for these lesions, we describe our institutional experience with transcortical approaches to Grade III/IV astrocytomas in the mesial temporal lobe. Between 1999 and 2009, 23 patients underwent surgery at the Johns Hopkins Medical Institutions for Grade III/IV astrocytomas involving the mesial temporal lobe (without involvement of the temporal neocortex). Clinical notes, operative records, and imaging were reviewed. Thirteen patients had tumors in the dominant hemisphere. All patients underwent surgery via a transcortical approach (14 via the inferior temporal gyrus and 9 via the middle temporal gyrus). Gross total resection was obtained in 92 % of the cohort. Neurological outcomes were: clinically significant stroke (2 patients), new visual deficits (2 patients), new speech deficit (1 patient); seizure control (53 %). In comparison to reported results in the literature for the transylvian and subtemporal approaches, the transcortical approach may provide the access necessary for a gross total resection with minimal neurological consequences. In our series of patients, there was no statistically significant difference in outcomes between the middle temporal gyrus versus the inferior temporal gyrus trajectories.

  20. Asymmetry of medial and lateral temporal regional glucose metabolism in temporal lobe epilepsy by F-18-FDG PET

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Yeo, Jeong Seok; Song, Ho Cheon; Lee, Sang Kun; Kim, Hyun Jip; Chung, June Key; Lee, Myung Chul

    1999-01-01

    We investigated the difference of glucose metabolism of medial and lateral temporal lobes of patients with temporal lobe epilepsy (TLE) utilizing quantitative comparison of regional metabolic activities using asymmetric index. We studied 19 pathologically proven mesial TLE and 25 lateral TLE patients. Lateral TLE patients were either normal on magnetic resonance imaging (cryptogenic: n=14) or had structural lesions (lesional: n=11). Asymmetric index (ASI) was calculated as [(ipsilateral contralateral)/(ipsilateral + contralateral )]x200. ASI of medial and lateral lobes of mesial TLE was decreased (-16.4±8.3 and -12.7± 5.5, respectively). In cryptogenic lateral TLE, ASI of lateral temporal lobe was decreased (-11.8± 4.7), whereas that of medial temporal lobe was not decreased (-4.6±6.3). ASI of medial lobe of lesional lateral TLE was -7.3±9.1, which was significantly different from that of mesial TLE (p<0.05). Patients with lesional lateral TLE had evident metabolic defects or decrease (ASI: -22±10.5) in lateral temporal lobe. While we could not find the difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by ASI quantitation. Asymmetric decrease of metabolic activity in both medial and lateral temporal lobes indicates medial temporal epilepsy. Symmetry of metabolic activity in medial temporal lobe combined with asymmetry of that in lateral temporal lobe may give hints that the epileptogenic zone is lateral

  1. Deviations of Mesial Root Canals of Mandibular First Molar Teeth at the Apical Third: A Micro-computed Tomographic Study.

    Science.gov (United States)

    Keles, Ali; Keskin, Cangül

    2018-04-19

    The present study aimed to quantitatively analyze apical foramen deviations of mesial root canals of mandibular first molar teeth by means of micro-computed tomographic (micro-CT) imaging. Micro-CT images of the mesial roots of 109 mandibular first molar teeth with independent mesiobuccal (MB) and mesiolingual (ML) root canals were analyzed. The deviations of the apical foramina of the MB, ML, and middle mesial root canals from the anatomic apex were measured. The vertical distance between the apical foramina of each mesial root canal in relation to each other was also calculated. The distances from the apical foramina of the MB, ML, and middle mesial root canals to the anatomic apex of the mesial root were up to 2.51 mm, 3.21 mm, and 5.67 mm, respectively. There was no significant difference between the deviations of MB and ML root canals from each other (P > .05). The middle mesial root canal showed the greatest deviation compared with the MB and ML canals (P < .05). The apical foramina of mesial root canals of mandibular first molar teeth showed greater variations from each other and anatomic apices than previously reported. Clinically, the use of electronic apex locators for the detection of minor apical foramen of each mesial root canal is of the utmost important. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. A inclusão na perspectiva do novo paradigma da ciência

    Directory of Open Access Journals (Sweden)

    Reinoldo Marqueza

    2011-12-01

    Full Text Available O estudo aborda o processo de transição paradigmática da ciência moderna para a ciência pós-moderna. Salienta as características do paradigma atual, a crise desse paradigma e aponta os contornos do paradigma emergente na perspectiva do sociólogo Boaventura Sousa Santos. Refere a Educação Inclusiva como um novo processo de produção e de apropriação do conhecimento e como uma nova forma de estar na relação.Palavras-chave: Paradigma. Conhecimento. Educação Inclusiva.

  3. Relationship Between the Wada Test and Preoperative/Postoperative Memory in Mesial Temporal Lobe Epilepsy Patients

    Directory of Open Access Journals (Sweden)

    Burcu POLAT

    2013-01-01

    Full Text Available Objectives: To study the correlation between Wada memory test and neuropsychometric tests which were applied preoperatively to mesialtemporal lobe epilepsy patients associated with hippocampal sclerosis (MTLE-HS who had undergone selective amygdalohippocampectomyand find out the effects of early onset epileptic seizures on atypical memory dominance.Methods: Drug-resistant 27 patients (16 left, 11 right MTLE-HS had video EEG, cranial MRI and Wada test preoperatively. Weschler visualsubtest and verbal memory processing tests were applied to all patients before surgery and the first year after the operation.Results: The number of left hemisphere memory dominant patients was 6 (22.2% and the number of atypical memory dominant patientswas 21 (77.8% according to the Wada test. There was a significant difference between the two groups when compared for epileptic seizureonset age; (p=0.042, and also a significant diffference when compared for HS (right/left side (p=0.002. When we analyzed the correlationbetween preoperative and postoperative verbal and nonverbal tests and left memory Wada dominance; in verbal memory processing tests‘delayed recall’ scores between groups were significant (p=0.042, on the other hand in patients with atypical memory dominance ‘total learning’ scores between groups were significant (p<0.001.Conclusion: As a result, we found that the earlier the onset of seizures, the more atypical the memory dominance (right or bilateral. The Wada test was effective for assessing verbal memory; on the other hand, it was inadequate for assessing visual memory dominance. If the scores of ‘delayed recall’ in verbal memory were high in the patients with typical verbal dominance and ‘total learning’ scores in the patients with atypical verbal dominance, the scores also tended to rise after the operation.

  4. Impaired hippocampal rhythmogenesis in a mouse model of mesial temporal lobe epilepsy

    Czech Academy of Sciences Publication Activity Database

    Dugladze, T.; Vida, I.; Tort, A.B.; Gross, A.; Otáhal, Jakub; Heinemann, U.; Kopell, N.J.; Gloveli, T.

    2007-01-01

    Roč. 104, č. 44 (2007), s. 17530-17535 ISSN 0027-8424 Grant - others:-(BR) 201038/2005-6; -(XE) FP6Epicure; -(DE) TR3/B5; -(US) R01NS46058 Institutional research plan: CEZ:AV0Z50110509 Keywords : interneurons * oscillations * patch-clamp Subject RIV: ED - Physiology Impact factor: 9.598, year: 2007

  5. Neurotrophin receptor immunoreactivity in the hippocampus of patients with mesial temporal lobe epilepsy

    NARCIS (Netherlands)

    Ozbas-Gerceker, F.; Gorter, J.A.; Redeker, S.; Ramkema, M.; van der Valk, P.; Baayen, J.C.; Ozguc, M.; Saygi, S.; Soylemezoglu, F.; Akalin, N.; Troost, D.; Aronica, E.

    2004-01-01

    Recent evidence supports a critical role of neurotrophins in the regulation of both neuronal survival and synaptic transmission during epileptogenesis. We have examined the immunohistochemical expression of high- (tyrosine kinase receptors, trk) and low-affinity (p75) neurotrophin receptors (NTRs)

  6. Pharmacodynamics of remifentanil. Induced intracranial spike activity in mesial temporal lobe epilepsy

    DEFF Research Database (Denmark)

    Kjær, Troels Wesenberg; Hogenhaven, Hans; Lee, Andrea P

    2017-01-01

    that remifentanil potentiates spike activity is in agreement with previous findings from smaller studies. Furthermore, we were able to describe the pharmacodynamics of the remifentanil effect on spike activity. Peri-operative provocation with remifentanil may play a future role in guiding neurosurgical intervention...

  7. Paradigma del Derecho a la salud en la actualidad Argentina

    Directory of Open Access Journals (Sweden)

    Mónica Alejandra Canteros

    2012-11-01

    Full Text Available El presente artículo tuvo como objeto describir el estado del arte en el que se encuentra el Derecho a la salud en la actualidad argentina, por medio de la revisión de los paradigmas reconocidos, sostenidos y recogidos en este país en los últimos treinta años.Este modelo ha sido plasmado en el Proyecto del Nuevo Código Civil y Comercial, hoy en debate.Tratándose de un trabajo cuyo diseño es de tipo bibliográfico, se buscó como objetivo general describir el paradigma actual del derecho a la salud argentina, tomando como fuentes, la lectura y el análisis de la legislación y doctrina nacional.Se arribaron a los siguientes resultados: en los últimos treinta años el derecho a la salud tomó expresa jerarquía constitucional, lo que significó el estallido de la legislación protegiendo especialmente al paciente, en búsqueda de una regulación tan protectoria como efectiva. El paradigma vigente, en la Argentina de hoy, resalta la no discriminación y el valor social quetiene el concepto de salud. Destaca derechos personalísimos, como la integridad personal, dignidad,intimidad, muerte digna, y otros derechos como la autodeterminación, derecho a una información sanitaria, libre elección y adhesión a un sistema de salud. 

  8. Convivencia paradójica de paradigmas de discapacidad

    OpenAIRE

    Ale, Adelina

    2014-01-01

    El presente artículo se propone abordar los paradigmas y modelos sobre discapacidad que se evidencian en discursos, contextos y tensiones, desde una perspectiva dialógica, fundada en polifonías y múltiples miradas. Ejercitaremos “la pedagogía de la pregunta”, tal como lo plantea Bonder (2012), para analizar a la discapacidad como objeto de estudio. Partimos de la premisa de que el colectivo de los discapacitados no es homogéneo ni definible en categorías y variables de análisis exclusivamente...

  9. El alumno de bellas artes ante un nuevo paradigma

    OpenAIRE

    Mayor Iborra, José; Morgado Aguirre, Borja; Tejeda Martín, Mª Isabel

    2011-01-01

    Este nuevo paradigma que nos enfrenta a un modelo cuantitativo y cualitativo de la enseñanza-aprendizaje, perturba y enmaraña los modos sobre métodos anteriores a la reforma de la enseñanza superior. El papel del alumno, ahora, como actor responsable, en gran medida de su aprendizaje, se concreta y define en el crédito ECTS, otorgándole este nuevo rol. En las Facultades de Bellas Artes, la docencia es eminentemente práctica. La teoría, va implícita junto al alumno en su puesto de trabajo, med...

  10. PARADIGMA KOMUNIKATIF: SEBUAH TAWARAN MODEL DALAM PEMBANGUNAN HUKUM

    Directory of Open Access Journals (Sweden)

    Mr. Hermansyah

    2011-06-01

    Full Text Available The rise of legal positivism paradigm places state law as the truest law. Nevertheless, there are other legal systems, such as religious and customary laws that have different cultural and political systems. Therefore, development in the field of law shall attempt to connect to the various existing legal systems. Menguatnya paradigma positivisme hukum menempatkan hukum negara sebagai hukum yang paling benar. Namun kenyataannya ada sistem hukum lain, seperti hukum adat dan agama, yang memiliki perbedaan sistem budaya, politik, serta kepercayaan. Karenanya, pembangunan di bidang hukum seharusnya merupakan upaya untuk mengkomunikasikan berbagai sistem hukum yang ada tersebut.

  11. A clinical approach to the successful management of variations of middle mesial canals: A case series

    Directory of Open Access Journals (Sweden)

    Raghavendra Penukonda

    2018-01-01

    Full Text Available The possible variations of anatomical and morphological characteristics of the teeth are very important especially for the endodontic practitioners for successful treatment. Mandibular molars are most commonly affected by dental caries and require endodontic treatment. Mandibular molars exhibit variations in its internal anatomy; one among those is the presence of an extra canal in the mesial root called as middle mesial (MM canal. Detection of these minute canals requires a proper clinical knowledge and radiographic examination. This article presents the treatment of three cases of mandibular first molars with MM canals without the aid of any magnification devices.

  12. Selective amygdalohippocampectomy via trans-superior temporal gyrus keyhole approach.

    Science.gov (United States)

    Mathon, Bertrand; Clemenceau, Stéphane

    2016-04-01

    Hippocampal sclerosis is the most common cause of drug-resistant epilepsy amenable for surgical treatment and seizure control. The rationale of the selective amygdalohippocampectomy is to spare cerebral tissue not included in the seizure generator. Describe the selective amygdalohippocampectomy through the trans-superior temporal gyrus keyhole approach. Selective amygdalohippocampectomy for temporal lobe epilepsy is performed when the data (semiology, neuroimaging, electroencephalography) point to the mesial temporal structures. The trans-superior temporal gyrus keyhole approach is a minimally invasive and safe technique that allows disconnection of the temporal stem and resection of temporomesial structures.

  13. Die impak van die verbond op 'n paradigma vir pastoraat: research ...

    African Journals Online (AJOL)

    Die verbond het 'n meer omvattende impak op pastorale sorg as ander paradigmas. Genoemde stelling word in hierdie artikel beredeneer. Daar word aangetoon dat die inhoud wat aan die gelowige gekommunikeer word, asook die tegnieke wat gebruik word, deur 'n verbondmatige paradigma vir pastorale sorg be?nvloed ...

  14. Temporal lobe sclerosis associated with hippocampal sclerosis in temporal lobe epilepsy: neuropathological features.

    Science.gov (United States)

    Thom, Maria; Eriksson, Sofia; Martinian, Lillian; Caboclo, Luis O; McEvoy, Andrew W; Duncan, John S; Sisodiya, Sanjay M

    2009-08-01

    Widespread changes involving neocortical and mesial temporal lobe structures can be present in patients with temporal lobe epilepsy and hippocampal sclerosis. The incidence, pathology, and clinical significance of neocortical temporal lobe sclerosis (TLS) are not well characterized. We identified TLS in 30 of 272 surgically treated cases of hippocampal sclerosis. Temporal lobe sclerosis was defined by variable reduction of neurons from cortical layers II/III and laminar gliosis; it was typically accompanied by additional architectural abnormalities of layer II, that is, abnormal neuronal orientation and aggregation. Quantitative analysis including tessellation methods for the distribution of layer II neurons supported these observations. In 40% of cases, there was a gradient of TLS with more severe involvement toward the temporal pole, possibly signifying involvement of hippocampal projection pathways. There was a history of a febrile seizure as an initial precipitating injury in 73% of patients with TLS compared with 36% without TLS; no other clinical differences between TLS and non-TLS cases were identified. Temporal lobe sclerosis was not evident preoperatively by neuroimaging. No obvious effect of TLS on seizure outcome was noted after temporal lobe resection; 73% became seizure-free at 2-year follow-up. In conclusion, approximately 11% of surgically treated hippocampal sclerosis is accompanied by TLS. Temporal lobe sclerosis is likely an acquired process with accompanying reorganizational dysplasia and an extension of mesial temporal sclerosis rather than a separate pathological entity.

  15. Civilização e cultura: paradigmas da nacionalidade

    Directory of Open Access Journals (Sweden)

    Regina Maria Monteiro

    Full Text Available O pensamento republicano paulista, analisado neste artigo sob o aspecto da educação escolar necessária à constituição do Estado Nacional no Brasil do final do século XIX, elegeu como base fundamental para a formação do cidadão a disseminação de valores morais cujos vértices centravam-se nas categorias civilização e cultura como forma de assimilação de um ethos liberal que levaria o país ao nível de desenvolvimento da sociedade européia. Essas categorias seriam os paradigmas pelos quais se estabeleceria a identificação do indivíduo comocidadão apto a participar do Estado e portanto a constituir a nação. A veiculação desse ethos liberal, por meio dos paradigmas civilização e cultura, seria, portanto, o papel reservado à formação escolar primária, segundo os expoentes do pensamento republicano paulista entre 1870 e 1889.

  16. Logística del siglo XXI, rompiendo paradigmas

    Directory of Open Access Journals (Sweden)

    Nolán Sánchez Tovar

    2010-01-01

    Full Text Available Durante los últimos 200 años, el país ha sufrido grandes cambios en todos los ámbitos, lo cual le ha generado un posicionamiento estratégico a todos los sectores productivos, haciéndolos mucho más competitivos y dinámicos. Estos avances se han logrado gracias al cambio de paradigmas, propiciado por quienes han impulsado estos negocios, desde mediados del siglo XX, con la aparición del término Logística1 y el reconocimiento de las necesidades del cliente, procurando una mayor fidelizacion y al mismo tiempo una reducción de sus costos de operación y maximizando las utilidades. Para cumplir con esta nueva misión, es indispensable apropiarse de los cambios tecnológicos que se están produciendo, rompiendo el paradigma de hábitos tradicionales. El gran reto es comenzar por cambiar la mentalidad empresarial de sus equipos.

  17. EL NUEVO PARADIGMA EMPRESARIAL: El Esquema de Redes

    Directory of Open Access Journals (Sweden)

    Ignasi Brunet Icart

    2004-07-01

    Full Text Available Hoy las organizaciones están cambiando drásticamente y adoptando nuevas formas de operación. Detrás de este fenómeno hay un compromiso con el rendimiento y con la creación de valores, que ha alterado profundamente la economía y la vida cotidiana. El principio de creación de valor estimula la tendencia de reemplazar la actual organización piramidal por un esquema de redes. El problema de fondo es cómo optimizar los recursos disponibles, y ello puede lograrse mediante un nuevo paradigma gerencial con redes de firmas interrelacionadas que maximizan la coordinación, la obtención de economías de escala y la explotación de sinergias. El objetivo de este artículo es describir este paradigma emergente que impone contar con estructuras flexibles que permitan la readaptación de las organizaciones. Por otra parte, la conclusión a que llegamos es que la generalización de los esquemas de redes explica que las sociedades avanzadas se articulan, cada vez más, en base a una lógica conexionista.

  18. Thalamic glucose metabolism in temporal lobe epilepsy measured with 18F-FDG positron emission tomography (PET)

    NARCIS (Netherlands)

    Khan, N; Leenders, KL; Hajek, M; Maguire, P; Missimer, J; Wieser, HG

    1997-01-01

    Thalamic glucose metabolism has been studied in 24 patients suffering from temporal lobe epilepsy (TLE) using interictal F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET). A total of 17 patients had a unilateral TL seizure onset, 11 of these patients had a mesial temporal lobe

  19. CONECTIVISMO, ¿UN NUEVO PARADIGMA EN LA EDUCACION ACTUAL?

    Directory of Open Access Journals (Sweden)

    Liana Carolina Ovalles Pabon

    2014-06-01

    Full Text Available Este proyecto es producto de una reflexión crítica y estructurada por la inminente presencia en la cotidianidad de mecanismos tecnológicos que directa o indirectamente están presentes en los actos pedagógicos, surge la necesidad de entender la forma como está estructurando el pensamiento de los estudiantes y desde el accionar docente, cómo se puede beneficiar el accionar docente y pedagógico de ésta nueva tendencia que gira entorno a la tecnología que permite la conectividad; la educación no puede ser agena a las tendencias y actualizaciones del mundo, por esta razón se crea el paradigma de la educación actual en base al conectivismo.

  20. Un acercamiento al paradigma cuántico

    OpenAIRE

    Zapata Mesa, John Fernando

    2009-01-01

    En este breve escrito se hace algunos comentarios sobre la física cuántica con el objetivo de hacer un acercamiento al lector a este nuevo paradigma y de motivar una reflexión en esta línea.La física cuántica es la ciencia más desarrollada y mejor fundamentada hasta el momento junto con la teoría de la relatividad de Einstein. Toda la tecnología actual es una consecuencia directa de la física cuántica, es decir sin física cuántica no hubiese sido posible la construcción de un láser, computado...

  1. Middle mesial canal of the permanent mandibular first molars: an anatomical challenge directly related to the outcome of endodontic treatment.

    Science.gov (United States)

    Perlea, Paula; Nistor, Cristina Coralia; Imre, Marina; Gheorghiu, Irina Maria; Iliescu, Alexandru Andrei

    2017-01-01

    To effectively clean and shape the mandibular permanent first molars it is mandatory to understand in detail their complex internal anatomy. The middle mesial canal is an additional canal located between the usual mesiobuccal and mesiolingual canals in the mesial root of mandibular first molars. The incidence of the middle mesial canal, its relationship with main canals of the mesial root and the possibility for it to be negotiated is an important practical issue in endodontics. To identify the presence of this canal is mandatory. Accordingly, a modified endodontic access, the use of the operating microscope and periapical radiographs in two different horizontal projections are indicated to enhance the long-term favorable outcome of the endodontic treatment.

  2. Psicología y discapacidad: un encuentro desde el paradigma social

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    Lucrecia Alfaro-Rojas

    2013-06-01

    Full Text Available El tema de la discapacidad ha sido abordado desde diversos paradigmas o modelos que han dictado el modo de brindar atención a personas con esta condición. Aunque en la literatura se encuentran diversas denominaciones para estos paradigmas, el presente artículo se refiere a los tres paradigmas que engloban las posturas más habituales hacia el tema de la discapacidad: el paradigma tradicional, el paradigma médico-biológico y el paradigma social. Es dentro de este último que se concibe a la persona con discapacidad desde un enfoque biopsicosocial y se apunta hacia una integración real y efectiva de esta población en todas las esferas de la vida en la sociedad. Este nuevo paradigma social obliga a replantear los abordajes, que, hasta hace poco tiempo, eran bien vistos y promovidos por los profesionales que se relacionaban laboralmente con esta población. La Psicología no escapa a esta influencia y, por tanto, se ve en la necesidad de revisar algunas de sus prácticas tradicionales a la luz del nuevo paradigma, que propone trascender la atención centrada exclusivamente en la persona para incidir en el contexto social. Esto implica, por ejemplo, el surgimiento de nuevas actitudes en el quehacer cotidiano de los y las profesionales en Psicología y, por tanto, una nueva planificación y orientación de los sistemas de atención.

  3. Independent and Confluent Middle Mesial Root Canals in Mandibular First Molars: A Report of Four Cases

    Directory of Open Access Journals (Sweden)

    Mohanavelu Deepalakshmi

    2012-01-01

    Full Text Available Mandibular molars demonstrate considerable variations with respect to number of roots and root canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. This paper discusses the endodontic management of the rare anatomical complexity middle mesial canals in mandibular first molar and also serves to remind the clinicians that such anatomical variations should be taken into account during the endodontic treatment of the mandibular molars.

  4. Evaluation of the anatomical alterations of lower molars mesial root?s apical third

    OpenAIRE

    FRÖNER Izabel Cristina; IMPERADOR Cristina Aparecida; SOUZA Luiz Gustavo de

    1999-01-01

    The anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. The knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy.

  5. Evaluation of the anatomical alterations of lower molars mesial root?s apical third

    Directory of Open Access Journals (Sweden)

    FRÖNER Izabel Cristina

    1999-01-01

    Full Text Available The anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. The knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy.

  6. Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

    Science.gov (United States)

    Sanz-García, Ancor; Vega-Zelaya, Lorena; Pastor, Jesús; Torres, Cristina V.; Sola, Rafael G.; Ortega, Guillermo J.

    2016-01-01

    Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control seizures. However, a significant minority of patients continues to exhibit post-operative seizures, even in those cases in which the suspected source of seizures has been correctly localized and resected. The protocol presented here combines a clinical procedure routinely employed during the pre-operative evaluation of temporal lobe epilepsy (TLE) patients with a novel technique for network analysis. The method allows for the evaluation of the temporal evolution of mesial network parameters. The bilateral insertion of foramen ovale electrodes (FOE) into the ambient cistern simultaneously records electrocortical activity at several mesial areas in the temporal lobe. Furthermore, network methodology applied to the recorded time series tracks the temporal evolution of the mesial networks both interictally and during the seizures. In this way, the presented protocol offers a unique way to visualize and quantify measures that considers the relationships between several mesial areas instead of a single area. PMID:28060326

  7. Secondary bilateral synchrony due to fronto-mesial lesions: an invasive recording study

    Directory of Open Access Journals (Sweden)

    CUKIERT ARTHUR

    1999-01-01

    Full Text Available Frontal lobe epilepsies may present difficulties in focus localization in the pre-operative work-up for epilepsy surgery. This is specially true in patients with normal MRIs. We report on a 16 years-old girl that started with seizures by the age of 8 years. They were brief nocturnal episodes with automatisms such as bicycling and boxing. Seizure frequency ranged from 4-10 per night. Scalp EEG showed few right frontal convexity spiking and intense secondary bilateral syncrhony (SBS. High resolution MRI directed to the frontal lobes was normal. Ictal SPECT suggested a right fronto-lateral focus. Ictal video-EEG showed no focal onset. She was submitted to invasive recordings after subdural plates implantation. Electrodes covered all the frontal convexity and mesial surface bilaterally. Ictal recordings disclosed stereotyped seizures starting from the right mesial frontal. Using a high-resolution tool to measure intra and interhemispheric latencies, the timing and direction of seizure spread from the right fronto-mesial region were studied. Motor strip mapping was performed by means of electrical stimulation. She was submitted to a right frontal lobe resection, 1.5 cm ahead of the motor strip and has been seizure free since surgery (8 months. Pathological examination found a 4 mm area of cortical dysplasia. Invasive studies are needed to allow adequate localization in patients with non-localizatory non-invasive work-up and may lead to excellent results in relation to seizures after surgery.

  8. Outcome of intracranial electroencephalography monitoring and surgery in magnetic resonance imaging-negative temporal lobe epilepsy.

    Science.gov (United States)

    Lee, Ricky W; Hoogs, Marietta M; Burkholder, David B; Trenerry, Max R; Drazkowski, Joseph F; Shih, Jerry J; Doll, Karey E; Tatum, William O; Cascino, Gregory D; Marsh, W Richard; Wirrell, Elaine C; Worrell, Gregory A; So, Elson L

    2014-07-01

    We evaluated the outcomes of intracranial electroencephalography (iEEG) recording and subsequent resective surgery in patients with magnetic resonance imaging (MRI)-negative temporal lobe epilepsy (TLE). Thirty-two patients were identified from the Mayo Clinic Epilepsy Surgery Database (Arizona, Florida, and Minnesota). Eight (25.0%) had chronic iEEG monitoring that recorded neocortical temporal seizure onsets; 12 (37.5%) had mesial temporal seizure onsets; 5 (15.6%) had independent neocortical and mesial temporal seizure onsets; and 7 (21.9%) had simultaneous neocortical and mesial seizure onsets. Neocortical temporal lobe seizure semiology was the only factor significantly associated with neocortical temporal seizure onsets on iEEG. Only 33.3% of patients who underwent lateral temporal neocorticectomy had an Engel class 1 outcome, whereas 76.5% of patients with iEEG-guided anterior temporal lobectomy that included the amygdala and the hippocampus had an Engel class 1 outcome. Limitations in cohort size precluded statistical analysis of neuropsychological test data. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Cortical projection of the inferior choroidal point as a reliable landmark to place the corticectomy and reach the temporal horn through a middle temporal gyrus approach

    Directory of Open Access Journals (Sweden)

    Thomas Frigeri

    2014-10-01

    Full Text Available Objective To establish preoperatively the localization of the cortical projection of the inferior choroidal point (ICP and use it as a reliable landmark when approaching the temporal horn through a middle temporal gyrus access. To review relevant anatomical features regarding selective amigdalohippocampectomy (AH for treatment of mesial temporal lobe epilepsy (MTLE. Method The cortical projection of the inferior choroidal point was used in more than 300 surgeries by one authors as a reliable landmark to reach the temporal horn. In the laboratory, forty cerebral hemispheres were examined. Conclusion The cortical projection of the ICP is a reliable landmark for reaching the temporal horn.

  10. Cortical projection of the inferior choroidal point as a reliable landmark to place the corticectomy and reach the temporal horn through a middle temporal gyrus approach.

    Science.gov (United States)

    Frigeri, Thomas; Rhoton, Albert; Paglioli, Eliseu; Azambuja, Ney

    2014-10-01

    To establish preoperatively the localization of the cortical projection of the inferior choroidal point (ICP) and use it as a reliable landmark when approaching the temporal horn through a middle temporal gyrus access. To review relevant anatomical features regarding selective amigdalohippocampectomy (AH) for treatment of mesial temporal lobe epilepsy (MTLE). The cortical projection of the inferior choroidal point was used in more than 300 surgeries by one authors as a reliable landmark to reach the temporal horn. In the laboratory, forty cerebral hemispheres were examined. The cortical projection of the ICP is a reliable landmark for reaching the temporal horn.

  11. Novos paradigmas para o ensino e o planejamento da paisagem

    Directory of Open Access Journals (Sweden)

    Lúcia Capanema Álvares

    2006-12-01

    Full Text Available As condições de vida nas cidades vêm, desde fins do século XIX, demandando a constante evolução do planejamento e do profissional que o exerce. Este estudo parte da hipótese de descompasso entre a prática profissional do planejador – e a demanda no planejamento da paisagem; seu objetivo é abordar paradigmas do planejamento da paisagem e sua incorporação ao ensino de arquitetura e urbanismo. Analisa as grades curriculares de três cursos de arquitetura e urbanismo em Belo Horizonte, avaliando a formação do profissional para a prática do planejamento.Verificou-se que o ensino aponta algumas diretrizes contemporâneas, mas ainda não é visto como processo – complexo, contínuo e integrado. As recomendações visam formar um profissional crítico, reflexivo e de conhecimento multidisciplinar que contemple as ciências sociais e ambientais, sem o qual não se pode atuar na paisagem urbana da atualidade.

  12. Excitons in conjugated polymers: Do we need a paradigma change?

    Energy Technology Data Exchange (ETDEWEB)

    Beenken, Wichard J.D. [Department of Theoretical Physics I, Ilmenau University of Thechnology (Germany)

    2009-12-15

    We have previously shown that both, polymer conformation and dynamics are crucial for the exciton transport in conjugated polymers. Thereby we found that the usual Foerster-type hopping transfer model - even if one applies the line-dipole approximation - falls short in one crucial aspect: the nature of the sites the excitons are transferred between is still unclear. We found that the simple model of spectroscopic units defined as segments of the polymer chains separated by structural defects breaking the {pi}-conjugation is only justified for chemical defects like hydrogenated double bonds, or extreme gauche (90 ) torsions between the monomers. Both defects are far too rare in a well-prepared conjugated polymer to explain the mean spectroscopic-unit length of typically 6-7 monomers. Meanwhile, also the concept of dynamical formation of the spectroscopic units, we had previously suggested, has also failed. Thus the question of a paradigma change concerning the exciton transport in conjugated polymers appears on the agenda. (Abstract Copyright [2009], Wiley Periodicals, Inc.)

  13. Oficio de historiador, ¿nuevo paradigma o positivismo?

    Directory of Open Access Journals (Sweden)

    Carlos Barros

    2014-07-01

    Full Text Available Balance sobre las tendencias y los debates actuales e internacionales, desde una óptica trasatlántica y latina, sobre el método, la historiografía, la teoría y la relación con la sociedad de los historiadores del siglo XXI.   Partiendo del preámbulo y  las posiciones del Manifiesto de Historia a Debate (2001, y recogiendo los  últimos debates de HAD en las redes sociales, analizamos la polarización historiográfica, entre los partidarios de nuevos paradigmas que no hacemos tabla rasa de las vanguardias del siglo XX, y los partidarios de un retorno al positivismo, aguijoneados por el posmodernismo radical. Repliegue historiográfico  que estudiamos a través de frases, prácticas  y lugares comunes, dichos y hechos  dentro y fuera de aulas y despachos. Datos de tipo digital y oral que vienen manifestando, en cuanto al regreso de Ranke, una gran homogeneidad y transversalidad entre las diferentes especialidades, universidades y países.

  14. Endodontic treatment of a mandibular first molar with three mesial canals and broken instrument removal.

    Science.gov (United States)

    Faramarzi, Farhad; Fakhri, Hamidreza; Fakri, Hamidreza; Javaheri, Homan H

    2010-04-01

    To succeed in any dental procedure, the clinician's awareness of the patient's dental anatomy and its variations is crucial. In endodontic therapy, obtaining full information about the root canals' variations can affect the outcome substantially. This case report presents the endodontic treatment of a mandibular first molar exhibiting three mesial root canals with 4 mm of a separated K-file in the coronal third of the mesiolingual canal on an 18-year-old female patient. This case demonstrates the importance of locating additional canals in any roots undergoing endodontic treatment and how the clinician's awareness of aberrant internal anatomy may change the treatment results.

  15. Evaluation of the anatomical alterations of lower molars mesial root’s apical third

    OpenAIRE

    FRÖNER, Izabel Cristina; IMPERADOR, Cristina Aparecida; SOUZA, Luiz Gustavo de

    1999-01-01

    The anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. The knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy. A presente pesquisa analisa in vitro as alterações anatômicas dos 4 mm apic...

  16. Cambios de Paradigmas en la Psiquiatría

    Directory of Open Access Journals (Sweden)

    Carlos A. León Saltos

    1999-04-01

    Full Text Available

    He concebido la presente ponencia a manera de un ensayo cuyo título más acertado quizás podría ser: “Asociaciones libres de un psiquiatra ecléctico en torno al tema del cambio de paradigmas en la psiquiatría, con incursiones inevitables en el terreno de la reminiscencia.” Ante todo, es necesario formular una aclaración semántica respecto al uso del término paradigma.

    Su empleo tuvo una extraordinaria difusión a raíz del trabajo de Kuhn sobre la estructura de las revo-luciones científicas (1, donde lo definió como “los logros científicos reconocidos universalmente que aportan por un tiempo problemas y soluciones modelo a una comunidad de practicantes.” En su acepción original el vocablo sólo denota un modelo, patrón o pauta y por extensión una noción directriz o una orientación, sin necesidad de que hubiesen alcanzado aceptación universal pero sí muestren un claro predominio en el ámbito de una disciplina durante un tiempo determinado. Es en este sentido como el término se usará en la presente exposición.

    Los cambios de paradigma por describirse a continuación comprenden tres casos y corresponden a tres órdenes temporales diferentes: El primero registra el hecho cumplido de la psiquiatría biológica como orientación predominante en el campo general de la psiquiatría; el segundo se refiere a un nuevo concepto, en proceso de aceptación, que refuta la noción tradicional de la esquizofrenia como un trastorno deteriorante, y el tercero se insinúa como un desarrollo futuro probable acerca del papel del cerebelo en el funcionamiento mental.

    A lo largo de la presentación se hará un intento por señalar las posibles implicaciones de los cambios mencionados para el estado actual o futuro de la psiquiatría, y finalmente se ilustrará con una anécdota personal, la conveniencia de un enfoque multidisciplinario para la exploración y el entendimiento de los fenómenos mentales. Auge de la

  17. EDUCAÇÃO E SOFRIMENTO: MARCAS DE UM PARADIGMA

    Directory of Open Access Journals (Sweden)

    Nize Campos Pellanda

    2008-07-01

    Full Text Available Com essa comunicação pretendemos apresentar um relato de uma pesquisa em andamento sobre sofrimento dos estudantes como consequência de práticas educativas que não contemplam necessidades fundamentais dos seres humanos em termos biológicos, epistêmicos e ontológicos. Essas necessidades estão sendo apontadas por pesquisas transdisciplinares recentes sobre o funcionamento dos seres vivos. Essas práticas didáticas são consideradas na pesquisa como altamente inibidoras do ser/conhecer. Essa inseparabilidade das dimensões da realidade é a marca principal da investigação pautada no paradigma da complexidade fazendo contraponto com as questões da fragmentação da modernidade que representam um foco importante de análise. O quadro teórico de fundo para análise dos dados é construído a partir de ciências que constituem o movimento de auto-organização (MAO focalizando principalmente as teorias biológico/cognitivas da Biologia do Conhecer de H. Maturana e F. Varela e Complexificação pelo ruído de H. Atlan. Os dados referem-se a duas fontes principais de coleta: conversas com crianças de 5ª a 8ª séries do Ensino Fundamental de escolas estaduais de duas cidades diferentes e depoimentos de educadores em forma de história de vida. Nessa apresentação serão discutidos apenas os dados referentes à primeira parte pois a segunda parte ainda não foi analisada. Esclarecemos que trata-se de uma pesquisa em andamento e, por esse motivo, não aparecerão aqui situações conclusivas mas sim uma ênfase no devir da pesquisa. A partir desse quadro teórico, são feitas as análises cujo eixo situa-se na questão da (nãoconstrução de sentido na escola. Usamos sentido como aquilo que emerge da ação humana e, portanto, como produção dos seres humanos no bojo de sua ação sobre a realidade. Nessa perspectiva, ele faz parte integrante do processo de conhecimento que, por sua vez, não se separa do processo de viver. Palavras

  18. La salud mental (en la argentina: dos paradigmas en pugna

    Directory of Open Access Journals (Sweden)

    Croxatto, Guido L.

    2012-12-01

    Full Text Available En el presente trabajo se analiza una relectura crítica de la institución de la “discapacidad” en el Derecho Civil argentino a la luz de los nuevos paradigmas en materia de salud mental que tienden a restablecer a los sujetos (mal llamados “discapacitados o “incapaces” en su dignidad y su autonomía, entendiendo que la discapacidad más que una enfermedad o limitación de la persona, (como a menudo se la ha visto es una barrera que traza la misma sociedad que luego, a través del derecho, discapacita (declara discapacitada a la persona. Se sostendrá que la discapacidad encarna una contradicción del derecho. En este marco, se analiza una propuesta de cambio a partir de un nuevo modelo social (en reemplazo del modelo tutelar del Código Civil argentino, que ha demostrado que la “tutela” es un modelo vertical que tiende a silenciar y aislar a quienes más necesitan ser escuchados que pone en el centro el pleno respeto de la dignidad y de la autonomía de las personas usuarias de servicios de salud mental. Se analiza el rol del curador provisorio en los juicios de insania, planteando el interrogante de si debe actuar como un abogado de la persona (Kraut o como un auxiliar del juez (Llambías, acentuando en esos casos el carácter vertical (tutelar de estos procesos (que asimilan el proceso jurídico a una parte del tratamiento médico y en consecuencia, el aislamiento y el silenciamiento de la persona que más necesita ser escuchada durante el proceso judicial: el presunto “incapaz”. La conclusión es que el Derecho Civil debe abandonar la figura de la discapacidad porque discapacitando no ha “protegido” ni “recuperado” a los “incapaces”, sino que los ha aislado, silenciado, matado y anulando como personas (muchas veces, al solo efecto de resguardar un patrimonio. Para el derecho ya no puede haber discapacitados ni incapaces. Solo personas. Se demostrará que la discapacidad es una institución incompatible con un

  19. Violência familiar reinterpretada: paradigmas de intervenção

    OpenAIRE

    Pereira, M. Graça

    1998-01-01

    O fenónemo da violência é analisado tendo como pano de referência os quatro paradigmas definidos por Burrell e Morgan. O autor seleciona uam teoria que no seu entender protagoniza casa um desses paradigmas e tece reflexões àcerca da conceptualização da violência ao nível do casal. As quatro teorias selecionadas são a teoria geral de sistemas, construtivismo, modelos narrativos e a perspectiva feminista. Implicações ao nivel da intervenção são apresentadas e discutidas.

  20. O paradigma económico de eficácia organizacional

    OpenAIRE

    Fernandes, António

    2007-01-01

    Este artigo faz uma breve revisão da literatura acerca do estudo do paradigma de eficácia organizacional cujo espírito gravita em torno do processo interno. No paradigma económico de eficácia podem incluir-se três grandes contributos, designadamente, da teoria da gestão científica do trabalho de Taylor, da teoria clássica desenvolvida por Fayol e da teoria da burocracia de Weber. This article is about the economic paradigm of effectiveness whose main theme regards the internal ...

  1. Aplicación del paradigma de redes centradas en contenido a redes de sensores

    OpenAIRE

    Carrillo Sánchez, David

    2013-01-01

    El presente trabajo de fin de grado va a exponer los fundamentos de un nuevo paradigma de comunicaciones en red, CCN (Content Centric Networking), una reciente propuesta alternativa al modelo TCP/IP actual. Dicho paradigma de comunicaciones se caracteriza por basar sus operaciones de comunicación en los propios nombres de los contenidos, abstrayéndose del concepto de localización de los contenidos. Es decir en CCN pedimos un contenido identificándolo por su nombre, en contraposici...

  2. Auras and clinical features in temporal lobe epilepsy: a new approach on the basis of voxel-based morphometry.

    Science.gov (United States)

    Santana, Maria Teresa Castilho Garcia; Jackowski, Andrea Parolin; da Silva, Henrique Hattori; Caboclo, Luis Otávio Sales Ferreira; Centeno, Ricardo Silva; Bressan, Rodrigo A; Carrete, Henrique; Yacubian, Elza Márcia Targas

    2010-05-01

    MRI investigations in patients with temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) have demonstrated structural abnormalities extending beyond ipsilateral hippocampus which may be studied through voxel-based morphometry (VBM). We investigated brain morphology related to clinical features in patients with refractory TLE with MTS using VBM. One hundred patients with unilateral TLE with MTS (59 left) and 30 controls were enrolled. VBM5 was employed to analyze (1) hemispheric damage, (2) influence of initial precipitating injury (IPI): 23 patients with febrile seizures and 19 with status epilepticus, and (3) types of auras classified as: mesial, including psychic auras (19 patients); anterior mesio-lateral, as autonomic symptoms, specially epigastric auras (27 patients) and neocortical, which included auditory, vertiginous, somatosensory and visual auras (16 patients). (1) Left TLE patients presented more widespread gray matter volume (GMV) reductions affecting ipsilateral hippocampus, temporal neocortex, insula and also left uncus, precentral gyrus, thalamus, parietal lobule, cuneus and bilateral cingulum. (2) Febrile seizures group presented ipsilateral GMV reductions in hippocampus, neocortical temporal, frontal and occipital cortices, insula and cingulum. Status epilepticus group presented more widespread GMV reductions involving temporal and extratemporal lobes. (3) Patients with mesial auras showed significant ipsilateral GMV reductions in hippocampus and amygdala, particularly right TLE group, who presented greater extension of GMV reduction in the entorhinal cortex. Significant reductions in hippocampus, amygdala and insula were seen in patients with anterior mesio-lateral auras. This study evaluated a large number of TLE-MTS patients showing structural damage extending beyond hippocampus, and different types of IPI associated with the extension of brain damage. Subtypes of auras are related to different clusters of areas of GMV reductions in

  3. Evaluation of refractory temporal lobe epilepsy of nontumorous origin with qualitative and quantitative MR imaging

    International Nuclear Information System (INIS)

    Tanna, N.K.; Zimmerman, R.A.; Sperling, M.R.; Kohn, M.I.

    1990-01-01

    This paper reports that although MR imaging is superior to CT in the detection of focal lesions in refractory temporal lobe epilepsy (TLE), its role in the detection of mesial temporal sclerosis remains controversial. This is significant, as the latter represents a frequent cause of TLE and manifests with only subtle atrophic changes and occasional high signal abnormalities. PReoperative MR images of 47 patients who had undergone temporal lobectomy for nontumoral TLE and of 20 control subjects were valuated for focal atrophy and hippocampal high signal abnormalities. Quantitative measurements were performed in 33 patients and 20 control subjects with use of a new brain volumetric analysis program to determine volumes of temporal lobes

  4. PARADIGMA ”PERLAWANAN” DALAM KONSTRUKSI PENDIDIKAN ISLAM

    Directory of Open Access Journals (Sweden)

    Fuad Mardhatillah

    2017-09-01

    dipelihara. Melalui paradigma perlawanan, pendidikan Islam yang dibangun akan mampu membebaskan dan mengeluarkan muslim yang hari ini tampak sedang terpuruk dalam liang keterbelakangan dan keterhinaan sosial, menuju terbentuknya komunitas pemilik peradaban yang menjadi exemplary centers (pusat-pusat pencontohan. Dengan demikian, misi diturunkannya ajaran Islam yang semestinya menjadi khaira ummatin yang rahmatan lil ’alamin dapat diharapkan terwujudkan melalui pendidikan perlawanan tersebut.

  5. O que é problematizar? Géneses de um paradigma

    Directory of Open Access Journals (Sweden)

    Michel Fabre

    2011-12-01

    Full Text Available A ideia de problema invade, atualmente, a escola e a formação. Como evitar que esta ideia não se dilua e se caricature? Parece ser necessário voltar à questão de raiz: o que é problematizar? Estuda-se, aqui, a génese do paradigma da problematização a partir de 4 filosofias do problema: John Dewey, Gaston Bachelard, Gilles Deleuze e Michel Meyer. Ainda que estas filosofias se manifestem a partir de intuições diferentes e desenvolvam teses próprias, elas convergem largamente sobre a ideia de problematização o que permite uma definição rigorosa de conceitos (a problematização, o problemático, a problemática. Estas filosofias permitem, igualmente, evidenciar as exigências intelectuais de uma atitude que parece ter de fazer o percurso normal do pensamento comum e até - segundo alguns dos nossos autores - do pensamento filosófico, marcado precisamente pelo esquecimento do problema. Não há problematização se não for instaurado um autocontrole do pensamento, uma dialética entre dados e condições do problema, o que necessita conceber uma lógica da pesquisa, centrada na construção do problema e não apenas sobre a respetiva resolução. É possível delinear as incidências pedagógicas dos quatro esboços estudados quanto à relação entre saber e problema. As suas próprias divergências revelam-se pedagogicamente sobre determinadas: reenviam para os problemas de uma pedagogia dos problemas.Nowadays, the idea of the problem invades the school and training. How to avoid that this idea does not dilute and caricaturizes itself? It seems necessary to go back to the root question: What is problematization? The genesis of the paradigm of problematization is studied here departing from 4 problem philosophies from John Dewey, Gaston Bachelard, Gilles Deleuze and Michel Meyer. While these philosophies come up from different intuitions and develop their own theories, they largely converge on the idea of problematization which

  6. A epidemiologia, os valores e o significado de paradigma Epidemiology, values, and the meaning of paradigm

    Directory of Open Access Journals (Sweden)

    Djalma Agripino de Melo Filho

    1997-10-01

    Full Text Available Recentemente, o emprego do termo paradigma chegou ao âmbito epidemiológico. Este texto analisou criticamente uma classificação de 'paradigmas epidemiológicos', proposta por Almeida-Filho. Inicialmente constatou-se que os valores não foram considerados como elementos fundamentais para a construção dos paradigmas, distanciando-se, assim, da matriz kuhniana. Uma vez que a sistematização procurou unir tendências antitéticas, ela pareceu estar mais próxima da epistéme foucaultiana. Finalmente, considerou-se mais apropriada a utilização do termo hegemonia, em vez de paradigma, para sistematizar períodos epidemiológicos, pois os valores das vertentes estão comprometidos com a particularidade (principalmente classe social.Use of the term paradigm has recently reached the epidemiological milieu. This article provides a critical analysis of a classification of "epidemiological paradigms" as proposed by Almeida-Filho. It was initially ascertained that values were not considered fundamental elements for the construction of paradigms, and that they therefore distanced themselves from the Kuhnian matrix. Systematization sought to unite antithetical tendencies and thus seemed closer to the Foucaltian epistéme. Finally, hegemony was considered a more appropriate term than paradigm for systematizing epidemiological periods, since the values of the different watersheds are committed to particularity (principally social class.

  7. Visual paired-associate learning: in search of material-specific effects in adult patients who have undergone temporal lobectomy.

    Science.gov (United States)

    Smith, Mary Lou; Bigel, Marla; Miller, Laurie A

    2011-02-01

    The mesial temporal lobes are important for learning arbitrary associations. It has previously been demonstrated that left mesial temporal structures are involved in learning word pairs, but it is not yet known whether comparable lesions in the right temporal lobe impair visually mediated associative learning. Patients who had undergone left (n=16) or right (n=18) temporal lobectomy for relief of intractable epilepsy and healthy controls (n=13) were administered two paired-associate learning tasks assessing their learning and memory of pairs of abstract designs or pairs of symbols in unique locations. Both patient groups had deficits in learning the designs, but only the right temporal group was impaired in recognition. For the symbol location task, differences were not found in learning, but again a recognition deficit was found for the right temporal group. The findings implicate the mesial temporal structures in relational learning. They support a material-specific effect for recognition but not for learning and recall of arbitrary visual and visual-spatial associative information. Copyright © 2010 Elsevier Inc. All rights reserved.

  8. Task activation and functional connectivity show concordant memory laterality in temporal lobe epilepsy.

    Science.gov (United States)

    Sideman, Noah; Chaitanya, Ganne; He, Xiaosong; Doucet, Gaelle; Kim, Na Young; Sperling, Michael R; Sharan, Ashwini D; Tracy, Joseph I

    2018-04-01

    In epilepsy, asymmetries in the organization of mesial temporal lobe (MTL) functions help determine the cognitive risk associated with procedures such as anterior temporal lobectomy. Past studies have investigated the change/shift in a visual episodic memory laterality index (LI) in mesial temporal lobe structures through functional magnetic resonance imaging (fMRI) task activations. Here, we examine whether underlying task-related functional connectivity (FC) is concordant with such standard fMRI laterality measures. A total of 56 patients with temporal lobe epilepsy (TLE) (Left TLE [LTLE]: 31; Right TLE [RTLE]: 25) and 34 matched healthy controls (HC) underwent fMRI scanning during performance of a scene encoding task (SET). We assessed an activation-based LI of the hippocampal gyrus (HG) and parahippocampal gyrus (PHG) during the SET and its correspondence with task-related FC measures. Analyses involving the HG and PHG showed that the patients with LTLE had a consistently higher LI (right-lateralized) than that of the HC and group with RTLE, indicating functional reorganization. The patients with RTLE did not display a reliable contralateral shift away from the pathology, with the mesial structures showing quite distinct laterality patterns (HG, no laterality bias; PHG, no evidence of LI shift). The FC data for the group with LTLE provided confirmation of reorganization effects, revealing that a rightward task LI may be based on underlying connections between several left-sided regions (middle/superior occipital and left medial frontal gyri) and the right PHG. The FCs between the right HG and left anterior cingulate/medial frontal gyri were also observed in LTLE. Importantly, the data demonstrate that the areas involved in the LTLE task activation shift to the right hemisphere showed a corresponding increase in task-related FCs between the hemispheres. Altered laterality patterns based on mesial temporal lobe epilepsy (MTLE) pathology manifest as several

  9. Acute diffusion abnormalities in the hippocampus of children with new-onset seizures: the development of mesial temporal sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Farina, L. [Department of Neuroradiology, Istituto Nazionale Neurologico C. Besta, Milan (Italy); Department of Pediatrics, Division of Neurology, The Children' s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, PA 19104, Philadelphia (United States); Bergqvist, C.; Zimmerman, R.A.; Haselgrove, J.; Hunter, J.V.; Bilaniuk, L.T. [Department of Pediatrics, Division of Neurology, The Children' s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, PA 19104, Philadelphia (United States); Department of Radiology, The Children' s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, PA 19104, Philadelphia (United States)

    2004-04-01

    We studied the role of early diffusion-weighted imaging DWI in the investigation of children with new-onset prolonged seizures which eventually result in unilateral hippocampal sclerosis (HS). We carried out MRI on five children aged 17 months to 7 years including conventional and diffusion-weighted sequences. We calculated apparent diffusion coefficients (ADC) for the affected and the normal opposite hippocampus. Follow-up examinations were performed, including DWI and ADC measurements in four. We studied four children within 3 days of the onset of prolonged psychomotor seizures and showed increased signal on T2-weighted images, and DWI, indicating restricted diffusion, throughout the affected hippocampus. The ADC were reduced by a mean of 14.4% in the head and by 15% in the body of the hippocampus. In one child examined 15 days after the onset of seizures, the ADC were the same on both sides. All five patients showed hippocampal atrophy on follow-up 2-18 months later. In the four patients in whom ADC were obtained on follow-up, they were increased by 19% in the head and 17% in the body. DWI may represent a useful adjunct to conventional MRI for identifying acute injury to the hippocampus which results in sclerosis. (orig.)

  10. Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy

    Czech Academy of Sciences Publication Activity Database

    Malíková, H.; Krámská, L.; Vojtěch, Z.; Šroubek, J.; Lukavský, Jiří; Liščák, R.

    2015-01-01

    Roč. 2015, č. 11 (2015), s. 2927-2932 ISSN 1178-2021 Institutional support: RVO:68081740 Keywords : amygdalohippocampectomy * thermocoagulation * MRI * volumetry * neuro­psychology Subject RIV: FH - Neurology OBOR OECD: Psychology (including human - machine relations) Impact factor: 1.867, year: 2015

  11. PET imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Semah, F.

    2006-01-01

    The research projects on epilepsy addressed two main issues: the pathophysiology of the inter-ictal hypo-metabolism in temporal lobe epilepsy and the role of the basal ganglia in the control of seizure. Our research projects focused primarily on temporal lobe epilepsy: The pathophysiology of inter-ictal hypo-metabolism and its correlation with the epileptogenic network was investigated in patients with mesial temporal lobe epilepsy. Inter-ictal hypo-metabolism is commonly found in mesio-temporal lobe epilepsy (MTLE) but its pathophysiology remains incompletely understood. We hypothesized that metabolic changes reflect the preferential networks involved in ictal discharges. We analyzed the topography of inter-ictal hypo-metabolism according to electro-clinical patterns in 50 patients with unilateral hippocampal sclerosis (HS) and consistent features of MTLE. Based on electro-clinical correlations we identified 4 groups:1) mesial group characterized by mesial seizure onset without evidence of early spread beyond the temporal lobe; 2) anterior mesio-lateral group (AML) with early anterior spread, involving the anterior lateral temporal cortex and insulo-fronto-opercular areas; 3) widespread mesio-lateral group (WML) with widespread spread, involving both anterior and posterior lateral temporal and peri-sylvian areas; 4) bi-temporal group (BT) with early contralateral temporal spread. Results of FDG-PET imaging in each group were compared to control subjects using statistical parametric mapping software (SPM99). MRI data and surgical outcome in each group were compared to metabolic findings. Hypo-metabolism was limited to the hippocampal gyrus, the temporal pole and the insula in the mesial group. Gradual involvement of the lateral temporal cortex, the insula and the peri-sylvian areas was observed in the AML and WML groups. The BT group differed from the others by mild bi-temporal involvement, bilateral insular hypo-metabolism and longer epilepsy duration. MRI

  12. PET imaging in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Semah, F. [Service Hospitalier Frederic Joliot, DSV-CEA, 91 Orsay (France)

    2006-07-01

    The research projects on epilepsy addressed two main issues: the pathophysiology of the inter-ictal hypo-metabolism in temporal lobe epilepsy and the role of the basal ganglia in the control of seizure. Our research projects focused primarily on temporal lobe epilepsy: The pathophysiology of inter-ictal hypo-metabolism and its correlation with the epileptogenic network was investigated in patients with mesial temporal lobe epilepsy. Inter-ictal hypo-metabolism is commonly found in mesio-temporal lobe epilepsy (MTLE) but its pathophysiology remains incompletely understood. We hypothesized that metabolic changes reflect the preferential networks involved in ictal discharges. We analyzed the topography of inter-ictal hypo-metabolism according to electro-clinical patterns in 50 patients with unilateral hippocampal sclerosis (HS) and consistent features of MTLE. Based on electro-clinical correlations we identified 4 groups:1) mesial group characterized by mesial seizure onset without evidence of early spread beyond the temporal lobe; 2) anterior mesio-lateral group (AML) with early anterior spread, involving the anterior lateral temporal cortex and insulo-fronto-opercular areas; 3) widespread mesio-lateral group (WML) with widespread spread, involving both anterior and posterior lateral temporal and peri-sylvian areas; 4) bi-temporal group (BT) with early contralateral temporal spread. Results of FDG-PET imaging in each group were compared to control subjects using statistical parametric mapping software (SPM99). MRI data and surgical outcome in each group were compared to metabolic findings. Hypo-metabolism was limited to the hippocampal gyrus, the temporal pole and the insula in the mesial group. Gradual involvement of the lateral temporal cortex, the insula and the peri-sylvian areas was observed in the AML and WML groups. The BT group differed from the others by mild bi-temporal involvement, bilateral insular hypo-metabolism and longer epilepsy duration. MRI

  13. Diagnosis of temporal lobe epilepsy by positron emission tomography

    International Nuclear Information System (INIS)

    Shimizu, Hiroyuki; Ishijima, Buichi; Iio, Masaaki.

    1985-01-01

    Positron emission tomography(PET) was performed in 18 temporal lobe epileptics. About 20 mCi of 11 C-glucose was perorally administered to the patients and 30 minutes later scanning was started when the transport of 11 C-glucose from blood to the brain tissue reached equilibrium. At the level of 25mm above orbitomeatal line, the slice image of the temporal lobe shows a relatively high metabolic oval ring involving the amygdala, hippocapal formation and the hippocampal gyrus medially and the T 1 , T 2 and T 3 neocortices laterally in normal subjects. The epileptic focus, when detected on PET images, was observed as a defect in this oval ring. In 15(83.3%) out of 18 cases, the location of epileptic focus was confirmed as a low metabolic defect. This diagnosis rate was higher than that of other focal epilepsy by PET study. The locations of foci were devided into three types: mesial (5 cases), lateral (4 cases) and combined (6 cases). The seizure symptoms of the patients were analyzed in terms of the correspondence to the focus types. The results showed that automatism and pseudoabsence had a close relation to the mesial and combined types and psychical, vertiginous or visual seizures correlated to the combined and lateral types. Visceral or motor seizures were induced equally by any focus types. These facts suggested that automatism and pseudoabsence were correlated with the mesial organs such as the amygdala and hippocampus and psychical, vertiginous or visual seizures had origin in lateral neocortices. Visceral or motor seizures were supposed to be the results of the spread from the temporal focus to the adjacent structures. It was concluded that PET was very useful in localization diagnosis of temporal lobe epilepsy. In surgical treatment of epilepsy, in which the knowledge of the exact extent of epileptic foci is strongly demanded, PET study will offer invaluable data to the strategy of operation and foreseeing its prognosis. (author)

  14. Sociedad y medicina: Paradigmas médicos en las coordenadas de la modernidad

    Directory of Open Access Journals (Sweden)

    Lorenzo Pablo Camejo Ramos

    2016-02-01

    Full Text Available Objetivo:Explicar la relación sociedad-medicina a partir de los paradigmas médicos de la modernidad. Desarrollo: La medicina como producción social está marcada por la vida sociocultural de cualquier sociedad. La Modernidad capitalista europea impuso a todo el mundo su proyecto económico, político e ideológico y su cosmovisión, fruto de ello, la medicina moderna se debate entre dos paradigmas formativos y prácticos: el biomédico, hegemónico y basado en la racionalidad instrumental de la ciencia y por otro lado un paradigma crítico y contrahegemónico: el sociomédico. Conclusiones: La evolución de la medicina y sus paradigmas formativos y axiológicos modernos están marcados por las condiciones económicas, políticas, sociales y culturales de la modernidad. La evolución histórica evidencia la existencia, en franca contradicción, de dos modelos médicos: el modelo biomédico, resultado de los preceptos socio filosóficos de la modernidad y el modelo sociomédico que por oposición ha logrado, al menos, el reconocimiento de buena parte de la comunidad médica internacional, de su lugar y papel en los procesos formativos y en la práctica cotidiana de la medicina como vía para entender y transformar las realidades de nuestros pueblos en el campo de la salud. Lo anterior, tiene que materializarse con un replanteo y redefiniciones de nuevos caminos teóricos, conceptuales y metodológicos.

  15. LOS PARADIGMAS EN LAS CIENCIAS SOCIALES DE LA RELIGIÓN

    Directory of Open Access Journals (Sweden)

    Roberto Cipriani

    2012-06-01

    Full Text Available El objetivo del artículo es revisar los distintos paradigmas de las Ciencias Sociales para el estudio teórico metodológico de la religión. En el artículo se algunos de las principales tradiciones de estudios, entre los que se destacan el pragmatismo del fenómeno religioso de William James y la sociología comparada de Clifford Geertz, entre otros.

  16. Micro-computed tomography study of the internal anatomy of mesial root canals of mandibular molars.

    Science.gov (United States)

    Villas-Bôas, Marcelo Haas; Bernardineli, Norberti; Cavenago, Bruno Cavalini; Marciano, Marina; Del Carpio-Perochena, Aldo; de Moraes, Ivaldo Gomes; Duarte, Marco H; Bramante, Clovis M; Ordinola-Zapata, Ronald

    2011-12-01

    The aim of this study was to determine the mesiodistal and buccolingual diameter, apical volume, and the presence of isthmuses at the apical level of mesial root canals of mandibular molars. Sixty extracted first and second mandibular molars were scanned by using a SkyScan 1076 micro-computed tomography system with a voxel size of 18 μm. The apical thirds of the samples were reconstructed to allow a perpendicular section of the apical third by using the multiplanar reconstruction tool of the OsiriX software. The mesiodistal and the buccolingual distances of root canals were measured between the 1- to 4-mm levels. The type of root canal isthmuses present at these levels was classified by using modified criteria of Hsu and Kim. The volume of the root canal anatomy between the 1- to 3-mm apical levels was obtained by using the CTAN-CTVOL software. The medians of the mesiodistal diameter at the 1-, 2-, 3-, and 4-mm levels in the mesiobuccal and mesiolingual canals were 0.22 and 0.23 mm, 0.27 and 0.27 mm, 0.30 and 0.30 mm, and 0.36 and 0.35 mm, respectively. The buccolingual lengths at the 1-, 2-, 3-, and 4-mm levels were 0.37-0.35 mm, 0.55-0.41 mm, 0.54-0.49 mm, and 0.54 and 0.60 mm, respectively. The presence of isthmuses was more prevalent at the 3- to 4-mm level. However, 27 cases presented complete or incomplete isthmuses at the 1-mm apical level. The mean of the volume of the apical third was 0.83 mm(3), with a minimum value of 0.02 and a maximum value of 2.4 mm(3). Mesial root canals of mandibular molars do not present a consistent pattern. A high variability of apical diameters exists. The presence of isthmuses at the apical third was not uncommon even at the 1-mm apical level. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  17. Identification and Endodontic Management of Middle Mesial Canal in Mandibular Second Molar Using Cone Beam Computed Tomography

    Directory of Open Access Journals (Sweden)

    Bonny Paul

    2015-01-01

    Full Text Available Endodontic treatments are routinely done with the help of radiographs. However, radiographs represent only a two-dimensional image of an object. Failure to identify aberrant anatomy can lead to endodontic failure. This case report presents the use of three-dimensional imaging with cone beam computed tomography (CBCT as an adjunct to digital radiography in identification and management of mandibular second molar with three mesial canals.

  18. Sistemas de investigação e paradigmas, de Håkan Törnebohm

    Directory of Open Access Journals (Sweden)

    Mário Antônio Eufrásio

    1996-11-01

    Full Text Available O artigo traz a incorporação por Törnebohm, no contexto de sua teoria de pesquisa, de versões alternativas, ampliadas e mais flexíveis, da concepção dos programas de pesquisa cientifica, proposta por Lakatos em 1968m e a dos paradigmas em Ciência, proposta por Kühn em 1962. As disciplinas cientificas, ou sistemas de investigação, compõem-se de complexos H, I P, de hipóteses, instrumentos e problemas que se modificam no decorrer dos processos de investigação (ou programas de pesquisa, que compreendem ações de planejamento de procedimentos e de implementação de decisões e a obtenção de resulados que se sucedem no tempo, em novos complexos H, I, P, e dão margem às sequências dos programas de pesquisa em desenvolvimento. Em cada disciplina se exerce uma crítica interna, com critérios de avaliação de resultados que permitam identificar as mudanças progressivas nos próprios programas de pesquisa, tendo em vista revisar erros e socializar resultados. O trabalho realizado nos programas de pesquisa é dirigido e controlado por um conjunto de fatores orientadores ou paradigma, que se compõe de uma concepção de pesquisa e da ciência que se trabalha, de orientações para as decisões quanto a procedimentos a adotar na pesquisa e de uma representação do mundo, bem como de critérios éticos e estéticos de avaliação crítica. Trasmitidos na instrução do pesquissdor e afetados por sua experiência de pesquisa, os paradigmas estão na origem das tradições de pesquisa, das famílias de teorias e das integrações interdisciplinares. Discussões metodológicas especiais, de planejamento tático da pesquisa, para a resolução dos problemas em cada disciplina, implicam a aceitação de um dado paradigma: as discussões metodológicas gerais, de planejamento estratégico da pesquisa, debatem os próprios paradigmas

  19. Spike voltage topography in temporal lobe epilepsy.

    Science.gov (United States)

    Asadi-Pooya, Ali A; Asadollahi, Marjan; Shimamoto, Shoichi; Lorenzo, Matthew; Sperling, Michael R

    2016-07-15

    We investigated the voltage topography of interictal spikes in patients with temporal lobe epilepsy (TLE) to see whether topography was related to etiology for TLE. Adults with TLE, who had epilepsy surgery for drug-resistant seizures from 2011 until 2014 at Jefferson Comprehensive Epilepsy Center were selected. Two groups of patients were studied: patients with mesial temporal sclerosis (MTS) on MRI and those with other MRI findings. The voltage topography maps of the interictal spikes at the peak were created using BESA software. We classified the interictal spikes as polar, basal, lateral, or others. Thirty-four patients were studied, from which the characteristics of 340 spikes were investigated. The most common type of spike orientation was others (186 spikes; 54.7%), followed by lateral (146; 42.9%), polar (5; 1.5%), and basal (3; 0.9%). Characteristics of the voltage topography maps of the spikes between the two groups of patients were somewhat different. Five spikes in patients with MTS had polar orientation, but none of the spikes in patients with other MRI findings had polar orientation (odds ratio=6.98, 95% confidence interval=0.38 to 127.38; p=0.07). Scalp topographic mapping of interictal spikes has the potential to offer different information than visual inspection alone. The present results do not allow an immediate clinical application of our findings; however, detecting a polar spike in a patient with TLE may increase the possibility of mesial temporal sclerosis as the underlying etiology. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Thalamotemporal impairment in temporal lobe epilepsy: a combined MRI analysis of structure, integrity, and connectivity.

    Science.gov (United States)

    Keller, Simon S; O'Muircheartaigh, Jonathan; Traynor, Catherine; Towgood, Karren; Barker, Gareth J; Richardson, Mark P

    2014-02-01

    Thalamic abnormality in temporal lobe epilepsy (TLE) is well known from imaging studies, but evidence is lacking regarding connectivity profiles of the thalamus and their involvement in the disease process. We used a novel multisequence magnetic resonance imaging (MRI) protocol to elucidate the relationship between mesial temporal and thalamic pathology in TLE. For 23 patients with TLE and 23 healthy controls, we performed T1 -weighted (for analysis of tissue structure), diffusion tensor imaging (tissue connectivity), and T1 and T2 relaxation (tissue integrity) MRI across the whole brain. We used connectivity-based segmentation to determine connectivity patterns of thalamus to ipsilateral cortical regions (occipital, parietal, prefrontal, postcentral, precentral, and temporal). We subsequently determined volumes, mean tractography streamlines, and mean T1 and T2 relaxometry values for each thalamic segment preferentially connecting to a given cortical region, and of the hippocampus and entorhinal cortex. As expected, patients had significant volume reduction and increased T2 relaxation time in ipsilateral hippocampus and entorhinal cortex. There was bilateral volume loss, mean streamline reduction, and T2 increase of the thalamic segment preferentially connected to temporal lobe, corresponding to anterior, dorsomedial, and pulvinar thalamic regions, with no evidence of significant change in any other thalamic segments. Left and right thalamotemporal segment volume and T2 were significantly correlated with volume and T2 of ipsilateral (epileptogenic), but not contralateral (nonepileptogenic), mesial temporal structures. These convergent and robust data indicate that thalamic abnormality in TLE is restricted to the area of the thalamus that is preferentially connected to the epileptogenic temporal lobe. The degree of thalamic pathology is related to the extent of mesial temporal lobe damage in TLE. © 2014 The Authors. Epilepsia published by Wiley Periodicals, Inc

  1. Temporal lobe epilepsy: analysis of patients with dual pathology.

    Science.gov (United States)

    Salanova, V; Markand, O; Worth, R

    2004-02-01

    To determine the frequency and types of dual pathology in patients with temporal lobe epilepsy (TLE) and to analyze the clinical manifestations and surgical outcome. A total of 240 patients with TLE underwent temporal resections following a comprehensive pre-surgical evaluation. Thirty-seven (15.4%) of these had hippocampal sclerosis (HS) or temporal lobe gliosis in association with another lesion (dual pathology). Eighteen of 37 patients with dual pathology had heterotopia of the temporal lobe, nine had cortical dysplasia, four had cavernous angiomas or arteriovenous malformations, one had a dysembryoplastic neuroepithelial tumor, one had a contusion and four patients had cerebral infarctions in childhood. 68.5% had abnormal head magnetic resonance imagings, 91.3% had abnormal positron emission tomography scans, and 96% had abnormal ictal SPECT. The intracarotid amobarbital procedure (IAP) showed impaired memory of the epileptogenic side in 72% of the patients. Twenty patients had left and 17 had right-sided en bloc temporal resections, including the lesion and mesial temporal structures. Twenty-six (70.2%) became seizure-free, eight (21.6%) had rare seizures, two (5.4%) had worthwhile seizure reduction and one (2.7%) had no improvement (range of follow-up 1-16 years, mean = 7.4 years). 15.4% had dual pathology. The dual pathology was almost exclusively seen in patients whose lesions were congenital, or occurred early in life, suggesting that the hippocampus is more vulnerable and more readily develops HS in early childhood. Resections, including the lateral and mesial temporal structures led to a favorable outcome with no mortality and little morbidity.

  2. Effect of Temporal Neocortical Pathology on Seizure Freeness in Adult Patients with Temporal Lobe Epilepsy.

    Science.gov (United States)

    Kemerdere, Rahsan; Ahmedov, Merdin Lyutviev; Alizada, Orkhan; Yeni, Seher Naz; Oz, Buge; Tanriverdi, Taner

    2018-05-23

    Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy. Focal cortical dysplasia is the most common dual pathology found in association with the hippocampal sclerosis. In this study, the effect of dual pathology on freedom from seizure was sought in patients with TLE. This study performed a retrospective analysis of patients with TLE who underwent surgery between 2010 and 2017. Histopathologic analysis was performed on patients with and without dual pathology in the temporal neocortex. Seizure outcomes were compared. A total of 54 patients with TLE were included. The rate of overall favorable seizure outcome was found to be 96.3%. In 53.7%, dual pathology was present in the temporal cortices in addition to the hippocampal sclerosis. Patients without dual pathology showed significantly greater freedom from seizure (P = 0.02). Patients without dual pathology had a significantly higher seizure-free rate after anterior temporal resection than patients with dual pathology. Resection of the temporal cortex in addition to mesial temporal structures seems to be reasonable for better seizure outcome. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. The renin-angiotensin system is upregulated in the cortex and hippocampus of patients with temporal lobe epilepsy related to mesial temporal sclerosis

    OpenAIRE

    Arganaraz, Gustavo Adolfo [UNIFESP; Konno, Ana Carla [UNIFESP; Perosa, Sandra Regina [UNIFESP; Santiago, Joselita Ferreira Carvalho [UNIFESP; Boim, Mirian A. [UNIFESP; Vidotti, Daniela Berguio [UNIFESP; Varella, Pedro Paulo Vasconcellos [UNIFESP; Costa, Luciana Gilbert [UNIFESP; Canzian, Mauro; Porcionatto, Marimelia Aparecida [UNIFESP; Yacubian, Elza Marcia [UNIFESP; Sakamoto, Americo Ceiki [UNIFESP; Carrete, Henrique [UNIFESP; Centeno, Ricardo Silva [UNIFESP; Amado, Debora [UNIFESP

    2008-01-01

    Purpose: As reported by several authors, angiotensin II (AngII) is a proinflammatory molecule that stimulates the release of inflammatory cytokines and activates nuclear factor kappa B (NF kappa B), being also associated with the increase of cellular oxidative stress. Its production depends on the activity of the angiotensin converting enzyme (ACE) that hydrolyzes the inactive precursor angiotensin I (AngI) into AngII. It has been suggested that AngII underlies the physiopathological mechanis...

  4. Epilepsia temporal: relato de caso = Temporal epilepsy: case report

    Directory of Open Access Journals (Sweden)

    Souza, Taís Amara da Costa de

    2006-01-01

    Full Text Available Este trabalho tem o objetivo de divulgar um recurso terapêutico da epilepsia do lobo temporal por esclerose hipocampal: a cirurgia. Aproximadamente vinte e cinco mil pacientes com esta patologia são refratários aos tratamentos medicamentosos no sul do país e muitos chegam ao neurocirurgião com 30-40 anos de evolução, muitas vezes já mutilados em conseqüência das crises. Convulsões parciais originadas no lobo temporal são comuns, e grande parte originam-se em estruturas mesiais (esclerose mesial temporal – EMT. Como aí se encontram a sede de funções nobres do sistema nervoso – memória, aprendizagem, comportamento, entre outras –, os sintomas podem apresentar-se como alterações em qualquer uma delas. Ressaltamos a necessidade do correto diagnóstico e dos métodos para fazê-lo: através da anamnese, da ressonância magnética, do eletroencefalograma (EEG, do vídeo-EEG e por vezes através de sensores intracranianos (strips. Apesar de existirem métodos confiáveis para realizar o diagnóstico e tratamento cirúrgico com grande índice de sucesso, a desinformação dos profissionais que atendem pacientes com EMT acerca do assunto leva ao prolongamento de tratamentos clínico ineficiente e conseqüente seqüelas físicas, psicológicas e sociais

  5. Complete remission of epileptic psychosis after temporal lobectomy: case report

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    Marchetti Renato Luiz

    2001-01-01

    Full Text Available We report a case of a female patient with refractory complex partial seizures since 15 years of age, recurrent postictal psychotic episodes since 35 which evolved to a chronic refractory interictal psychosis and MRI with right mesial temporal sclerosis (MTS. After a comprehensive investigation (video-EEG intensive monitoring, interictal and ictal SPECT, and a neuropsychological evaluation including WADA test she was submitted to a right temporal lobectomy. Since then, she has been seizure-free with remission of psychosis, although with some persistence of personality traits (hiperreligiosity, viscosity which had been present before surgery. This case supports the idea that temporal lobectomy can be a safe and effective therapeutic measure for patients with MTS, refractory epilepsy and recurrent postictal epileptic psychosis or interictal epileptic psychosis with postictal exacerbation.

  6. Microencephaloceles: another dual pathology of intractable temporal lobe epilepsy in childhood.

    Science.gov (United States)

    Aquilina, Kristian; Clarke, Dave F; Wheless, James W; Boop, Frederick A

    2010-04-01

    Temporal lobe encephaloceles can be associated with temporal lobe epilepsy. The authors report on the case of an adolescent with multiple microencephaloceles, in the anterolateral middle fossa floor, identified at surgery (temporal lobectomy) for intractable partial-onset seizures of temporal origin. Magnetic resonance imaging revealed only hippocampal atrophy. Subdural electrodes demonstrated ictal activity arising primarily from the anterior and lateral temporal lobe, close to the microencephaloceles, spreading to the anterior and posterior mesial structures. Pathological examination revealed diffuse temporal gliosis involving the hippocampus, together with microdysgenesis of the amygdala. The literature on epilepsy secondary to encephaloceles is reviewed and the contribution of the microencephaloceles to the seizure disorder in this patient is discussed.

  7. Paradigmas del mercado financiero rural en países en desarrollo.

    OpenAIRE

    Fuentes Méndez, Luis Alberto; Gutiérrez S., Alejandro

    2007-01-01

    1.- Artículos Tenencia de la tierra y desarrollo rural sostenible: algunos puntos para la reflexión en el caso venezolano. Land tenure and sustained rural development: points for reflecting on the Venezuelan case. Tenure de la terre et développement rural durable : quelques points pour la réflexion dans le cas du Venezuela. Delahaye, Olivier Paradigmas del mercado financiero rural en países en desarrollo. Paradigms in the rural financial markets in developing countries. ...

  8. Um novo paradigma para a gestão de recursos hídricos

    OpenAIRE

    Hespanhol,Ivanildo

    2008-01-01

    A política de importar água de bacias cada vez mais distantes para satisfazer o crescimento da demanda teve início há mais de dois mil com os romanos, dando origem aos seus famosos aquedutos. Esse é o "velho paradigma" que persiste ainda hoje, resolvendo, precariamente, o problema de abastecimento de água de uma região, em detrimento daquela que a fornece. A transferência sistemática de grandes volumes de água de fontes distantes, gerando volumes adicionais de esgoto, não pode mais ser aceita...

  9. La producción de enfermedad en el paradigma de la salud del siglo XXI

    OpenAIRE

    Rodríguez Zoya, Paula G.

    2013-01-01

    Este trabajo pone en relación el imperativo de cuidado del cuerpo y la salud paraalcanzar una salud perfecta y el fenómeno de expansión de la medicalización a travésde la invención de enfermedades. La tesis central sostiene que la imbricación de ambosfenómenos constituye los fundamentos del paradigma sanitario que se arraiga en lassociedades occidentales del siglo XXI. La investigación problematiza la articulaciónde dichos fenómenos a partir de la circulación social de significaciones en torn...

  10. Los negocios realizados por internet, ¿cambian los paradigmas existentes?

    OpenAIRE

    Rodríguez Acosta, Beatriz Marlene

    2018-01-01

    Resumen: Internet en sus inicios fue una red de carácter militar, restringida, que evolucionó hacia una red abierta, pública y con acceso a casi todos los habitantes del planeta. Conforme a ello, este es un punto clave para que los negocios que se plantean como paradigmas tradicionales, cambien al usar esta herramienta, ya que está modificando los esquemas habituales de hacer las cosas. En este artículo se trata de determinar cómo han cambiado los negocios con la aparición de Internet, cómo h...

  11. Embajadas y guerras: algunos paradigmas compositivos en el auto sacramental de Calderón

    OpenAIRE

    Sáez, Adrián J.

    2012-01-01

    Entre los diversos materiales que Calderón emplea para el diseño de sus autos sacramentales se encuentra una serie de paradigmas estrechamente vinculados a argumentos bélicos. Sus fuentes no son únicamente literarias, sino que también se asientan en la realidad del momento. La embajada, misión diplomática habitual, contribuye a la exaltación de la monarquía hispánica y legitima sus acciones bélicas, pues son solo el último camino posible tras las constantes ofertas de paz. A su vez, las diver...

  12. Paradigmas Tecnológicos e Teorias Econômicas da Firma

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    Paulo Bastos Tigre

    2005-01-01

    Full Text Available Este artigo analisa a evolução das teorias da firma à luz das mudanças tecnológicas ocorridas em três paradigmas: (i a Revolução Industrial britânica, que dominou a economia mundial durante todo o século XIX e foi a base de observaçãopara a elaboração da teoria neoclássica; (ii o paradigma Fordista, que efetivamente deu origem à economia industrial; e (iii o paradigma das Tecnologias da Informação, cuja construção teórica está baseada, principalmente nas correntes evolucionistas e neo-institucionalistas. A análise da evolução das teorias da firma e sua relação com paradigmas organizacionais distintos mostra que não existe um corpo teórico único e coerente, pois as teorias estão condicionadas por diferentes filiações metodológico-teóricas, enfocam aspectos distintos (produção ou transação e baseiam-se em contextos institucionais, históricos e setoriais diversos. Conclui que o processo de mudanças tecnológicas e institucionais exige que a teoria evolua continuamente, adotando aportes interdisciplinares e recorrendo mais sistematicamente a pesquisa empírica.The structure of the world industry is constantly affected by technological innovations and by an institutional dynamics which destroy and create firms and markets. Historically, the increasing speed of these changes has demanded a continuous reformulation of the economic theories dealing with the firm. This article examines such theories under the analytical framework of technological change in three paradigms: (i the British industrial revolution which dominated the world economy during the XIX century and was a starting point to the development of the neoclassical microeconomic theory; (ii the fordist paradigm which gave rise to the industrial economics; and (iii the information technology paradigm, in which theories are still under development, based mainly on evolutionist and neo-institutionalist frameworks. The analysis of the evolution of the

  13. MRI and brain spect findings in patients with unilateral temporal lobe epilepsy and normal CT scan

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    P.G. Carrilho

    1994-06-01

    Full Text Available 26 patients with temporal lobe epilepsy clinically documented by several abnormal interictal surface EEGs with typical unitemporal epileptiform activity and a normal CT scan were studied. Interictal99mTC HMPAO brain SPECT and MRI were performed in all subjects. Abnormalities were shown in 61.5% of MRI (n=16 and 65.4% of SPECT (n=17. Hippocampal atrophy associated to a high signal on T2-weighted MRI slices suggesting mesial temporal sclerosis was the main finding (n=12; 75% of abnormal MRI. MRI correlated well to surface EEG in 50% (n=13. There was also a good correlation between MRI and SPECT in 30.7% (n=8. SPECT and EEG were in agreement in 57.7% (n=l5. MRI, SPECT and EEG were congruent in 26.9% (n=7. These results support the usefulness of interictal brain SPECT and MRI in detecting lateralized abnormalities in temporal lobe epilepsy. On the other hand, in two cases, interictal SPECT correlated poorly with surface EEG. This functional method should not be used isolately in the detection of temporal lobe foci. MRI is more useful than CT as a neuroimaging technique in temporal lobe epilepsy. It may detect small structural lesions and mesial temporal lobe sclerosis which are not easily seen with traditional CT scanning.

  14. Transcortical selective amygdalohippocampectomy technique through the middle temporal gyrus revisited: An anatomical study laboratory investigation.

    Science.gov (United States)

    Bozkurt, Baran; da Silva Centeno, Ricardo; Chaddad-Neto, Feres; da Costa, Marcos Devanir Silva; Goiri, Marcelo Augusto Acosta; Karadag, Ali; Tugcu, Bekir; Ovalioglu, Talat Cem; Tanriover, Necmettin; Kaya, Serdar; Yagmurlu, Kaan; Grande, Andrew

    2016-12-01

    The anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (SelAH) have been used for surgical treatment of mesial temporal lobe epilepsy. We examined the comprehensive white matter tract anatomy of the temporal lobe to gain an insight into the trans-middle temporal gyrus, a lateral approach which has been commonly used. The transmiddle temporal gyrus approach was performed in a stepwise manner on cadaveric human heads to examine the traversing white matter pathways through it and the structures located in the temporal horn. We reviewed the literature to compare the trans-middle temporal gyrus approach with other SelAH techniques based on surgical outcomes. There does not appear to be a significant difference in seizure outcome between SelAH and ATL. However, the SelAH provides a better neuropsychological outcomes than the ATL in selected patients. Each SelAH approach has individual advantages and disadvantages. Based on our anatomical study, in the transcortical amygdalohippocampectomy technique through the middle temporal gyrus the white matter pathways to be encountered. In the temporal horn, the collateral eminence, hippocampus, lateral ventricular sulcus, choroidal fissure, inferior choroidal point, choroid plexus, fimbria of the fornix, and amygdala are exposed. The subpial dissection is performed along the lateral ventricular sulcus from the collateral eminence on lateral side and from the choroidal fissure on medial side by microdissector for en bloc resection of the hippocampus proper. The trans-middle temporal gyrus approach is commonly used in treatment of mesial temporal lobe epilepsy patients. A better anatomical and functional understanding of the structures of the temporal lobe is crucial for safer and more accurate surgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Paradigmas e cognições no campo da administração educacional: das políticas de avaliação à avaliação como política

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    José Alberto Correia

    2010-01-01

    constituir como un paradigma alternativo, no normativo y relacionado con la rehabilitación de los desconocimientos producidos por el paradigma de la evaluación, valorando sobre todo las mediaciones epistemológicas, institucionales y cognitivas.

  16. Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study.

    Science.gov (United States)

    Pauli, Carla; Schwarzbold, Marcelo Liborio; Diaz, Alexandre Paim; de Oliveira Thais, Maria Emilia Rodrigues; Kondageski, Charles; Linhares, Marcelo Neves; Guarnieri, Ricardo; de Lemos Zingano, Bianca; Ben, Juliana; Nunes, Jean Costa; Markowitsch, Hans Joachim; Wolf, Peter; Wiebe, Samuel; Lin, Katia; Walz, Roger

    2017-05-01

    To investigate prospectively the independent predictors of a minimum clinically important change (MCIC) in quality of life (QOL) after anterior temporal lobectomy (ATL) for drug-resistant mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE-HS) in Brazilian patients. Multiple binary logistic regression analysis was performed to identify the clinical, demographic, radiologic, and electrophysiologic variables independently associated with MCIC in the Quality of Life in Epilepsy-31 Inventory (QOLIE-31) overall score 1 year after ATL in 77 consecutive patients with unilateral MTLE-HS. The overall QOLIE-31 score and all its subscale scores increased significantly (p Epilepsy.

  17. Esplendor y ruina de un paradigma. Lo relacional: París-Madrid, Madrid-León

    OpenAIRE

    Albarrán Diego, Juan

    2011-01-01

    [ES] El objetivo de este artículo es analizar el nacimiento de la estética relacional como propuesta teórica y paradigma institucional a partir de los escritos y programas expositivos desarrollados por Nicolas Bourriaud desde finales de los años noventa, revisando al mismo tiempo las críticas recibidas por dicho paradigma en el contexto de una problemática articulación de lo estético, lo artístico y lo político. Acto seguido, estudiaremos hasta qué punto y desde qué presupuestos se produce un...

  18. La pedagogía ambiental: hacia un nuevo paradigma educativo

    Directory of Open Access Journals (Sweden)

    Guillermo Torres Carral

    2015-01-01

    Full Text Available En el presente artículo, se debate sobre la necesidad de construir un nuevo paradigma educativo en torno a la pedagogía ambiental, considerándola como parte de los cambios requeridos en el mundo para enfrentar la crisis de la civilización. Para lograr lo anterior, el punto de partida es el debate sobre la articulación de las disciplinas en una metadisciplina ; y la integración del conocimiento científico con el “no científico” en el marco de la pérdida de vigencia del viejo modelo positi - vista. De esta forma, se ubica el proceso de enseñanza-aprendizaje desde la perspectiva de la complejidad socioambiental. Posteriormente, se discute los fundamentos de la pedagogía ambiental a través de la conversión del paradigma científico en nuevo conocimiento popular, lo cual debe fincarse en la educación para la compatibilidad-sustentabilidad, mediante la generación de diálogos multidimensionales, y transitar hacia un nuevo modelo educativo. Se concluye discutiendo el necesario impulso, en las comunidades, del aprendizaje socioambiental como ancla de dicha pedagogía ambiental.

  19. NUEVO PARADIGMA PEDAGÓGICO PARA ENSEÑANZA DE CIENCIAS Y MATEMÁTICA

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    Horacio E. Bosch

    2011-01-01

    Full Text Available El objetivo del trabajo es presentar un nuevo paradigma pedagógico (Pedagogía STEM para el aprendizaje de ciencias, tecnología, ingeniería y matemática (Sciences, Technology, Engineering and Mathematics, basado so- bre políticas, programas y experiencias desarrolladas en el mundo en los últimos años, adaptado a instituciones, profesores y alumnos de habla hispana. El cuerpo fundamental del trabajo está constituido por el perfecciona- miento de criterios de pertinencia para la implantación de dicho paradigma (enfoque transdisciplinario, constitu- ción de redes, utilización de tecnologías para experimentación, producción de recursos pedagógicos, transferen- cia. Como resultado de investigaciones educativas realizadas durante la última década, se hace referencia a la producción de nuevos recursos didácticos para trabajar con docentes en ambientes de laboratorio. Estos recur- sos son propuestas de ejemplos cómo debe enseñarse física, química, biología y matemática asistidas por tecno- logías electrónica e informática, ofrecidos en forma abierta para profesores y alumnos de habla hispánica.

  20. REVITALISASI PARADIGMA KONSERVATIF PENDIDIKAN DEMOKRASI PADA PKN DENGAN INOVASI MEDIA PEMBELAJARAN

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    Abdinur Batubara

    2017-12-01

    Full Text Available Abstract : This article aimed to describe the conservative paradigm revitalization of democratic learning on civic education (PKn direction using the Innovation of Digital Democracy Learning Media (IMPDD. The process using quantitative descriptive approach to the design of classroom action research. Data collection tools using techniques of observation and questionnaires. The study population is a class XI student of SMAN 1 Medan with samples of class XI-MIA 7. Results showed 99.3% of students (respondents responded strongly agree on IMPDD. While teachers tutor (Respondent gave a very good score at the interval IMPDD. Thus it can be a factor IMPDD imperative to build an effective learning paradigm Civics in school Abstrak : Kajian ini bertujuan mendeskripsikan revitalisasi paradigma konservatif pembelajaran demokrasi pada pendidikan kewarganegaraan (PKn ke arah yang Innovatifdengan menggunakan Inovasi Media Pembelajaran Demokrasi Digital (IMPDD. Proses yang ada menggunakan pendekatan deskriptif kuantitatif dengan desain penelitian tindakan kelas. Alat pengumpulan data menggunakan tehnik observasi dan angket. Populasi penelitian adalah siswa kelas XI SMA N 1 Medan dengan sampel kelas XI-MIA 7. Hasil kajian menunjukkan bahwa 99,3% siswa (responden merespon sangat setuju pada IMPDD. Sedangkan guru pamong (responden memberi skor sangat baik pada interval keberhasilan IMPDD. Dengan demikian maka IMPDD dapat menjadi faktor imperative untuk membangun paradigma pembelajaran PKn yang efektif di sekolah   DOI : http://dx.doi.org/10.17977/um019v2i22017p081

  1. LA NECESIDAD DE UNIFICAR LA PSICOLOGIA: EL PARADIGMA DE LA SINTESIS EXPERIMENTAL DEL COMPORTAMIENTO

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    Rubén Ardila

    2003-07-01

    Full Text Available Se analizan los orígenes de la psicología en las preocupaciones iniciales del hombre acerca de su comportamiento y del de las demás personas. Tales problemas interesaron a pensadores tan disímiles como Aristóteles, Kant, Wundt, Freud, Watson, Piaget y Skinner. El paso de los problemas psicológicos de la metafísica a la ciencia representó una importante revolución conceptual. En psicología se ha enfatizado en los últimos cien años la objetividad científica y la experimentación. Una de las alternativas más importantes desde el punto de vista metodológico ha sido el operacionalismo, cuyos elementos positivos y negativos se analizan. Las ‘escuelas’ psicológicas —análogas a los paradigmas de Kuhn— han representado diferentes marcos conceptuales sobre la naturaleza de la psicología. Hoy no hay escuelas sino sistemas, más reducidos y menos dogmáticos. Se considera que la síntesis experimental del comportamiento, cuyas características se presentan, puede llegar a ser un paradigma unificador para toda la psicología.

  2. Nuevos Paradigmas en la Investigación en la Historia de la Contabilidad

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    Miriam Núñez Torrado

    2000-12-01

    Full Text Available En la última década se ha despertado un interés creciente por la historia de la contabilidad en diversos foros académicos. Ese interés ha impulsado un nuevo debate sobre las posibilidades metodológicas a la hora de acometer una investigación en este área. En este trabajo se presentan los dos paradigmas fundamentales de la historiografía contable, el positivista y el crítico, para a continuación proponer un nuevo paradigma integrador de ambas posiciones metodológicas. Ello se hará a partir de la consideración de la contabilidad como construcción social, en cuanto a conjunto de prácticas que influyen y configuran la realidad social, más allá de las asunciones que tradicionalmente se le atribuyen de racionalidad, objetividad y neutralidad. The last decade has seen the revival of a growing interest in accounting history in different academic fields. Such interest has pushed a new debate about methodological ways to undertake research in this area. This paper reviews the main paradigms in accounting historiography, the positivist and the critical, and proposes a new paradigm integrating both methodological positions. This is done by considering accounting as a social construction, as a set of practices that influence and form social reality, moving beyond conventionally conferred assumptions of rationality, objectivity and neutrality.

  3. Temporal plus epilepsy: Anatomo-electroclinical subtypes

    Science.gov (United States)

    Andrade-Machado, René; Benjumea-Cuartas, Vanessa

    2016-01-01

    Background: Mesial temporal lobe epilepsy (TLE) is a remediable epileptic syndrome. About 40% of patients continue to have seizures after standard temporal lobectomy. It has been suggested that some of these patients could actually suffer from a more complex epileptogenic network. Because a few papers have been dedicated to this topic, we decided to write an article updating this theme. Methods: We performed a literature search using the following terminology: “temporal plus epilepsy and networks,” “temporal plus epilepsy,” “orbito-temporal epilepsy,” “temporo-insular epilepsy,” “temporo-parieto-occipital (TPO) epilepsy,” “parieto-temporal epilepsy,” “intracortical evoked potential and temporal plus epilepsy,” “temporal lobe connectivity and epilepsy,” “intracortical evoked potential and epilepsy surgery,” “role of extratemporal structures in TLE,” “surgical failure after temporal lobectomy,” “Diffusion tensor imaging (DTI) and temporal epilepsy,” and “positron emission tomography (PET) in temporal plus lobe epilepsy” in the existing PubMed databases. We searched only English and Spanish literature. Only papers that fit with the above-mentioned descriptors were included as part of the evidence. Other articles were used to reference some aspects of the temporal plus epilepsy. Results: A total of 48 papers from 2334 were revised. The most frequently reported auras in these groups of patients are gustatory hallucinations, vestibular illusions, laryngeal and throat constriction, atypical distribution of somatosensory symptoms (perioral and hands, bilaterally hands paresthesias, trunk and other). The most common signs are tonic posturing, hemifacial twist, and frequent bilateral clonic movements. Interictal electroencephalographic (EEG) patterns exhibit regional and frequently bilateral spikes and/or slow waves. The first ictal electrographic change is mostly regional. It is important to note that the evidence is

  4. Characterization of neurons in the cortical white matter in human temporal lobe epilepsy.

    Science.gov (United States)

    Richter, Zsófia; Janszky, József; Sétáló, György; Horváth, Réka; Horváth, Zsolt; Dóczi, Tamás; Seress, László; Ábrahám, Hajnalka

    2016-10-01

    The aim of the present work was to characterize neurons in the archi- and neocortical white matter, and to investigate their distribution in mesial temporal sclerosis. Immunohistochemistry and quantification of neurons were performed on surgically resected tissue sections of patients with therapy-resistant temporal lobe epilepsy. Temporal lobe tissues of patients with tumor but without epilepsy and that from autopsy were used as controls. Neurons were identified with immunohistochemistry using antibodies against NeuN, calcium-binding proteins, transcription factor Tbr1 and neurofilaments. We found significantly higher density of neurons in the archi- and neocortical white matter of patients with temporal lobe epilepsy than in that of controls. Based on their morphology and neurochemical content, both excitatory and inhibitory cells were present among these neurons. A subset of neurons in the white matter was Tbr-1-immunoreactive and these neurons coexpressed NeuN and neurofilament marker SMI311R. No colocalization of Tbr1 was observed with the inhibitory neuronal markers, calcium-binding proteins. We suggest that a large population of white matter neurons comprises remnants of the subplate. Furthermore, we propose that a subset of white matter neurons was arrested during migration, highlighting the role of cortical maldevelopment in epilepsy associated with mesial temporal sclerosis. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  5. Temporal networks

    CERN Document Server

    Saramäki, Jari

    2013-01-01

    The concept of temporal networks is an extension of complex networks as a modeling framework to include information on when interactions between nodes happen. Many studies of the last decade examine how the static network structure affect dynamic systems on the network. In this traditional approach  the temporal aspects are pre-encoded in the dynamic system model. Temporal-network methods, on the other hand, lift the temporal information from the level of system dynamics to the mathematical representation of the contact network itself. This framework becomes particularly useful for cases where there is a lot of structure and heterogeneity both in the timings of interaction events and the network topology. The advantage compared to common static network approaches is the ability to design more accurate models in order to explain and predict large-scale dynamic phenomena (such as, e.g., epidemic outbreaks and other spreading phenomena). On the other hand, temporal network methods are mathematically and concept...

  6. Gestión estratégica "Navegando hacia el cuarto paradigma". Revisión del libro

    Directory of Open Access Journals (Sweden)

    Rubén Mario Lurbé

    2013-03-01

    Full Text Available El trabajo consiste en una revisión del libro NAVEGANDO HACIA EL CUARTO PARADIGMA, CLIMA Y COMPROMISO ORGANIZACIONAL, 3° Edición, del autor, JOSÉ R. BETANCOURT T. y analizar las estrategias propuestas por el autor para logar organizaciones de “clase mundial” en America Latina.

  7. PROPUESTA METODOLÓGICA PARA DESARROLLAR UN PROGRAMA CON PROGRAMACIÓN ESTRUCTURADA A PARTIR DEL PARADIGMA FUNCIONAL

    Directory of Open Access Journals (Sweden)

    Omar Iván Trejos Buriticá

    2013-01-01

    Full Text Available El presente artículo es producto de un Proyecto de Investigación 1 desarrollado en el área de la programación de computadores y su relación con los procesos de aprendizaje que se involucran alrededor de ella. En este artículo se plantea una metodología para el desarrollo de programas que se basa en la programación estructurada, pero tomando como base los conceptos centrales del Paradigma Funcional para su desarrollo. Se busca con esta propuesta metodológica enfrentar y solucionar los tres grandes problemas de la programación e igualmente, se persigue la simplificación de la programación estructurada a partir de la utilización de funciones. Se acude a una concepción general del programa a realizar y se va desglosando poco a poco, al tiempo que se construyen funciones que cumplan con los micro-objetivos planteados. Se ha encontrado que, para los estudiantes, es una forma muy sencilla y simplificada de concebir tanto el paradigma estructurado como el paradigma funcional y que su relación facilita la comprensión de los conceptos asociados a dichos paradigmas.

  8. Gestión estratégica "Navegando hacia el cuarto paradigma". Revisión del libro

    OpenAIRE

    Rubén Mario Lurbé

    2013-01-01

    El trabajo consiste en una revisión del libro NAVEGANDO HACIA EL CUARTO PARADIGMA, CLIMA Y COMPROMISO ORGANIZACIONAL, 3° Edición, del autor, JOSÉ R. BETANCOURT T. y analizar las estrategias propuestas por el autor para logar organizaciones de “clase mundial” en America Latina.

  9. The predictive value of FDG-PET with 3D-SSP for surgical outcomes in patients with temporal lobe epilepsy.

    Science.gov (United States)

    Higo, Takuma; Sugano, Hidenori; Nakajima, Madoka; Karagiozov, Kostadin; Iimura, Yasushi; Suzuki, Masaru; Sato, Kiyoshi; Arai, Hajime

    2016-10-01

    We retrospectively evaluated the diagnostic value of (18)F-2-fluorodeoxy-d-glucose positron emission tomography (FDG-PET) with statistical analysis for the foci detection and predictive utility for postsurgical seizure outcome of patients with mesial temporal lobe epilepsy (mTLE). We evaluated 40 patients who were diagnosed mTLE and underwent selective amygdalohippocampectomy (SAH) or anterior temporal lobectomy (ATL) in our institute. Preoperative interictal FDG-PET with statistical analysis using three-dimensional stereotactic surface projection (3D-SSP) was detected with several clinical data including seizure semiology, MRI, scalp electroencephalography, surgical procedure with SAH or ATL and postsurgical outcome. The region of interest (ROI) was defined on 'Hippocampus & Amygdala', 'Parahippocampal gyrus & Uncus', 'T1 & T2', and 'T3 & Fusiform gyrus'. We obtained the ratio of hypometabolism difference (RHD) by 3D-SSP, and evaluated the relation among hypometabolic extent, surgical outcome and surgical procedure. The RHD in each ROIs ipsilateral to operative side was significantly higher than that of contralateral side in good outcome group. Hypometabolism of 'Hippocampus & Amygdala' was most reliable prognostic factor. Patients of discordant with presurgical examinations hardly showed obvious lateralized hypometabolism. Nevertheless, when they have significantly high RHD in mesial temporal lobe, good surgical outcome was expected. There was not significant difference of RHD distribution between SAH and ATL in good outcome group. Significant hypometabolism in mesial temporal lobe on FDG-PET with 3D-SSP is useful to predict good surgical outcome for patients with mTLE, particularly in discordant patients with hypometabolism in mesial temporal structure. However, FDG-PET is not indicative of surgical procedure. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  10. Memory in children with symptomatic temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Catarina A. Guimarães

    2014-03-01

    Full Text Available In children with temporal lobe epilepsy (TLE, memory deficit is not so well understood as it is in adults. The aim of this study was to identify and describe memory deficits in children with symptomatic TLE, and to verify the influence of epilepsy variables on memory. We evaluated 25 children with TLE diagnosed on clinical, EEG and MRI findings. Twenty-five normal children were compared with the patients. All children underwent a neuropsychological assessment to estimate intellectual level, attention, visual perception, handedness, and memory processes (verbal and visual: short-term memory, learning, and delayed recall. The results allowed us to conclude: besides memory deficits, other neuropsychological disturbances may be found in children with TLE such as attention, even in the absence of overall cognitive deficit; the earlier onset of epilepsy, the worse verbal stimuli storage; mesial lesions correlate with impairment in memory storage stage while neocortical temporal lesions correlate with retrieval deficits.

  11. LA UNIVERSIDAD ANTE LOS NUEVOS PARADIGMAS DE LA INFORMACIÓN Y EL CONOCIMIENTO (PIC

    Directory of Open Access Journals (Sweden)

    Edgar Chirinos

    2009-07-01

    las universidades, su gerencia y sus actores principales (docentes y estudiantes ante el surgimiento de nuevos paradigmas de la información y el conocimiento (PIC causados por la aprehensión de las tecnologías de información y comunicación (TIC. Se tomó como base la definición de la universidad del siglo XXI bajo la dimensión tecnológica de una sociedad sustentada en el conocimiento, cuyo pilar fundamental está integrado por las plataformas tecnológicas, las telecomunicaciones y redes del conocimiento. Se concluye que una de las brechas en el propósito de democratización y acceso social al conocimiento.

  12. A musa sem paradigmas ou A história na era dos saberes desnorteados

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    Plinio Freire Gomes

    1996-11-01

    Full Text Available Durante os anos 70, certos autores começaram a duvidar de seus modelos explicativos. Embora possa parecer algo circunscrito ao meio acadêmico, este fenômeno estava diretamente relacionado com muitos acontecimentos concretos do mundo real. A "crise dos paradigmas", que já se tornou tão familiar para nós, era o complexo resultado de uma série de revoluções, movimentos políticos e instabilidades, bem como de inquietações muito pessoas. Dentre todas as humanidades, a História foi aquela que sofreu o se impacto mais profundo. Com o declínio da teoria, nosso interesse está se deslocando dos problemas estruturais para o homem propriamente dito

  13. O novo paradigma da violência The new paradigm of violence

    Directory of Open Access Journals (Sweden)

    Michel Wieviorka

    1997-05-01

    Full Text Available O autor procura redimensionar o conceito de violência dentro do atual estado de globalização mundial. Crise internacional, narcotráfico, derrocada do bloco socialista no leste europeu, políticas assistenciais de organismos internacionais, conceitos de desenvolvimento e de subdesenvolvimento, terrorismo, sectarismo político e religioso, novas conceituações culturais e sociais são temas trabalhados pelo autor com vistas ao estabelecimento de um novo paradigma da violência.The author tries to requalify the concept of violence under the influences of a context of world globalization. International crisis, drug traffic, collapse of the socialist governments, concepts of development and under-development, terrorism, political and religious sectarisms, new culture and social conceptualizations, these are some of the themes which are discussed by the author with the objective to propose a new pardigm for violence.

  14. EL CAPITAL SOCIAL: UN PARADIGMA EN EL ACTUAL DEBATE SOBRE EL DESARROLLO. TENDENCIAS Y PROBLEMAS

    Directory of Open Access Journals (Sweden)

    Laura Mota Díaz

    2002-01-01

    Full Text Available El presente ensayo hace referencia al concepto de capital social como un paradigma que se ha ido rescatando y reformulando en la reciente discusión sobre el desarrollo y que está siendo impulsado por diversos organismos internacionales como el Banco Mundial, el Banco Interamericano de Desarrollo, el Programa de Naciones Unidas para el Desarrollo y la CEPAL, entre otros, con el objetivo de producir efectos en la reducción de la pobreza y desigualdad, con miras a lograr la equidad y democracia que se constituyen como factores indispensables para los actuales procesos de internacionalización económica. Se reflexiona sobre las principales tendencias de la creación, promoción y uso de capital social como elemento importante para el desarrollo y se mencionan algunos de los problemas que pueden impedir que dicho capital sea funcional en ciertos contextos.

  15. Organizações no paradigma de transformação

    Directory of Open Access Journals (Sweden)

    Ursula Blattmann

    1999-04-01

    Full Text Available This article presents a series of questions about organizational change. Intends to discuss a vision of the transformation paradigm where the rupture of values in aspects of the organizational environment, people, activities and use of new technologies interact provoking a continuous learning.Apresenta uma série de indagações sobre mudanças organizacionais. As reflexões estão no sentido de provocar uma visão do paradigma da transformação, onde ruptura de valores referente aos aspectos do ambiente organizacional, das pessoas, das atividades e do uso de novas tecnologias se interagem provocando um contínuo aprender do ser humano.

  16. El Concepto de Marketing Bajo el Paradigma Relacional. Una Agenda para Latinoamérica

    Directory of Open Access Journals (Sweden)

    Judith Cavazos Arroyo

    2010-03-01

    Full Text Available Este artículo presenta un análisis sobre la situación del marketing en América Latina y sus implicaciones en relación a la globalidad. Se reflexiona en la necesidad de repensar la conceptualización del marketing considerando los avances y los retos para las empresas de la región, así como las características de mercados dinámicos con demandas de un trato más personalizado. Se destaca la necesidad del uso de las nuevas tecnologías y la adopción de nuevos enfoques, tal es el caso del marketing de relaciones, a través del cual se propone un nuevo paradigma en la disciplina. DOI: 10.5585/remark.v8i1.2124

  17. Escola Contemporânea Criativa e Inovadora na transição de paradigmas

    Directory of Open Access Journals (Sweden)

    Maria José de Pinho

    2014-11-01

    Full Text Available O presente artigo traz a discussão sobre a ruptura do paradigma conservador para a educação emancipatória. Uma mudança de acordo com os referenciais teóricos acerca das concepções sobre o criar e o inovar na ‘visão de transformação’ enquanto instituições educativas. Este trabalho tem como objetivo conhecer as principais concepções de criatividade e inovação na escola contemporânea no rompimento do paradigma conservador para uma educação emancipatória. É um estudo de caráter bibliográfico que iniciou com a análise dos aportes teóricos no Grupo de Pesquisa em Rede Internacional Investigando Escolas Criativas e Inovadoras. Esta reflexão trouxe a percepção de que a escola contemporânea pode ser definida como emancipatória na perspectiva criativa e inovadora, quando a mesma caminha na contramão de um ensino conservador; o qual prioriza o trabalho individual e um saber fragmentado. Em oposição a este modelo, esta escola possui a visão formadora e transformadora de seu fazer pedagógico e coletivo, buscando-se a interligação do saber e a produção do conhecimento. Uma instituição que valoriza os potenciais criativos, a natureza e o ser humano; visando o bem individual, social e planetário, através dos princípios que parte da vida e para a vida.Palavras-chave: educação formadora e transformadora; criatividade e inovação; mudança paradigmática.

  18. La Reforma, un nuevo paradigma de la teología

    Directory of Open Access Journals (Sweden)

    Martin Hoffmann

    2017-05-01

    Full Text Available A 500 años del origen del protestantismo, se plantea la pregunta: ¿Cuál es el significado de la Reforma para hoy? El autor sostiene que la importancia de la Reforma va más allá de una época histórica o de una controversia teológica de su tiempo. Más bien la Reforma es un proceso permanente, un movimiento y un cierto método del quehacer teológico. Remontándose a la teología de la cruz del apóstol Pablo, Martín Lutero, el iniciador de la Reforma, desarrolló un nuevo paradigma de la teología. Es caracterizado por tres aspectos: La cruz como principio epistemológico, la justicia de Dios como contenido esencial del Evangelio, y una ética discursiva de los mandamientos. Este paradigma de la teología posibilita una renovación y una transformación continua de las iglesias y de la teología enfrente de los desafíos contemporáneos como las crisis de la ecología, de la economía, de la justicia social y el aumento de violencia y guerras. La actualidad de la Reforma se demuestra en su nuevo modo de pensar y de actuar, o sea en su potencial crítico a partir del Crucificado y sus perspectivas constructivas para la humanidad y la convivencia a partir de la justicia de Dios.

  19. Project Temporalities

    DEFF Research Database (Denmark)

    Tryggestad, Kjell; Justesen, Lise; Mouritsen, Jan

    2013-01-01

    Purpose – The purpose of this paper is to explore how animals can become stakeholders in interaction with project management technologies and what happens with project temporalities when new and surprising stakeholders become part of a project and a recognized matter of concern to be taken...... into account. Design/methodology/approach – The paper is based on a qualitative case study of a project in the building industry. The authors use actor-network theory (ANT) to analyze the emergence of animal stakeholders, stakes and temporalities. Findings – The study shows how project temporalities can...... multiply in interaction with project management technologies and how conventional linear conceptions of project time may be contested with the emergence of new non-human stakeholders and temporalities. Research limitations/implications – The study draws on ANT to show how animals can become stakeholders...

  20. De la instrucció a l’aprenentatge. Un nou paradigma per a l’educació universitària

    OpenAIRE

    Barr, Robert B.; Tagg, John

    2004-01-01

    S’està produint un canvi de paradigma en l’educació superior nord-americana. El paradigma que ha regit als centres universitaris fins ara concep la universitat com una institució que té per objecte proporcionar ensenyament. De manera subtil però intensa, s’està evolucionant cap a un nou paradigma que entén que la finalitat de la universitat és produir aprenentatge. Aquest canvi suposa una modificació profunda de totes les dimensions de l’educació superior.

  1. El paradigma del ZMOT como modelo de negocio aplicado al sector turístico en el año 2013 : estudio sobre el comportamiento del consumidor turístico de la Ciudad Autónoma de Buenos Aires en los medios online

    OpenAIRE

    Costas Chillemi, Martín

    2014-01-01

    Costas Chillemi, M. (2014). El paradigma del ZMOT como modelo de negocio aplicado al sector Turístico en el año 2013. Estudio sobre el comportamiento del consumidor turístico de la Ciudad Autónoma de Buenos Aires en los medios online (Tesis de posgrado). Universidad Nacional de Quilmes, Bernal, Argentina. El presente estudio es de finalidad aplicada, alcance temporal transversal y grado de conocimiento Exploratorio, fundamentalmente porque se realiza un primer acercamiento al fenómeno del ...

  2. Gender and hemispheric differences in temporal lobe epilepsy: a VBM study.

    Science.gov (United States)

    Santana, Maria Teresa Castilho Garcia; Jackowski, Andrea Parolin; Britto, Fernanda Dos Santos; Sandim, Gabriel Barbosa; Caboclo, Luís Otávio Sales Ferreira; Centeno, Ricardo Silva; Carrete, Henrique; Yacubian, Elza Márcia Targas

    2014-04-01

    Gender differences are recognized in the functional and anatomical organization of the human brain. Differences between genders are probably expressed early in life, when differential rates of cerebral maturation occur. Sexual dimorphism has been described in temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS). Several voxel-based morphometry (VBM) studies have shown that TLE-MTS extends beyond mesial temporal structures, and that there are differences in the extent of anatomical damage between hemispheres, although none have approached gender differences. Our aim was to investigate gender differences and anatomical abnormalities in TLE-MTS. VBM5 was employed to analyze gender and hemispheric differences in 120 patients with TLE-MTS and 50 controls. VBM abnormalities were more widespread in left-TLE; while in women changes were mostly seen in temporal areas, frontal regions were more affected in men. Our study confirmed that gender and laterality are important factors determining the nature and severity of brain damage in TLE-MTS. Differential rates of maturation between gender and hemispheres may explain the distinct areas of anatomical damage in men and women. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. The correlation between E.M.I. scan appearances and the pathologic findings in a small group of patients submitted to anterior temporal lobectomy for intractable epilepsy

    International Nuclear Information System (INIS)

    Polkey, C.E.

    1978-01-01

    In a group of nine patients undergoing anterior temporal lobectomy for intractable epilepsy, EMI scans are available for direct comparison with other neuroradiological investigations and the pathology found in the resected temporal lobes. The atrophic lesion of mesial temporal sclerosis is difficult to demonstrated by CAT scanning. However, lesions such as tumours and angiomas containing areas of increased radiodensity are better indentified by this method. Because of this difference, CAT scanning is not a suitable single investigation for screening epileptic populations for surgical candidates. (orig.) [de

  4. The patient had a normal magnetic resonance imaging and temporal lobe epilepsy secondary to a porencephalic cyst but showed structural lesions (hippocampal sclerosis)☆

    Science.gov (United States)

    Matsubara, Teppei; Ayuzawa, Satoshi; Aoki, Tsukasa; Fujiomto, Ayataka; Osuka, Satoru; Matsumura, Akira

    2013-01-01

    Patients with a porencephalic cyst frequently develop intractable temporal lobe epilepsy (TLE). We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst. Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus. Temporal lobectomy brought an end to the patient's seizures. Hippocampal sclerosis was histopathologically confirmed (dual pathology). Careful evaluation of hippocampal epileptogenicity is required, and temporal lobectomy, which is less invasive than hemispherectomy, can be a treatment of choice for patients with mTLE secondary to a porencephalic cyst. PMID:25667851

  5. Application of dynamic susceptibility contrast-enhanced perfusion in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Xing, Wu; Wang, Xiaoyi; Xie, Fangfang; Liao, Weihua [Dept. of Radiology, Xiangya Hospital of Central South Univ., Changsha (China)], e-mail: doctoring@sina.com

    2013-02-15

    Background: Accurately locatithe epileptogenic focus in temporal lobe epilepsy (TLE) is important in clinical practice. Single-photon emission computed tomography (SPECT) and positron-emission tomography (PET) have been widely used in the lateralization of TLE, but both have limitations. Magnetic resonance perfusion imaging can accurately and reliably reflect differences in cerebral blood flow and volume. Purpose: To investigate the diagnostic value of dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) in the lateralization of the epileptogenic focus in TLE. Material and Methods: Conventional MRI and DSC-MRI scanning was performed in 20 interictal cases of TLE and 20 healthy volunteers. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) of the bilateral mesial temporal lobes of the TLE cases and healthy control groups were calculated. The differences in the perfusion asymmetry indices (AIs), derived from the rCBV and rCBF of the bilateral mesial temporal lobes, were pared between the two groups. Results: In the control group, there were no statistically significant differences between the left and right sides in terms of rCBV (left 1.55 {+-} 0.32, right 1.57 {+-} 0.28) or rCBF (left 99.00 {+-} 24.61, right 100.38 {+-} 23.46) of the bilateral mesial temporal lobes. However, in the case group the ipsilateral rCBV and rCBF values (1.75 {+-} 0.64 and 96.35 {+-} 22.63, respectively) were markedly lower than those of the contralateral side (2.01 {+-} 0.79 and 108.56 {+-} 26.92; P < 0.05). Both the AI of the rCBV (AIrCBV; 13.03 {+-} 10.33) and the AI of the rCBF (AIrCBF; 11.24 {+-} 8.70) of the case group were significantly higher than that of the control group (AIrCBV 5.55 {+-} 3.74, AIrCBF 5.12 {+-} 3.48; P < 0.05). The epileptogenic foci of nine patients were correctly lateralized using the 95th percentile of the AIrCBV and AIrCBF of the control group as the normal upper limits. Conclusion: In

  6. Application of dynamic susceptibility contrast-enhanced perfusion in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Xing, Wu; Wang, Xiaoyi; Xie, Fangfang; Liao, Weihua

    2013-01-01

    Background: Accurately locatithe epileptogenic focus in temporal lobe epilepsy (TLE) is important in clinical practice. Single-photon emission computed tomography (SPECT) and positron-emission tomography (PET) have been widely used in the lateralization of TLE, but both have limitations. Magnetic resonance perfusion imaging can accurately and reliably reflect differences in cerebral blood flow and volume. Purpose: To investigate the diagnostic value of dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) in the lateralization of the epileptogenic focus in TLE. Material and Methods: Conventional MRI and DSC-MRI scanning was performed in 20 interictal cases of TLE and 20 healthy volunteers. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) of the bilateral mesial temporal lobes of the TLE cases and healthy control groups were calculated. The differences in the perfusion asymmetry indices (AIs), derived from the rCBV and rCBF of the bilateral mesial temporal lobes, were pared between the two groups. Results: In the control group, there were no statistically significant differences between the left and right sides in terms of rCBV (left 1.55 ± 0.32, right 1.57 ± 0.28) or rCBF (left 99.00 ± 24.61, right 100.38 ± 23.46) of the bilateral mesial temporal lobes. However, in the case group the ipsilateral rCBV and rCBF values (1.75 ± 0.64 and 96.35 ± 22.63, respectively) were markedly lower than those of the contralateral side (2.01 ± 0.79 and 108.56 ± 26.92; P < 0.05). Both the AI of the rCBV (AIrCBV; 13.03 ± 10.33) and the AI of the rCBF (AIrCBF; 11.24 ± 8.70) of the case group were significantly higher than that of the control group (AIrCBV 5.55 ± 3.74, AIrCBF 5.12 ± 3.48; P < 0.05). The epileptogenic foci of nine patients were correctly lateralized using the 95th percentile of the AIrCBV and AIrCBF of the control group as the normal upper limits. Conclusion: In patients with TLE interictal

  7. Four canals in the mesial root of a mandibular first molar. A case report under the operating microscope.

    Science.gov (United States)

    Kontakiotis, Evangelos G; Tzanetakis, Giorgos N

    2007-08-01

    In this era of microscope-assisted endodontics, finding variations in root canal system anatomy is not uncommon. Operating microscopes combined with careful clinical examination and radiographic interpretation can aid the clinician to successfully treat cases with such internal anatomy. The understanding of this view enables the possible location of additional canals in any tooth requiring endodontic treatment. The present clinical article demonstrates a rare anatomical complexity in the mesial root of a mandibular first molar. Four independent root canal orifices were found in this root by clinical detection with the aid of a dental operating microscope. This case shows that additional canals can be located in any root undergoing endodontic treatment and clinicians should always be aware of aberrant internal anatomy.

  8. Temporal and occipital lobe features in children with hypochondroplasia/FGFR3 gene mutation.

    Science.gov (United States)

    Philpott, Cristina M; Widjaja, Elysa; Raybaud, Charles; Branson, Helen M; Kannu, Peter; Blaser, Susan

    2013-09-01

    Thanatophoric dysplasia (TD) and hypochondroplasia are both caused by FGFR3 (fibroblast growth factor receptor 3) gene mutations. Temporal lobe dysplasia has been well described in thanatophoric dysplasia; however, only a couple of anecdotal cases of temporal lobe dysplasia in hypochondroplasia have been described. To define temporal lobe abnormalities in patients with hypochondroplasia, given that they share the same genetic mutation. We identified brain imaging studies of nine children with hypochondroplasia. The temporal lobes were assessed on CT and MRI for size and configuration of the temporal horn and aberrant sulcation of the inferior surface of the temporal lobe. All children had a triangular-shape temporal horn and deep transverse fissures of the inferior temporal lobe surface. Neuroimaging in our cohort revealed enlarged temporal lobes and oversulcation of the mesial temporal and occipital lobes, with abnormal inferomedial orientation of these redundant gyri. Hippocampal dysplasia was also universal. We confirmed frequent inferomesial temporal and occipital lobe abnormalities in our cohort of children with hypochondroplasia. Murine models with mutant fgfr3 display increased neuroprogenitor proliferation, cortical thickness and surface area in the temporo-occipital cortex. This is thought to result in excessive convolution and likely explains the imaging findings in this patient cohort. (Note that fgfr3 is the same genetic mutation in mice as FGFR3 is in humans.).

  9. An evaluation of canal curvature at the apical one third in type II mesial canals of mandibular molars

    Directory of Open Access Journals (Sweden)

    Hye-Rim Yun

    2012-05-01

    Full Text Available Objectives The purpose of this study was to evaluate the buccolingual curvature at the apical one third in type II mesial canals of mandibular molars using the radius and angle of curvature. Materials and Methods Total 100 mandibular molars were selected. Following an endodontic access in the teeth, their distal roots were removed. #15 H- or K-files (Dentsply Maillefer were inserted into the mesiobuccal and mesiolingual canals of the teeth. Radiographs of the teeth were taken for the proximal view. Among them, type II canals were selected and divided into two subgroups, IIa and IIb. In type IIa, two separate canals merged into one canal before reaching the apex and in type IIb, two separate canals merged into one canal within the apical foramen. The radius and angle of curvature of specimens were examined. Results In type II, mean radius of curvature in mesiolingual and mesiobuccal canals were 2.82 mm and 3.58 mm, respectively. The radius of the curvature of mesiolingual canals were significantly smaller than that of mesiobuccal canals in type II, and especially in type IIa. However, there were no statistically significant differences in radius of curvature between mesiobuccal and mesiolingual canals in type IIb and there were no significant differences in angle of curvature between type IIa and IIb. Conclusion In this study, type II mesial canals of mandibular molars showed severe curvature in the proximal view. Especially, mesiolingual canals of type IIa had more abrupt curvature than mesiobuccal canals at the apical one third.

  10. Paradigms for subdural grids' implantation in patients with refractory epilepsy Paradigmas para implante de placas subdurais em pacientes com epilepsia refratária

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    ARTHUR CUKIERT

    2000-09-01

    Full Text Available RATIONALE: The need for invasive monitoring in patients with refractory epilepsy has been greatly reduced by the introduction of new technologies such as PET, SPECT and MRI in the clinical practice. On the other hand, 10 to 30% of the patients with refractory epilepsy have non-localizatory non-invasive preoperative work-up results. This paper reports on the paradigms for subdural electrodes implantation in patients with different refractory epileptic syndromes. METHODS: Twenty-nine adult refractory epileptic patients were studied. Patients were divided into five different epileptic syndromes that represented the majority of the patients who needed invasive recordings: bitemporal (Group I; n=16 , bi-frontal-mesial (Group II, n=5, hemispheric (Group III; n=2, anterior quadrant (Group IV; n=3 and posterior quadrant (Group V; n=3. All of them were submitted to extensive subdural electrodes' implantation (from 64 to 160 contacts covering all the cortical surface potentially involved in epileptogenesis under general anesthesia. Results: All patients tolerated well the procedure. There was no sign or symptom of intracranial hypertension except for headache in 22 patients. In all except one Group II patient, prolonged electrocorticographic monitoring using the described subdural cortical coverage patterns was able to define a focal area amenable for resection. In all Groups II-V patients cortical stimulation was able to adequately map the rolandic and speach areas as necessary. CONCLUSION: Despite recent technological advances invasive neurophysiological studies are still necessary in some patients with refractory epilepsy. The standardization of the paradigms for subdural implantation coupled to the study of homogeneous patients' populations as defined by MRI will certainly lead to a better understanding of the pathophysiology involved in such cases and an improved surgical outcome.INTRODUÇÃO: O advento de novas tecnologias de imagem tais como o PET

  11. Clinical study on temporal lobe epilepsy in childhood caused by temporal lobe space occupying lesions

    International Nuclear Information System (INIS)

    Matsuura, Mariko; Oguni, Hirokazu; Funatsuka, Makoto; Osawa, Makiko; Yamane, Fumitaka; Hori, Tomokatsu; Shimizu, Hiroyuki

    2008-01-01

    We studied the clinicoelectrical and neuroimaging features of 11 patients with symptomatic temporal lobe epilepsy (TLE) caused by temporal lobe space occupying lesions (SOLs), and compared its characteristics with those of 19 mesial TLE (MTLE) patients. Brain MRI demonstrated SOLs in the mesiotemporal lobe in 9, and laterotemporal lobe in the remaining 2 patients. Ten of the 11 patients successfully underwent surgery, which revealed tumors in 7 and focal cortical dysplasia in 3 patients. Comparisons of the clinical features between those with space occupying TLE (SOTLE) and MTLE showed that both conditions shared the same clinical seizure manifestations such as gastric uprising sensation or ictal fear and a favorable response to surgery. However, the patients with SOTLE had fewer febrile convulsion, and more frequent seizure recurrences as well as TLE EEG discharges and associations of the monophasic clinical course than those with MTLE. In addition, the MRI findings were characterized by unilateral hippocampal atrophy in MTLE and expanding or SOLs in the SOTLE group. Children with complex partial seizures of suspected temporal lobe origin should undergo extensive neuroimaging evaluation. (author)

  12. PARADIGMA, DIREITO E MODERNIDADE: EM BUSCA DE UMA VISÃO COMPLEXA DO FENÔMENO JURÍDICO

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    Marcos Luís Diehl

    2016-11-01

    Full Text Available O artigo traz uma análise das transformações do Direito na modernidade. Existe uma crise do paradigma (cartesiano/mecanicista que informa a construção da modernidade, sendo que isso está ligado a um fenômeno mais amplo: a crise da própria visão de mundo consolidada nesse período histórico. Buscar uma visão de integralidade acerca do fenômeno jurídico é um dos caminhos para superar essa crise paradigmática. Palavras-chave: Direito; modernidade; paradigma; transformação; complexidade.

  13. PARADIGMA PEMBANGUNAN EKONOMI; SATU ANALISIS TINJAUAN ULANG DARI PERSPEKTIF EKONOMI ISLAM

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    SYAMSURI SYAMSURI

    2016-10-01

    Full Text Available Abstract. Paradigm of Economic Development; Perspective of Islamic Economics Analysis. The capitalist economic system has failed because the rich exploiting the poor and a socialist economic system justifies the poor seize property of the rich. This problem becomes an important issue for the Muslim economists. Paradigm both the liberal system is exploitative, unfair and treats people not as people. Not pay attention to moral values and akhlaqs, a dichotomy between religion and economics, make man a slave of development and not development for human. This paper is a reflection phenomenon of damage to the environment, social inequality and poverty not been abated. So the liberal economic theories and concepts need to be reviewed by presenting a new economic development concept that comes from revelation that is the Quran and hadith. Finally, from the discussion can be concluded that economic development can not be achieved except with implementing Islamic guidance in everything. And the nature of development must necessarily multi-dimensional, included the gratification of physical and ruh. Economic development must also be able to create a balance between individual interests and the interests of society, kindness balanced and consistent according the rules of Islam. Measure of the success of development if the concept of caliphate, ‘adalah, and tazkiyah can meet all basic needs of every human being and nature conservation around for the long term future generations. Abstrak. Paradigma Pembangunan Ekonomi; Satu Analisis Tinjauan Ulang Dari Perspektif Ekonomi Islam. Kegagalan sistem ekonomi kapitalis yang membenarkan orang kaya mengeksploitasi orang miskin, dan sistem sosialis membenarkan orang miskin merampas harta orang kaya menjadi satu isu penting bagi para ekonom muslim. Paradigma kedua sistem liberal tersebut bersifat eksploitatif dan tidak fair serta memperlakukan manusia bukan sebagai manusia. Mengesampingkan nilai moral dan akhlak

  14. Temporal networks

    Science.gov (United States)

    Holme, Petter; Saramäki, Jari

    2012-10-01

    A great variety of systems in nature, society and technology-from the web of sexual contacts to the Internet, from the nervous system to power grids-can be modeled as graphs of vertices coupled by edges. The network structure, describing how the graph is wired, helps us understand, predict and optimize the behavior of dynamical systems. In many cases, however, the edges are not continuously active. As an example, in networks of communication via e-mail, text messages, or phone calls, edges represent sequences of instantaneous or practically instantaneous contacts. In some cases, edges are active for non-negligible periods of time: e.g., the proximity patterns of inpatients at hospitals can be represented by a graph where an edge between two individuals is on throughout the time they are at the same ward. Like network topology, the temporal structure of edge activations can affect dynamics of systems interacting through the network, from disease contagion on the network of patients to information diffusion over an e-mail network. In this review, we present the emergent field of temporal networks, and discuss methods for analyzing topological and temporal structure and models for elucidating their relation to the behavior of dynamical systems. In the light of traditional network theory, one can see this framework as moving the information of when things happen from the dynamical system on the network, to the network itself. Since fundamental properties, such as the transitivity of edges, do not necessarily hold in temporal networks, many of these methods need to be quite different from those for static networks. The study of temporal networks is very interdisciplinary in nature. Reflecting this, even the object of study has many names-temporal graphs, evolving graphs, time-varying graphs, time-aggregated graphs, time-stamped graphs, dynamic networks, dynamic graphs, dynamical graphs, and so on. This review covers different fields where temporal graphs are considered

  15. Nem holismo nem individualismo metodológicos: Marcel Mauss e o paradigma da dádiva

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    Caillé Alain

    1998-01-01

    Full Text Available O artigo se situa no contexto da crítica ao utilitarismo que vem sendo conduzida, desde o início dos anos 80, por um grupo de intelectuais reunidos em torno do MAUSS - Movimento Antiutilitarista nas Ciências Sociais, cujas idéias são divulgadas pela La Revue du MAUSS, publicada pela Editora La Découverte, em Paris. Alain Caillé procura resgatar a importância de Marcel Mauss no interior da escola sociológica francesa, ressaltando a contribuição deste autor clássico na sistematização inicial do paradigma do dom, que subsiste na modernidade, como o demonstram, em várias oportunidades, os colaboradores deste movimento antiutilitarista. Para Caillé, o paradigma do dom constitui o fundamento necessário de criação de uma teoria paradoxal e pluridimensional da ação, capaz de resolver a dicotomia clássica entre holismo e individualismo. No entanto, ressalta o diretor da Revue du MAUSS, na constituição do novo paradigma, as imbricações entre o dom e o simbolismo ainda permanecem imprecisas e algo misteriosas.

  16. Compreensões da Educação Ambiental: possibilidades e desafios do paradigma da complexidade

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    Filipi Vieira Amorim

    2013-10-01

    Full Text Available http://dx.doi.org/10.5007/2178-4582.2013v47n2p272 A contemporaneidade carrega consigo inúmeros desafios impostos ao ser humano. Cada vez mais, questões de ordem social, ambiental, educacional, etc., mostram-se interligadas; e interconectados, os desafios da atualidade emergem. Os seres humanos são convidados a compreender o metabolismo entre sociedade e Natureza, suas partes e seu todo, suas causas e agentes, sua complexidade. Por essas constatações é que propomos a reflexão teórica e epistemológica sobre a Educação Ambiental em suas possibilidades e desafios. Nosso aporte epistêmico é guiado pela Teoria da Complexidade, do pensador francês Edgar Morin (1921-. Esse percurso conceitual transpassa os princípios da ciência clássica e do paradigma dominante. É vislumbrado no paradigma emergente, o paradigma do pensamento complexo, mostrando que existem caminhos que entrelaçam conceito e discurso prático, conhecimentos e saberes, técnica e reflexão, filosofia e ciência.

  17. Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study

    International Nuclear Information System (INIS)

    Deblaere, K.; Vandemaele, P.; Achten, E.; Backes, W.H.; Hofman, P.; Wilmink, J.; Boon, P.A.; Vonck, K.; Boon, P.; Troost, J.; Vermeulen, J.; Aldenkamp, A.

    2002-01-01

    Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery. (orig.)

  18. Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Deblaere, K.; Vandemaele, P.; Achten, E. [MRI Department -1 K12, Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Backes, W.H.; Hofman, P.; Wilmink, J. [Department of Neuroradiology, University Hospital Maastricht, Postbus 5800, 6202 AZ Maastricht (Netherlands); Boon, P.A.; Vonck, K. [Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Boon, P. [Department of Medical Psychology, University Hospital Maastricht (Netherlands); Troost, J. [Department of Neurology, University Hospital Maastricht (Netherlands); Vermeulen, J. [S.E.I.N Heemstede, Psychological Laboratory, Achterweg 5, 2103 SW Heemstede (Netherlands); Aldenkamp, A. [Epilepsy Center ' Kempenhaeghe' , Postbus 61, 5900 AB Heeze (Netherlands)

    2002-08-01

    Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery. (orig.)

  19. Ex vivo study of dentate gyrus neurogenesis in human pharmacoresistant temporal lobe epilepsy.

    Science.gov (United States)

    Paradisi, M; Fernández, M; Del Vecchio, G; Lizzo, G; Marucci, G; Giulioni, M; Pozzati, E; Antonelli, T; Lanzoni, G; Bagnara, G P; Giardino, L; Calzà, L

    2010-10-01

    Neurogenesis in adult humans occurs in at least two areas of the brain, the subventricular zone of the telencephalon and the subgranular layer of the dentate gyrus in the hippocampal formation. We studied dentate gyrus subgranular layer neurogenesis in patients subjected to tailored antero-mesial temporal resection including amygdalohippocampectomy due to pharmacoresistant temporal lobe epilepsy (TLE) using the in vitro neurosphere assay. Sixteen patients were enrolled in the study; mesial temporal sclerosis (MTS) was present in eight patients. Neurogenesis was investigated by ex vivo neurosphere expansion in the presence of mitogens (epidermal growth factor + basic fibroblast growth factor) and spontaneous differentiation after mitogen withdrawal. Growth factor synthesis was investigated by qRT-PCR in neurospheres. We demonstrate that in vitro proliferation of cells derived from dentate gyrus of TLE patients is dependent on disease duration. Moreover, the presence of MTS impairs proliferation. As long as in vitro proliferation occurs, neurogenesis is maintained, and cells expressing a mature neurone phenotype (TuJ1, MAP2, GAD) are spontaneously formed after mitogen withdrawal. Finally, formed neurospheres express mRNAs encoding for growth (vascular endothelial growth factor) as well as neurotrophic factors (brain-derived neurotrophic factor, ciliary neurotrophic factor, glial-derived neurotrophic factor, nerve growth factor). We demonstrated that residual neurogenesis in the subgranular layer of the dentate gyrus in TLE is dependent on diseases duration and absent in MTS. © 2010 The Authors. Neuropathology and Applied Neurobiology © 2010 British Neuropathological Society.

  20. Una nota sobre complejidad y paradigma cualitativo (A Note Regarding Complexity and Qualitative Paradigm

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    Roberto Bueno Cuadra

    2014-12-01

    Full Text Available RESUMEN: En las ciencias sociales el tema de la complejidad se presenta con frecuencia en el marco de la discusión entre los paradigmas cuantitativo y cualitativo y en ese debate, casi siempre, es asociado con este último, sobre la base de que la complejidad implica, necesariamente, asumir un enfoque holístico, idiográfico, no reduccionista y comprensivo en las ciencias sociales. El presente artículo se propone argumentar en contra de ese supuesto mostrando que no se requiere ningún desplazamiento paradigmático hacia el enfoque cualitativo para asumir una visión compleja en las ciencias sociales. ABSTRACT: n social sciences, the subject of complexity arises frequently in the context of the discussion between the quantitative and qualitative paradigms and in that debate, it is almost always associated with the latter, on the basis, that complexty necessarily implies, taking a holistic, idiographic approach, not reductionist or comprehensive in the social sciences. This article intends to argue against that assumption, showing that any paradigm shift towards the qualitative approach is not required to assume a complex vision in social sciences.

  1. El caso Breivik como paradigma de la nueva violencia política en Europa

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    Jesús Pérez

    2014-01-01

    Full Text Available Tras el doble atentado en Noruega del 22 de julio de 2011 cometido por Anders Behring Breivik, el terrorismo en Europa se enfrenta a una nueva amenaza. La novedad ideológica de Breivik es escasa, salvo por actualizar peligros que parecían del pasado. Por el contrario, su novedad operativa sí es relevante, ya que demuestra la posibilidad de la actuación de "lobos solitarios" en Europa y ejemplifica de qué manera el occidental medio puede actuar con un potencial muy alto de causar daños. Se concluye con el avance de un nuevo paradigma, el de sujetos que actúan movidos políticamente por un objetivo irrealizable, para favorecer a grupos que son extremadamente abstractos o no existen, lo que les proporciona un blindaje ideológico sin capacidad alta de movilización pero con destacadas cotas de destrucción.

  2. A LA BÚSQUEDA DE UN PARADIGMA JURÍDICO MEDIOAMBIENTAL

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    Mario Ruiz Sanz

    2012-06-01

    Full Text Available RESUMEN. El Derecho ambiental siempre será una realidad inacabada por la necesidad de superación que tiene el ser humano así como de disponer de los medios para conseguir sus objetivos, sean o no legítimos. La protección de medio ambiente quedará insuficiente ante nuevas realidades y problemas de aparición constante. Por este motivo, tiene una importancia básica para construir unas normas jurídicas aplicables tener en cuenta los paradigmas o modos de vida socialmente aceptados. Sin este requisito previo, puede haber una desconexión importante entre Derecho y Sociedad al valorar los mecanismos de protección medioambiental.ABSTRACT. The Environmental Law unfinished always be a reality by the need to overcome the human being as well as have the means to achieve their goals, whether or not legitimate. Environmental protection will be insufficient to new realities and problems of constant occurrence. For this reason, it has a basic importance to construct legal rules applicable to consider the paradigms or socially accepted ways of life. Without this prerequisite, there may be a significant disconnect between Law and Society to assess the mechanisms of environmental protection.

  3. DE BATESON A INGOLD: PASSOS NA CONSTITUIÇÃO DE UM PARADIGMA ECOLÓGICO

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    Otávio Velho

    2001-10-01

    Full Text Available Em 2000 foi finalmente reeditado o mais importante livro de Gregory Bateson, Steps to an Ecology of Mind. Nesse mesmo ano, foi lançado o livro de Tim Ingold, The Perception of the Environment, que retoma muitas das preocupações de Bateson. Este ensaio considera que esses dois eventos marcam passos importantes na constituição de um "paradigma ecológico", o qual vem responder a alguns dilemas que rondam a antropologia e abrir perspectivas para um diálogo interdisciplinar em novas bases.Gregory Bateson’s most important book, Steps to an Ecology of Mind, was finally re-edited in 2000. In the same year, Tim Ingold’s book, The Perception of the Environment, which takes up many of Bateson’s preocupations, was released. This essay proposes that these two events represent important steps towards an "ecological paradigm", which attempts to answer some of anthropology’s dilemas, and open up perspectives for interdisciplinary dialogue on new terms.

  4. Paradigmas de los efectos de las TIC en la cultura y en el conocimiento 

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    O Velarde

    2015-05-01

    Full Text Available Introducción. Los usos sociales de las nuevas tecnologías de la información y de la comunicación (TIC están transformando la cultura y el conocimiento. Este artículo analiza cómo se interpretan esas transformaciones y sus consecuencias, en la bibliografía científica y académica. Metodología. La investigación se basa en un análisis de contenido procedente de una muestra representativa de dicha bibliografía. Resultados. Se describe el repertorio de efectos culturales y cognitivos atribuidos a las aplicaciones de las TIC. Los argumentos contenidos en esas descripciones son las unidades que se analizan con metodologías sistémicas. Se muestra que tales descripciones se pueden transferir a tipologías, cuyos componentes y relaciones son representados en modelos. Conclusiones. En esos modelos se explica cómo los colectivos científicos configuran la producción de conocimiento referida a los efectos culturales y cognitivos de las TIC. Y se comprueba que los modelos enlazan con unos paradigmas determinados de las ciencias de la comunicación.

  5. Los límites del paradigma estratégico israelí

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    Guillem Colom

    2011-05-01

    Full Text Available Este artículo repasa la evolución del paradigma estratégico israelí desde la creación del Estado de Israel en 1948 hasta la guerra de verano de 2006, un conflicto cuyo desenlace no sólo puso de manifiesto la erosión del modelo de ciudadano-soldado vigente hasta la fecha, la inadecuación de los tradicionales planteamientos estratégicos al nuevo entorno regional, o las carencias operativas de unas fuerzas armadas orientadas al mantenimiento de la supremacía militar convencional hebrea en Oriente Medio; sino también reveló el nuevo rostro de la guerra. Todos estos elementos están comportando una redefinición de la política de seguridad y defensa israelí para adaptarla a la nueva situación estratégica de la región.

  6. El paradigma de las competencias hacia la educación superior

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    Hernando Rodríguez Zambrano

    2007-01-01

    Full Text Available En el presente artículo trabaja el paradigma de las competencias en el ámbito de la educación superior, haciendo un recorrido exploratorio de la concepción y defi nición del término de competencia y el estado del arte desde diferentes visiones, estas defi nen las diversas clases de competencias y sus tendencias en los campos laboral y educativo. Con ello, se busca una aproximación a las siguientes preguntas: ¿qué es una competencia?, ¿qué es una competencia académica?, ¿qué es una competencia laboral?, ¿cuáles son los atributos de la competencia?, ¿cuáles son las evidencias que demuestran las competencias?, ¿cuáles son los indicadores o criterios de comparación del desempeño?, ¿cuál es la ventaja competitiva con el uso de las competencias?, entre otra

  7. El humanismo como paradigma de la enfermería como ciencia

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    Núñez Gómez Nicolás Arturo

    1999-12-01

    Full Text Available

    Humanism's philosophical conception is presented to development a paradigm of nursing science. The nursing from creation has been guided toward professional practice and category; of Care has been fundamental contribution. In this article our intends is to grow some fine general of reflection so that nurses contribute to development of a science called nursing and whose accent is man in their multiple dimensions.

    A partir del humanismo como concepción filosófica se presenta una propuesta para crear un paradigma de la enfermería como ciencia. Desde su creación, la enfermería se ha orientado hacia su práctica profesional y la categoría de cuidado ha sido su aporte fundamental. Este artículo se propone crear unas líneas generales de reflexión, para que las enfermeras aporten al desarrollo de una ciencia llamada enfermería y cuyo acento es el hombre en sus múltiples dimensiones.

  8. crítica al paradigma económico moderno

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    Liliana Olarte Rodríguez

    2005-01-01

    Full Text Available Luego de publicarse, Walden Dos sería rechazado a causa de falsas concepciones que sugerían que la obra era la defensa y representación de los valores sociales y económicos capitalistas. Sin embargo, un análisis detallado muestra cómo la edificación de la sociedad propuesta por Skinner critica los pilares fundamentales del paradigma económico y social actual, como lo son el egoísmo como base para el bienestar social, el consumismo como motor económico y la “libertad” según el capitalismo. Si bien Walden Dos no deja de ser una utopía, deja entrever que es necesario implementar los principios de la ingeniería de conducta, aspecto poco considerado por disciplinas como la economía, la ciencia política, entre otras, si se quieren resolver las falencias del sistema actual.

  9. Un nuevo paradigma latinoamericano en la regulación de la comunicación

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    Romel Jurado Vargas

    2010-12-01

    Full Text Available El trabajo propone la idea de que en realidad la región está interpelando el paradigma vigente, no solo porque éste, encarnado en la interpretación hegemónica del capitalismo individualista acerca de la libertad de expresión y universalizado a partir de la Declaración de Derechos Humanos, es insuficiente para procesar los conflictos, necesidades y demandas contemporáneas relacionadas con la comunicación y el desarrollo de los pueblos en el marco de la democracia y el Estado de Derecho, sino también porque no ha variado el estado de cosas en relación a las problemáticas, dependencias y exclusiones generadas en y desde el ámbito de la comunicación social desde hace 40 años, siendo que desde los 80 esta situación se consideraba inaceptable en Naciones Unidas, reclamándose un cambio urgente y radical.

  10. Weber no Século XXI: Desafios e Dilemas de um Paradigma Weberiano

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    Carlos Eduardo Sell

    2014-03-01

    Full Text Available Después de décadas de intensivo trabajo de exegesis de la obra de Weber, una amplia investigación realizada en Alemania sobre este autor condujo a la caracterización de su obra en torno al tema de la racionalización. A partir de este presupuesto, una nueva generación de investigadores viene intentando formular una propuesta de actualización de la teoría weberiana, por medio de su confrontación con los principales problemas de análisis de la sociología contemporánea. ¿Cuáles son las características del "paradigma weberiano" y cómo evaluarlo en términos de agenda teórica contemporánea? Con base en estas cuestiones, se examina, en primer lugar, cómo el programa de investigación weberiano se inserta en la disputa alrededor de la articulación entre agencia (plano micro y estructura (macro en la teoría social. El segundo eje de análisis trata la teoría de la modernidad y evalúa el intento de sus intérpretes de desplegar las investigaciones weberianas del plano de la génesis al plano de la diversificación de la modernidad (modernidades múltiples.

  11. Temporal naturalism

    Science.gov (United States)

    Smolin, Lee

    2015-11-01

    Two people may claim both to be naturalists, but have divergent conceptions of basic elements of the natural world which lead them to mean different things when they talk about laws of nature, or states, or the role of mathematics in physics. These disagreements do not much affect the ordinary practice of science which is about small subsystems of the universe, described or explained against a background, idealized to be fixed. But these issues become crucial when we consider including the whole universe within our system, for then there is no fixed background to reference observables to. I argue here that the key issue responsible for divergent versions of naturalism and divergent approaches to cosmology is the conception of time. One version, which I call temporal naturalism, holds that time, in the sense of the succession of present moments, is real, and that laws of nature evolve in that time. This is contrasted with timeless naturalism, which holds that laws are immutable and the present moment and its passage are illusions. I argue that temporal naturalism is empirically more adequate than the alternatives, because it offers testable explanations for puzzles its rivals cannot address, and is likely a better basis for solving major puzzles that presently face cosmology and physics. This essay also addresses the problem of qualia and experience within naturalism and argues that only temporal naturalism can make a place for qualia as intrinsic qualities of matter.

  12. Prevalence of the middle mesial canal in non surgical root canal treated mandibular first and second molars in a local military population

    Science.gov (United States)

    2016-06-13

    or second mandibular molar), sex, and age. Materials and Methods Approximately 7, 000 dental records in paper chart format were reviewed at a...Army Post Graduate Dental School Douglas D. Lancaster, COL, DC 3 August 2016 Prevalence of the middle mesial canal in non-surgical root canal...Methods: 7000 dental records were reviewed for non-surgical root canals performed from October 1970 to October 2015. The data collected included

  13. AN INVESTIGATION OF IMPLICIT MEMORY THROUGH LEFT TEMPORAL LOBECTOMY FOR EPILEPSY

    Science.gov (United States)

    Tracy, Joseph I.; Osipowicz, Karol; Godofsky, Samuel; Shah, Atif; Khan, Waseem; Sharan, Ashwini; Sperling, Michael R.

    2012-01-01

    Temporal lobe epilepsy patients have demonstrated a relative preservation in the integrity of implicit memory procedures. We examined performance in a verbal implicit and explicit memory task in left anterior temporal lobectomy patients (LATL) and healthy normal controls (NC) while undergoing fMRI. We hypothesized that despite the relative integrity of implicit memory in both the LATL patients and normal controls, the two groups would show distinct functional neuroanatomic profiles during implicit memory. LATLs and NCs performed Jacoby’s Process Dissociation Process (PDP) procedure during fMRI, requiring completion of word stems based on the previously studied words or new/unseen words. Measures of automaticity and recollection provided uncontaminated indices of implicit and explicit memory, respectively. The behavioral data showed that in the face of temporal lobe pathology implicit memory can be carried out, suggesting implicit verbal memory retrieval is non-mesial temporal in nature. Compared to NCs, the LATL patients showed reliable activation, not deactivation, during implicit (automatic) responding. The regions mediating this response were cortical (left medial frontal and precuneus) and striatal. The active regions in LATL patients have the capacity to implement associative, conditioned responses that might otherwise be carried out by a healthy temporal lobe, suggesting this represented a compensatory activity. Because the precuneus has also been implicated in explicit memory, the data suggests this structure may have a highly flexible functionality, capable of supporting implementation of either explicit memory, or automatic processes such as implicit memory retrieval. Our data suggest that a healthy mesial/anterior temporal lobe may be needed for generating the posterior deactivation perceptual priming response seen in normals. PMID:22981890

  14. Autobiographical memory in temporal lobe epilepsy: role of hippocampal and temporal lateral structures.

    Science.gov (United States)

    Herfurth, Kirsten; Kasper, Burkhard; Schwarz, Michael; Stefan, Hermann; Pauli, Elisabeth

    2010-11-01

    The present study was aimed at investigating the impact of hippocampal and temporal cortical lesions on remote autobiographical memories in temporal lobe epilepsy (TLE). Episodic specificity, episodic richness, and personal semantic memory from different life periods were assessed using a modified version of the Autobiographical Memory Interview (AMI) (M.D. Kopelman, A.E. Wilson, A. Baddeley, The autobiographical memory interview. Bury St. Edmunds: Thames Valley Test Co.; 1990) in 47 patients with unilateral mesial or lateral TLE and 38 healthy controls. Patients with TLE performed significantly more poorly than controls. Patients with left and right mTLE were equally moderately impaired, but patients with left lateral TLE had the most severe episodic memory deficits, particularly for childhood memories. With respect to personal semantic memory, patients with left TLE were significantly more impaired than those with right TLE, most pronounced for childhood memories. Both autobiographical memory aspects, episodic and personal semantic memory, were significantly intercorrelated, but both did not correlate with anterograde memory, indicating a structural dissociation between both functions. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Temporal contingency

    Science.gov (United States)

    Gallistel, C.R.; Craig, Andrew R.; Shahan, Timothy A.

    2015-01-01

    Contingency, and more particularly temporal contingency, has often figured in thinking about the nature of learning. However, it has never been formally defined in such a way as to make it a measure that can be applied to most animal learning protocols. We use elementary information theory to define contingency in such a way as to make it a measurable property of almost any conditioning protocol. We discuss how making it a measurable construct enables the exploration of the role of different contingencies in the acquisition and performance of classically and operantly conditioned behavior. PMID:23994260

  16. Temporal contingency.

    Science.gov (United States)

    Gallistel, C R; Craig, Andrew R; Shahan, Timothy A

    2014-01-01

    Contingency, and more particularly temporal contingency, has often figured in thinking about the nature of learning. However, it has never been formally defined in such a way as to make it a measure that can be applied to most animal learning protocols. We use elementary information theory to define contingency in such a way as to make it a measurable property of almost any conditioning protocol. We discuss how making it a measurable construct enables the exploration of the role of different contingencies in the acquisition and performance of classically and operantly conditioned behavior. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Preoperative MR imaging-based volume measurements of the hippocampal formation and anterior temporal lobe in epileptic patients

    International Nuclear Information System (INIS)

    Jack, C.R.; Sharbrough, F.W.; Twomey, C.; Zinsmeister, A.R.; Cascino, G.D.; Hirschorn, K.A.; Marsh, W.R.

    1989-01-01

    MR-based volume measurements of the anterior temporal lobe and hippocampal formation were performed in 36 patients who subsequently underwent surgery for medically refractory temporal lobe epilepsy. Seizure lateralization was based on standard clinical and electroencephalographic criteria. No surgical pathologic specimens contained structural lesions; epilepsy in these patients was therefore presumably due to mesial sclerosis. The right-minus-left hippocampal formation volume difference was greater than 0 in all 20 patients operated on the left side and less than 0 in all 16 patients operated on the right side. This difference completely separated the two surgical groups, while the same measurement in a group of 35 normal controls fell between the two surgical groups. Measurements of the anterior temporal to be showed a similar trend but incompletely separated controls, right- and left-sided epileptics. These results suggest that in a significant percentage of cases, MR-based volume measurements correctly identify the unilateral hippocampal atrophy that is known to occur in cases of mesial temporal sclerosis

  18. Evaluation of danger zone in mesial root of mandibular first molar by cone beam computed tomography (CBCT)

    International Nuclear Information System (INIS)

    Chang, Yoo Rhee; Choi, Yong Suk; Choi, Gi Woon; Park, Sang Hyuk

    2007-01-01

    To examine the danger zone of medial root of mandibular first molar of patient without extraction using CBCT (cone-beam computed tomography) to avoid the risk of root perforation. 20 mandibular first molars without caries and restorations were collected. CT images were obtained by CBCT (PSR9000N T M, Asahi Roentgen Co., Japan), reformed and analyzed by V-work 5.0 (CyberMed Inc., Korea). Distance between canal orifice and furcation was measured. In cross sectional images at 3, 4 and 5 mm below the canal office, distal wall thickness of central part (C-D), medial wall thickness of mesiobuccal canal (MB-M) and mesial wall thickness of mesiolongual canal (ML-M) were measured. The mean distance between the canal orifice and the furcation of the roots is 2.40 mm. Distal wall is found to be thinner than medial wall. Mean dentinal wall thickness of distal wall is about 1 mm. The wall thickness is thinner as the distance from the canal orifice is farther. But significant differences and not noted between 4 mm and 5 mm in MB-D and C-D. MB-D is thinner than ML-D although the differences is not significant. The present study confirmed the anatomical weakness of distal surface of the coronol part of the medial roots of mandibular first molar by CBCT and provided an anatomical guide line of wall thickness during endodontic treatment

  19. Detectability of Middle Mesial Root Canal Orifices by Troughing Technique in Mandibular Molars: A Micro-computed Tomographic Study.

    Science.gov (United States)

    Keleş, Ali; Keskin, Cangül

    2017-08-01

    The objective of the present study was to measure the orifice depth of middle mesial canals (MMCs) and evaluate the detectability of orifices using troughing preparation. For this study, 85 mandibular molar teeth with MMCs were selected from the scanned micro-computed tomographic images. The MMCs were categorized, and the distances between the MMC orifices and the cementoenamel junctions (CEJ) were recorded as the depth of the orifice. Data were evaluated with frequency analysis and a chi-square test using SPSS (SPSS Inc, Chicago, IL), and the results indicated a 5% significance level. It was found that 77.41% of the MMC orifices were at the CEJ level, whereas 5.38% and 9.69% of the MMC orifices were detectable within 1-mm and 2-mm depths from the CEJ, respectively. Of the specimens, 7.52% had MMC orifices deeper than 2 mm from the CEJ. Confluent anatomy was the most frequent configuration. No significant relation was detected between the orifice depth and MMC configuration (P > .05). It was concluded that 77.41% of the specimens did not require troughing preparation, the remaining 15.07% would require troughing, and 7.52% could not be accessed even with the troughing preparation. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  20. Dolor y modalidades físicas: un nuevo paradigma en fisioterapia

    Directory of Open Access Journals (Sweden)

    Marco Antonio Morales Osorio

    2014-01-01

    Full Text Available Las modalidades físicas son todas aquellas herramientas que posee el fisioterapeuta para intervenir con fines curativos; sin embargo, el aumento de las publicaciones científicas ha llevado a la necesidad de conocer la efectividad de estas modalidades en relación con el tratamiento del dolor. El objetivo de esta revisión fue entregar al lector conocimientos actualizados, referenciados y evidenciados sobre el dolor y la aplicación clínica de las modalidades físicas para su tratamiento. Se realizó una búsqueda de la mejor evidencia disponible para intentar responder la pregunta de investigación, la cual se sustenta en el paradigma que trae consigo la aplicación de las modalidades físicas más utilizadas (Crioterapia y Termoterapia, Ultrasonido Terapéutico, Laserterapia y Electroterapia. Hasta ahora el número de ensayos clínicos y revisiones sistemáticas que avalan el uso de las modalidades físicas para el manejo del dolor es muy limitado, sumado a la baja calidad metodológica de los ensayos clínicos disponibles. Muchos de los sustentos del uso de las modalidades físicas vienen acompañados de difusos fundamentos fisiológicos y sustento científico con demostraciones in vitro, mas no in vivo. A esto se le suma una limitada cantidad de información sobre los parámetros que se aplican para el manejo del dolor, por lo cual no es posible establecer conclusiones sobre la recomendación de la aplicación clínica de todas las modalidades físicas analizadas para el manejo del dolor.

  1. Nuevo paradigma normativo sobre la ciudad: Retornando a la ciudad tradicional

    Directory of Open Access Journals (Sweden)

    Tejedor, J.

    2015-03-01

    Full Text Available Spanish urbanism has been characterized historically for giving priority to the urban sprawl and new buildings. The attention to the existing urban space and buildings has been marginal in the legislation and slightly systematic in the practice. After the explosion of the real-estate bubble, but not only for this reason, the economic and financial reality of Spain, has turned into a priority the treatment of cities and buildings with new approaches, promoting integrated and energetically efficient urban regeneration, stimulating a new normative paradigm with the Act 8/2013, of June 26, regarding urban renewal, regeneration and renovation.El urbanismo español ha primado siempre el ensanche y la nueva edificación. La atención al tejido urbano y la edificación existentes ha sido marginal en la legislación y poco sistemática en la práctica. Tras la explosión de la burbuja inmobiliaria, pero no solo por esa razón, la realidad económica y financiera del país ha convertido en prioridad lo que era una necesidad, abordar con nuevos planteamientos el tratamiento de la ciudad y la edificación, promoviendo su regeneración integrada y energéticamente eficiente, impulsando un nuevo paradigma normativo mediante la Ley 8/2013, de 26 de junio, de rehabilitación, regeneración y renovación urbana.

  2. As relações de trabalho em uma empresa global: um novo paradigma ou neocorporativismo?

    Directory of Open Access Journals (Sweden)

    Arnaldo José França Mazzei Nogueira

    Full Text Available Este artigo trata das relações de trabalho em uma empresa global e foi resultado de pesquisa em uma montadora de caminhões instalada na região do ABC no Estado de São Paulo, Brasil. A empresa estudada apresenta um padrão dos mais avançados na dimensão organizacional das relações de trabalho ou no local de trabalho considerado o contexto brasileiro. A solução de conflitos do trabalho nesta empresa aponta fortemente para um padrão negocial em relação ao estatutário (Zylberstajn e Pastore, 1985, o que levou alguns autores a indicar um modo de cooperação-conflitiva para lidar com as relações de trabalho (Rodrigues, 1997 e uma via institucionalizada de inserção dos trabalhadores nos processos de inovação tecnológica e gerencial (Bresciani, 2002. O esquema montado dentro da empresa foi resultado da estratégia do sindicato no local de trabalho e da gestão da empresa em particular da gestão de recursos humanos. A análise da experiência permitiu verificar além de um paradigma avançado de relações de trabalho, a afirmação de uma tendência ao corporativismo societário ou neo-corporativismo em relação ao corporativismo estatal típico do sistema trabalhista brasileiro.

  3. MUDANÇAS DE PARADIGMAS NA GESTÃO DO PROFISSIONAL DE SECRETARIADO

    Directory of Open Access Journals (Sweden)

    Alzira da Silva Shimoura

    2010-09-01

    Full Text Available Neste mercado instável, com mudanças contínuas, torna-se necessário que os profissionais busquem, cada vez mais, qualificação e se preparem para uma competitividade avassaladora, buscando alternativas para o seu desenvolvimento. O profissional de secretariado evoluiu e se desenvolveu muito ao longo de uma trajetória de lutas e conquistas, incluindo a globalização e a revolução tecnológica. O perfil desse profissional mudou e, hoje, observa-se que ele atua como cogestor, empreendedor e consultor, trabalhando o operacional, mas com foco no resultado. A profissão conquistou muitas vitórias: promulgação das leis de regulamentação, código de ética, a criação da Federação Nacional das Secretárias e Secretários e Sindicatos de Classe no Brasil todo, entre outros. Mas, mesmo com toda essa evolução, ainda existem empresas e/ou gestores que não acreditam na mudança de paradigmas dessa profissão; julgam que o trabalho é o mesmo das décadas passadas. Assim, a presente pesquisa buscou investigar quais são as competências desejáveis a fim de que o profissional de secretariado contribua para a gestão de resultados da empresa.

  4. Teoria, conhecimento e pragmática da comunicação: o paradigma pulsional

    Directory of Open Access Journals (Sweden)

    Potiguara Mendes da Silveira Jr.

    2015-12-01

    Full Text Available Parte-se do estado da arte feito por Muniz Sodré (2012a sobre a abordagem acadêmica do campo comunicacional e a dificuldade para defini-lo em seu aspecto "científico". No intuito de prospectar além dos paradigmas identificados por Sodré (o sociológico, dos efeitos; e o semiótico, dos códigos, propõe-se o paradigma pulsional que orienta a Transformática, teoria psicanalítica da comunicação. PALAVRAS-CHAVE: Teorias da comunicação; Conhecimento; Psicanálise.   ABSTRACT According to the state of the art - made by Muniz Sodré (2012a - of  the academic approach of the communication field, there is a great difficulty in defining this field as "scientific". In order to examine beyond the two paradigms depicted by Sodré (sociological and semiotic this paper exposes the "drive (Freud: Trieb paradigm" which is the basis of Transformatics, the psychoanalytical theory of communication. KEYWORDS: Communication theories; Knowledge; Psychoanalysis.   RESUMEN Se inicia con el estado de la técnica hecha por Muniz Sodré (2012a en el enfoque académico del campo de la comunicación y la dificultad de definirla en su aspecto "científico". Con el fin de perspectiva más allá de los paradigmas identificados por Sodre (la sociológicos, los efectos y los semióticos, códigos, se propone paradigma instintivo que guía Transformática, la teoría psicoanalítica de la comunicación.  PALABRAS CLAVE: Teorías de la Comunicación; conocimiento; Psicoanálisis.   Referências ALONSO, Aristides. Aspectos do verbo Haver e seu uso na Nova Psicanálise. TranZ: Revista dos Estudos Transitivos do Contemporâneo, v. 5, 2010. Acessar: http://www.tranz.org.br/5_edicao/TranZ10-Aristides-VerboHaver-RevMD.pdf CUSA, Nicolau de. [1514] Deus é visto para lá da coincidência dos contraditórios e o seu ver é ser. In: A visão de Deus. Lisboa: Gulbenkian, 1988. p. 168-171 FREUD, S. [1930] Mal-estar na Civilização. ESB, vol. XXI. Rio de Janeiro: Imago, 1976

  5. NUEVO PARADIGMA EN LA GESTIÓN ORGANIZACIONAL: GESTIÓN DEL CONOCIMIENTO

    Directory of Open Access Journals (Sweden)

    William Boet Cisneros

    2003-09-01

    Full Text Available

    En este trabajo se presentan los resultados de una investigación exhaustiva, que tuvo la finalidad de proponer indicadores que permitieran medir el capital intangible de la organización. La motivación principal a la hora de emprender este trabajo estuvo condicionada por la ausencia de una metodología, con valores científicos apropiados para la selección de los indicadores del capital intangible (conocimientos en el Centro Universitario de Guantánamo. Para que el conocimiento se convierta en fuente de ventajas competitivas no basta con que exista, es necesario que se pueda capturar, crear, distribuir, almacenar, compartir y utilizar por los miembros de la organización, y es precisamente a través de la gestión del conocimiento, que se logran estos propósitos, de ahí la actualidad de este trabajo. El objeto de la investigación es dar respuesta a la hipótesis siguiente: Si se aprovechan las capacidades intelectuales de la organización, de forma que desarrolle su capacidad de aprendizaje, que potencie la innovación constante y la creación de nuevos conocimientos y que desarrolle los sistemas y la tecnología necesaria para ello, el Centro Universitario de Guantánamo estará en condiciones de afrontar los retos futuros, y asumir el nuevo paradigma, convertir el capital intelectual en capital financiero

    .

  6. A study using computerized tomography in the clinical practice of temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Yamamoto, Kunimitsu

    1982-01-01

    The author has studied about analysis of clinical data and CT findings examined conventional method for 50 cases of temporal lobe epilepsy and how to assess the foci of temporal lobe by CT. According to the examination of conventional neuroradiologic technique and routine work of CT for temporal lobe epilepsy, an extreme space occuping lesions were detected and marked cerebral atrophy, low density area in temporal lobe were found out, but, most of them were not able to detect foci of the temporal lobe and yet, the study of CT number based on the print out data did not give any precise informations about epileptogenic lesions of temporal lobe epilepsy. The method of reversed axial section CT was designed to photograph inferior horn of lateral ventricles with the purpose to delineate the hippocampus and amygdata, and precise pictures from autopsy brain and clinical cases were obtained by that method about scanning angle of reversed axial section CT, various angles are made an experiment on scanning, such as reversed 15 0 , 20 0 , 25 0 , 30 0 , 35 0 . Among them, it is proved that the reversed angle of almost 25 0 is most suitable to delineate mesial temporal structure, so as to say, foci of the temporal lobe. (J.P.N.)

  7. Políticas estatales y los paradigmas de la discapacidad: tres experiencias de producción cultural

    OpenAIRE

    Miranda Carvajal, Wilmer Wladimir

    2013-01-01

    Como académico y como persona que vive en condición de invidencia, me he sentido comprometido a estudiar expresiones culturales pensadas desde narrativas de personas en situación de discapacidad. Son narrativas que posibilitan la construcción de renovadores imaginarios, y ponen en escena las capacidades artísticas y creativas que compensan las dificultades físicas, sensoriales e intelectuales que una discapacidad significa. Así, busco reflexionar acerca de los paradigmas constr...

  8. A SA8000 e a responsabilidade social das empresas: a emergência de um novo paradigma?

    OpenAIRE

    Lopes, Ana Catarina Marques Figueiredo Caetano

    2004-01-01

    Mestrado em Desenvolvimento e Cooperação Internacional A Responsabilidade Social das Empresas, não é um tema novo. Durante muito tempo foi discutido e interpretado no âmbito do debate sobre as responsabilidades que uma empresa deve assumir para além daquelas que tem perante os seus accionistas, e das impostas por lei. Hoje, observamos a emergência de um novo paradigma assente no reconhecimento que o sector privado não só pode, mas deve, fazer mais para combater a pobreza, preservar o meio ...

  9. Paradigma Experimental en la Ingeniería de Software: Caso Programación en Pareja

    Directory of Open Access Journals (Sweden)

    Omar S. Gómez

    2013-08-01

    Full Text Available Contexto: La Ingeniería de Software (IS es una disciplina compleja donde a día de hoy el resultado de la aplicación de alguna tecnología para apoyar el desarrollo de software es impredecible. De manera similar a otras disciplinas ingenieriles, la IS requiere de construcción de modelos, experi-mentación y aprendizaje. La experimentación es un recurso va-lioso que permite evaluar de manera objetiva las distintas tecnologías disponibles para desarrollar software. Objetivo: Con la finalidad de promover el paradigma experimental en la IS, en este artículo se aplica el paradigma experimental para estudiar algunos efectos de la programación en pareja. Método: A través de un diseño experimental cuadrado latino con dos factores de bloqueo, se emplearon 21 estudiantes del programa de licen-ciatura en IS de la Universidad Autónoma de Yucatán (UADY para examinar la duración y esfuerzo que conlleva la progra-mación en pareja. Los estudiantes se agruparon en 7 parejas y 7 individuos donde codificaron durante dos sesiones dos programas pequeños. Resultados: Los resultados del experimento sugieren una diferencia significativa (en un nivel α=0.1 en favor de la programación en pareja con respecto a la duración de codi-ficación de los ejercicios asignados (28% decremento en tiempo. Por el contrario, los resultados sugieren una diferencia signifi-cativa (en un nivel α=0.1 en favor de la programación individual con respecto al esfuerzo (30% decremento en esfuerzo. Conclu-siones: En este artículo se presenta el paradigma experimental aplicado a la IS. A través del paradigma experimental es posible obtener observaciones de manera objetiva para acumular un cuerpo de conocimientos que pueda ser usado de manera confía-ble por profesionales en IS.

  10. Relaciones de gobernanza e innovación en la cadena de valor: nuevos paradigmas de competividad

    OpenAIRE

    Albors Garrigós, José; Hidalgo Nuchera, Antonio

    2012-01-01

    El objetivo de este trabajo es analizar la estructura de gobernanza de la cadena de valor territorial en el cluster cerámico español, a través de la comprensión de las funciones anteriores y actuales de los diversos sectores involucrados en el sistema de creación de valor. Por medio de un estudio de casos y el enfoque de la metodología cuantitativa, se explora el cambio de paradigma donde los actores tradicionales de la cadena de valor están perdiendo el control de su contribución al sistema ...

  11. Las crisis financieras y la evolución del paradigma en la práctica de las finanzas

    OpenAIRE

    Vargas Aguirre, Gildardo Adolfo; Universidad Autónoma de Aguascalientes; Díaz Flores, Manuel; Universidad Autónoma de Aguascalientes

    2016-01-01

    Este trabajo tiene como propósito reflexionar sobre las crisis financieras derivadas de la liberalización del sector financiero, y hace énfasis en elementos del paradigma que actualmente rige la práctica profesional en dicho sector. Para identificar los aspectos más importantes a discutir, se llevó a cabo una revisión bibliográfica, destacando sobre todo aquellas investigaciones históricas de las crisis financieras y algunos de los elementos teóricos utilizados para explicar este tipo de cris...

  12. Comprensión de la deprivación afectiva a partir del paradigma fenomenológico - existencial

    OpenAIRE

    Ricardo Arturo Jaramillo Moreno; Mercedes Claudia García Escallon

    2007-01-01

    El maltrato infantil y específicamente la deprivación afectiva es una práctica validada y trasmitida al interior de distintos núcleos sociales, la familia, la escuela y el estado, lo anterior aumenta la necesidad de tomar medidas que permitan actualizar y ampliar los actuales paradigmas que le explican y comprenden. En el presente artículo se propone la comprensión de la deprivación afectiva como una forma de maltrato infantil que va en deterioro del desarrollo, potencializacio...

  13. Determinantes del salario en Chile. Un análisis desde el paradigma de la reproducción social

    Directory of Open Access Journals (Sweden)

    Rodrigo, Luis Miguel

    2015-12-01

    Full Text Available We use the sociological paradigm of Social Reproduction, proposed by the work of Pierre Bourdieu, to explain the wage gap in Chile, in opposition to the Neoclassical economic paradigm, currently hegemonic in the analysis of wage differentials. We expose and compare both theoretical paradigms and describe the case study highlighting the peculiarities of the Chilean neoliberal model. We estimate the salary of the Chilean population in order to explain the explanatory capacity of both theoretical approaches. We estimate two statistical models using the National Socioeconomic Characterization survey (CASEN 2009, firstly, the Neoclassical model based on Mincer equations and, secondly, a model that tries to empirically capture the explanatory factors specific to the paradigm of Social Reproduction. The results indicate that, in the case of Chile, the Reproductive model has greater explanatory power than the Neoclassical model, both for the whole group of workers, and for each of the generations of this group.Frente al paradigma económico neoclásico, hegemónico en la explicación del salario, se presenta el paradigma sociológico de la Reproducción Social, a partir de la obra de Pierre Bourdieu, para dar cuenta de la diferencia salarial en Chile. Después de exponer y comparar ambos paradigmas teóricos, se describe el caso de estudio, destacando las peculiaridades del modelo neoliberal chileno. Para comparar la capacidad explicativa de ambos enfoques, se estima el salario de los chilenos mediante la encuesta de Caracterización Socioeconómica Nacional 2009 (CASEN a partir de dos modelos estadísticos, el modelo neoclásico basado en las ecuaciones de Mincer y un modelo que trata de capturar empíricamente los factores explicativos propios del paradigma de la Reproducción Social. Los resultados indican que, en el caso de Chile, el modelo Reproductivo tiene mayor capacidad explicativa que el Neoclásico, tanto para el conjunto de los asalariados

  14. Dream recall frequency and content in patients with temporal lobe epilepsy.

    Science.gov (United States)

    Bentes, Carla; Costa, João; Peralta, Rita; Pires, Joana; Sousa, Paula; Paiva, Teresa

    2011-11-01

    To evaluate morning dream recall frequency and content in patients with temporal lobe epilepsy (TLE). Fifty-two patients with pharmacoresistant TLE submitted to a written dream diary during five consecutive days and continuous video-electroencephalographic (video-EEG) monitoring. A matched control group of 41 healthy subjects completed the same diary at home. The number of recalled dreams (including long dreams) and nonrecalled dream mentation were collected, and the Dream Recall Rate (DRR) was calculated. Hall and Van de Castle dream content analysis was performed. Greater than 70% of patients with TLE (37 of 52) recall their dreams, but DRR rate in these patients is lower than in controls (p ≤ 0.001). Dream recall does not appear to be influenced by the presence of neuropsychological deficits nor seizure frequency. In dreams descriptions, TLE patients (vs. controls) have a higher percentage of familiarity in settings and fewer dreams with at least one success. Onirical activity of patients with TLE is different from that of healthy subjects. Our results support the role of mesial and neocortical temporal structures in dream experience. The selective activation of dysfunctional mesial structures may be responsible for some of the observed variability. However, dream content changes can also mirror social and psychological comorbidities of patients with epilepsy. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  15. Narrativa: problemas e promessas de um paradigma alternativo Narrative: problems and promises of an alternative paradigm

    Directory of Open Access Journals (Sweden)

    Jens Brockmeier

    2003-01-01

    Full Text Available O aumento de interesse no estudo da narrativa e seu contexto social sugere a emergência de outro caminho ao paradigma pós-positivista e um melhor refinamento da metodologia interpretativa nas ciências humanas. O problema do entendimento dos padrões dinâmicos do comportamento humano parece estar mais próximo de uma solução através dos estudos da narrativa do que até mesmo de abordagens bem conhecidas, como a utilização do modelo de regras e papéis. Nesse artigo, abordaremos algumas das qualidades que fizeram do estudo da narrativa uma abordagem produtiva. Procuramos definir a noção de narrativa e diferenciá-la de outros padrões de discurso, tendo como base estudos sócio-psicolingüísticos, filosóficos e literários. Procuramos também identificar algumas dificuldades teóricas e possíveis riscos dos quais os estudiosos da narrativa deveriam estar conscientes. Finalmente, esboçamos uma compreensão da narrativa que objetiva levar em conta sua condição particular de um discurso contextualizado e seu caráter aberto e transitório.The increasing interest in the study of narrative and its social contexts suggests the emergence of another strand to the post-positivist paradigm and a further refinement of interpretive methodology in the human sciences. The problem of accounting for the dynamic patterns of human behavior seems to be nearer to a solution through studies of narrative even than through such well-known approaches as the use of the role-rule model or script theory. In this paper we will look at some of the qualities that have made the study of narrative such a productive approach. In doing so, we shall define the notion of narrative and differentiate it from other patterns of discourse, drawing on socio- and psycholinguistics as well as on literary and philosophical studies. A second concern will be to identify some theoretical difficulties and possible dangers of which, we believe, students of narrative should be

  16. Os paradigmas da enfermagem obstétrica The nurse-midwifery paradigms

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    Ruth Hitomi Osava

    1997-04-01

    Full Text Available Descreve-se a trajetória da prática de atenção ao parto na Inglaterra e Estados Unidos da América, privilegiando-se as relações entre a incipiente profissão de enfermeira e a tradicional profissão de parteira, ao longo dos séculos XVIII e XIX. Propõe-se o estudo dessas relações adotando as deusas da mitologia grega como figuras arquetípicas do comportamento feminino. Relaciona a enfermeira à, deusa Atenas , protetora das artes, das cidades, dos valores patriarcais, do status quo - a personificação do arquétipo da filha do pai - e a parteira tradicional à, Ártemis, deusa da caça e da lua, protetora dos ermos, dos fracos e dos jovens - a personificação do arquétipo da grande irmã. Sob esta perspectiva, trata do declínio da prática da parte ira tradicional naqueles países. Finalmente , equaciona a questão do paradigma da enfermagem obstetra como algo a ser constituído em consonância e cumplicidade com o movimento organizado de mulheres e suas reivindicações no campo da saúde.The course of childbirth care practice in England and in the United States of America can be described by focusing on the relationship between the incipient nursing profession and the traditional profession of midwife, throughout the XVIIIth and the XIXth centuries. This paper proposes the study of such a relationship by adopting the Greek mythology goddesses as archetypical figures of female behavior. It relates the nurse to the goddess Athena, protector of the arts, the cities, the patriarcal values, the status quo - the personification of the father's daughter archetype - and the traditional midwife to Artemis, goddess of the hunt and the moon, protector of the wilderness, the weak, and the young - the personification of the great sister archetype. Under such a perspective, it deals with the decline of the traditional midwife practice in those countries. Finally, it poses the question of the obstetrics nursing pattern as something to be

  17. La antropología social española en los 80 como paradigma tardomoderno

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    Anta Félez, José-Luis

    2005-12-01

    Full Text Available In the end of the seventies and the decade of 80 in the XX Century are marked by a deep change in the structures and systems of the politics, the society and the Spanish economy, where it highlights the creation and consolidation of the Spain of the Autonomies. In this same period the social anthropology is devoted with profusion to sit down the bases of its own work, so much in the academi than institutionally. At the same cheats that it is centred in the systematic study of the differential reality of the Spain's century end, taking the topic of the identity central like. In this article it is meant to this process as tardomodem, to be able to arrive to a conformation of the history of the Spanish anthropology in syntony with the big contemporary paradigms and in consonance with the countries of our environment.

    El final de los años 70 y la década de los 80 del siglo XX están marcados por un cambio profundo en las estructuras y sistemas de la política, la sociedad y la economía españolas, donde destaca la creación y consolidación de la España de las Autonomías. En este mismo periodo la antropología social se dedica con profusión a sentar las bases de su propio trabajo, tanto académica como institucionalmente, a la par que se centra en el estudio sistemático de la realidad diferencial de la España finisecular, tomando como central el tema de la identidad. En este artículo se significa este proceso como tardomoderno, para poder llegar a una conformación de la historia de la antropología española en sintonía con los grandes paradigmas contemporáneos y en consonancia con los países de nuestro entorno.

  18. Por uma antropologia benjaminiana: repensando paradigmas do teatro dramático

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    John C. Dawsey

    2009-10-01

    Full Text Available Este ensaio se apresenta como um canteiro de obras benjaminiano. A justaposição de figuras aparentemente distantes em relações bruscas e surpreendentes talvez provoque estranhamento. Mas as afinidades são reveladoras. Nos remoinhos dos estudos de Michael Taussig, busco uma composição teórica em contraponto: de um lado, Victor Turner e Clifford Geertz, cujos escritos nos levam a pensar possivelmente numa espécie de paradigma do teatro dramático na antropologia e, de outro, duas figuras às margens da antropologia e do teatro dramático - Walter Benjamin e Bertolt Brecht. A força gravitacional do ensaio encontra-se nessas margens, especialmente na obra fragmentada de Benjamin. Trata-se de um ensaio por uma antropologia benjaminiana, que se organiza em torno de três alegorias: 1. espelho mágico; 2. estilhaçamento; e 3. lampejos. O percurso não deixa de sugerir a forma de um rito de passagem insólito: a passagem para uma condição de passagem.This essay is presented as a Benjaminian work site. The juxtaposition of apparently distant figures in brusque and surprising relations may well cause puzzlement. But the affinities are revealing. In the whirlpools of Michael Taussig's studies, I search for a theoretical composition in counterpoint: on one side, Victor Turner and Clifford Geertz, whose writings possibly lead us to think of a kind of paradigm of the dramatic theatre in anthropology, and, on the other, two figures on the margins of anthropology and the dramatic theatre - Walter Benjamin and Bertolt Brecht. The essay's gravitational force is located on these margins, especially the fragmented work of Benjamin. In short, this is an essay towards a Benjaminian anthropology, organized around three allegories: (1 magic mirror; (2 shattering; and (3 flashes of light. In some ways, the journey suggests the form of an unusual rite of passage: the passage towards a passing condition.

  19. Contribuciones del paradigma cultural latinoamericano a la comunicación para el desarrollo. Antecedentes, textos y contextos de una relación fecunda

    OpenAIRE

    Salazar Martínez, Rafael Ángel; Universidad de Holguín “Oscar Lucero Moya”,; Portal Moreno, Rayza; Universidad de La Habana; Fonseca Valido, Rafael Ángel; Universidad de Oriente

    2016-01-01

    Durante la década de 1980 se produce una ruptura en la investigación comunicológica latinoamericana, cuyo resultado fue el nacimiento de un nuevo paradigma que se apropia y hace uso de una concepción antropológica de la cultura, desde la cual comienzan a abordarse los procesos comunicativos. Las contribuciones de este paradigma a la comunicación para el desarrollo, campo que en América Latina ya contaba con una larga tradición, han resultado particularmente significativas. A examinar y discut...

  20. Temporal Glare

    DEFF Research Database (Denmark)

    Ritschel, Tobias; Ihrke, Matthias; Frisvad, Jeppe Revall

    2009-01-01

    Glare is a consequence of light scattered within the human eye when looking at bright light sources. This effect can be exploited for tone mapping since adding glare to the depiction of high-dynamic range (HDR) imagery on a low-dynamic range (LDR) medium can dramatically increase perceived contra...... to initially static HDR images. By conducting psychophysical studies, we validate that our method improves perceived brightness and that dynamic glare-renderings are often perceived as more attractive depending on the chosen scene.......Glare is a consequence of light scattered within the human eye when looking at bright light sources. This effect can be exploited for tone mapping since adding glare to the depiction of high-dynamic range (HDR) imagery on a low-dynamic range (LDR) medium can dramatically increase perceived contrast....... Even though most, if not all, subjects report perceiving glare as a bright pattern that fluctuates in time, up to now it has only been modeled as a static phenomenon. We argue that the temporal properties of glare are a strong means to increase perceived brightness and to produce realistic...

  1. Síndrome de personalidade interictal na epilepsia do lobo temporal não-dominante: relato de caso Interictal personality syndrome in temporal lobe epilepsy: case report

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    PAULO C. TREVISOL-BITTENCOURT

    2000-06-01

    Full Text Available A síndrome de personalidade interictal na epilepsia do lobo temporal não-dominante consiste de hipossexualidade, hiperreligiosidade, alteração do humor e hipergrafia. Sua descrição, em 1974, foi seguida de extensa busca por estes sinais em uma vasta população de pacientes epilépticos. No entanto, estes estudos científicos fracassaram em encontrar este síndrome na epilepsia do lobo temporal em geral. Sua existência foi, por conseguinte, posta em dúvida. Apresentamos o caso de um senhor de 35 anos cuja peculiaridade hipergráfica é o desenho de plantas de construção civil em grande quantidade, além de hiperreligiosidade, hipossexualidade e circunstancialidade. É o primeiro relato deste tipo de expressão gráfica associada à epilepsia parcial complexa e esclerose mesial temporal. Dentre os mecanismos fisiopatológicos propostos, o mais coerente é o da hiperconexão temporal. Embora as crises possam ser controladas em grande parte dos casos com tratamento clínico ou cirúrgico, a sintomatologia comportamental é refratária ao tratamento psicoterápico.The syndrome of interictal personality in non-dominant temporal lobe epilepsy consists of hyposexuality, hyperreligiosity, humorlessness and hypergraphia. Its notification, in 1974, was followed by an extensive search for these traits in broad epileptic populations. Nevertheless, these statistical studies failed to match this syndrome in general temporal lobe epileptics, and its existence became then target of doubt. We report the case of a 35 year-old man presenting partial complex epilepsy, whose singularity lies in his sophisticated drawing abilities. The large amount of buildings and houses he paints expresses his hypergraphia. He also presents hyposexuality and hyperreligiosity. MRI shows right mesial temporal sclerosis. Temporal hyperconnection, caused by a basal temporal irritative focus, is the most probable pathophysiological mechanism. Epileptic fits can be controlled

  2. La necesidad de unificar la psicología: El paradigma de la síntesis experimental del comportamiento

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    Rubén Ardila

    2003-01-01

    Full Text Available Se analizan los orígenes de la psicología en las preocupaciones iniciales del hombre acerca de su comportamiento y del de las demás personas. Tales problemas interesaron a pensadores tan disímiles como Aristóteles, Kant, Wundt, Freud, Watson, Piaget y Skinner. El paso de los problemas psicológicos de la metafísica a la ciencia representó una importante revolución conceptual. En psicología se ha enfatizado en los últimos cien años la objetividad científica y la experimentación. Una de las alternativas más importantes desde el punto de vista metodológico ha sido el operacionalismo, cuyos elementos positivos y negativos se analizan. Las ‘escuelas’ psicológicas —análogas a los paradigmas de Kuhn— han representado diferentes marcos conceptuales sobre la naturaleza de la psicología. Hoy no hay escuelas sino sistemas, más reducidos y menos dogmáticos. Se considera que la síntesis experimental del comportamiento, cuyas características se presentan, puede llegar a ser un paradigma unificador para toda la psicología

  3. Nuevos paradigmas científicos y su incidencia en la investigación jurídica

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    Andrés Botero Bernal

    2004-01-01

    Full Text Available En este artículo se estudian las nuevas propuestas epistémicas que se enfrentan al paradigma de lafragmentación, y se describen las consecuencias que ellas tendrían para la investigación jurídica. Además, se analizan teorías como la complejidad, el paradigma de las inteligencias múltiples, la investigación por problemas y no por territorios del saber deforma tal que confluyan todas las disciplinas posibles para eladecuado manejo investigativo de una pregunta planteada, la nueva unión de las disciplinas ya sean en una vuelta a Grecia (lafilosofía como unión del saber o una disminución del número de saberes propuestos, la unión entre la teología y el saber y, por último, la especialización sin fragmentación

  4. Comprensión de la deprivación afectiva a partir del paradigma fenomenológico - existencial

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    Ricardo Arturo Jaramillo Moreno

    2007-01-01

    Full Text Available El maltrato infantil y específicamente la deprivación afectiva es una práctica validada y trasmitida al interior de distintos núcleos sociales, la familia, la escuela y el estado, lo anterior aumenta la necesidad de tomar medidas que permitan actualizar y ampliar los actuales paradigmas que le explican y comprenden. En el presente artículo se propone la comprensión de la deprivación afectiva como una forma de maltrato infantil que va en deterioro del desarrollo, potencializacion del ser humano y restricción de la dimensión espiritual, facilitando la vulnerabilidad frente a la salud y el bienestar. Este término hace referencia a la carencia de un vínculo sano y suficiente, que garantice un desarrollo integral adecuado. Las causas y consecuencias han sido ampliamente señaladas; aunque se pasa por alto, las restricción de capacidades propiamente humanas, siendo estas producto de una serie de situaciones externas e internas que caracterizan y hacen particular cada historia de maltrato; por ello, la comprensión de este evento se hará desde una perspectiva humanista existencial más específicamente desde el análisis existencial, la logoterapia y la terapia gestalt, hasta llegar a un propuesta de intervención a partir del mentado paradigma.

  5. Imaging structural and functional brain networks in temporal lobe epilepsy

    Science.gov (United States)

    Bernhardt, Boris C.; Hong, SeokJun; Bernasconi, Andrea; Bernasconi, Neda

    2013-01-01

    Early imaging studies in temporal lobe epilepsy (TLE) focused on the search for mesial temporal sclerosis, as its surgical removal results in clinically meaningful improvement in about 70% of patients. Nevertheless, a considerable subgroup of patients continues to suffer from post-operative seizures. Although the reasons for surgical failure are not fully understood, electrophysiological and imaging data suggest that anomalies extending beyond the temporal lobe may have negative impact on outcome. This hypothesis has revived the concept of human epilepsy as a disorder of distributed brain networks. Recent methodological advances in non-invasive neuroimaging have led to quantify structural and functional networks in vivo. While structural networks can be inferred from diffusion MRI tractography and inter-regional covariance patterns of structural measures such as cortical thickness, functional connectivity is generally computed based on statistical dependencies of neurophysiological time-series, measured through functional MRI or electroencephalographic techniques. This review considers the application of advanced analytical methods in structural and functional connectivity analyses in TLE. We will specifically highlight findings from graph-theoretical analysis that allow assessing the topological organization of brain networks. These studies have provided compelling evidence that TLE is a system disorder with profound alterations in local and distributed networks. In addition, there is emerging evidence for the utility of network properties as clinical diagnostic markers. Nowadays, a network perspective is considered to be essential to the understanding of the development, progression, and management of epilepsy. PMID:24098281

  6. Imaging structural and functional brain networks in temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Boris eBernhardt

    2013-10-01

    Full Text Available Early imaging studies in temporal lobe epilepsy (TLE focused on the search for mesial temporal sclerosis, as its surgical removal results in clinically meaningful improvement in about 70% of patients. Nevertheless, a considerable subgroup of patients continues to suffer from post-operative seizures. Although the reasons for surgical failure are not fully understood, electrophysiological and imaging data suggest that anomalies extending beyond the temporal lobe may have negative impact on outcome. This hypothesis has revived the concept of human epilepsy as a disorder of distributed brain networks. Recent methodological advances in non-invasive neuroimaging have led to quantify structural and functional networks in vivo. While structural networks can be inferred from diffusion MRI tractography and inter-regional covariance patterns of structural measures such as cortical thickness, functional connectivity is generally computed based on statistical dependencies of neurophysiological time-series, measured through functional MRI or electroencephalographic techniques. This review considers the application of advanced analytical methods in structural and functional connectivity analyses in TLE. We will specifically highlight findings from graph-theoretical analysis that allow assessing topological organization of brain networks. These studies have provided compelling evidence that TLE is a system disorder with profound alterations in local and distributed networks. In addition, there is emerging evidence for the utility of network properties as clinical diagnostic markers. Nowadays, a network perspective is considered to be essential to the understanding of the development, progression, and management of epilepsy.

  7. Imaging structural and functional brain networks in temporal lobe epilepsy.

    Science.gov (United States)

    Bernhardt, Boris C; Hong, Seokjun; Bernasconi, Andrea; Bernasconi, Neda

    2013-10-01

    Early imaging studies in temporal lobe epilepsy (TLE) focused on the search for mesial temporal sclerosis, as its surgical removal results in clinically meaningful improvement in about 70% of patients. Nevertheless, a considerable subgroup of patients continues to suffer from post-operative seizures. Although the reasons for surgical failure are not fully understood, electrophysiological and imaging data suggest that anomalies extending beyond the temporal lobe may have negative impact on outcome. This hypothesis has revived the concept of human epilepsy as a disorder of distributed brain networks. Recent methodological advances in non-invasive neuroimaging have led to quantify structural and functional networks in vivo. While structural networks can be inferred from diffusion MRI tractography and inter-regional covariance patterns of structural measures such as cortical thickness, functional connectivity is generally computed based on statistical dependencies of neurophysiological time-series, measured through functional MRI or electroencephalographic techniques. This review considers the application of advanced analytical methods in structural and functional connectivity analyses in TLE. We will specifically highlight findings from graph-theoretical analysis that allow assessing the topological organization of brain networks. These studies have provided compelling evidence that TLE is a system disorder with profound alterations in local and distributed networks. In addition, there is emerging evidence for the utility of network properties as clinical diagnostic markers. Nowadays, a network perspective is considered to be essential to the understanding of the development, progression, and management of epilepsy.

  8. Temporal lobe epilepsy: etiology, fisiopathogeny and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Michaux, Ruben P.

    2003-01-01

    The seizures constitute one of the first causes of consultation in neurology and medical emergencies in all etary groups. The partial seizures are the most frequent form of clinical presentation specially those originated in the temporal lobes. In this revision article the author offers an update of the fisiopathogeny, the etiology and MRI findings in temporal epilepsy, and actualizes concepts derived from basic sciences. Selected cases of frequent pathologic causes contribute to illustrate this paper. In the physiopathology of the generalized seizures, alterations of the nets or thalamus cortical neuronal circuits and anomaly in the ionic canals functions have been demonstrated; in the partial seizures, particularly in the Mesial Temporal Sclerosis, alterations in the conformation of excitatory neo circuits have been verified. There are evidences of specific genetic seizures that express or appear sometime after birth, and others acquired, in which there is a variable time lapse between the action of a determined noxa and the installation of the clinical status, which suggest the existence of an epileptogenic mechanism as a gradual process in its development, and open a promissory field of investigation in search of preventive therapies. In many cases of acquired lesions seizures are related to the excitotoxicity mediated by glutamate as a possible trigger of the process. Besides, neuronal division has been demonstrated in the hippocampus, which could explain a neurogenic mechanism in the development of the seizures. The pathologic molecular findings in cortical malformations and the function of the glial cells in the neuronal homeostasis, contribute with data that sustain the neuro genesis of the seizures. The MRI provides a valuable information in Mesial Temporal Sclerosis, CNS tumoral lesions, neuronal migration disorders, vascular malformation, trauma and infections. Conclusion. The knowledge derived from areas as molecular biology, genetic and

  9. Surgical and postmortem pathology studies: contribution for the investigation of temporal lobe epilepsy.

    Science.gov (United States)

    Caboclo, Luís Otávio Sales Ferreira; Neves, Rafael Scarpa; Jardim, Anaclara Prada; Hamad, Ana Paula Andrade; Centeno, Ricardo Silva; Lancellotti, Carmen Lucia Penteado; Scorza, Carla Alessandra; Cavalheiro, Esper Abrão; Yacubian, Elza Márcia Targas; Sakamoto, Américo Ceiki

    2012-12-01

    Pathology studies in epilepsy patients bring useful information for comprehending the physiopathology of various forms of epilepsy, as well as aspects related to response to treatment and long-term prognosis. These studies are usually restricted to surgical specimens obtained from patients with refractory focal epilepsies. Therefore, most of them pertain to temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) and malformations of cortical development (MCD), thus providing information of a selected group of patients and restricted regions of the brain. Postmortem whole brain studies are rarely performed in epilepsy patients, however they may provide extensive information on brain pathology, allowing the analysis of areas beyond the putative epileptogenic zone. In this article, we reviewed pathology studies performed in epilepsy patients with emphasis on neuropathological findings in TLE with MTS and MCD. Furthermore, we reviewed data from postmortem studies and discussed the importance of performing these studies in epilepsy populations.

  10. Surgical and postmortem pathology studies: contribution for the investigation of temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Luís Otávio Sales Ferreira Caboclo

    2012-12-01

    Full Text Available Pathology studies in epilepsy patients bring useful information for comprehending the physiopathology of various forms of epilepsy, as well as aspects related to response to treatment and long-term prognosis. These studies are usually restricted to surgical specimens obtained from patients with refractory focal epilepsies. Therefore, most of them pertain to temporal lobe epilepsy (TLE with mesial temporal sclerosis (MTS and malformations of cortical development (MCD, thus providing information of a selected group of patients and restricted regions of the brain. Postmortem whole brain studies are rarely performed in epilepsy patients, however they may provide extensive information on brain pathology, allowing the analysis of areas beyond the putative epileptogenic zone. In this article, we reviewed pathology studies performed in epilepsy patients with emphasis on neuropathological findings in TLE with MTS and MCD. Furthermore, we reviewed data from postmortem studies and discussed the importance of performing these studies in epilepsy populations.

  11. Etomidate accurately localizes the epileptic area in patients with temporal lobe epilepsy.

    Science.gov (United States)

    Pastor, Jesús; Wix, Rybel; Meilán, María Luisa; Martínez-Chacón, José Luís; de Dios, Eva; Domínguez-Gadea, Luis; Herrera-Peco, Iván; Sola, Rafael G

    2010-04-01

    A variety of drugs have been used to activate and identify the epileptogenic area in patients during presurgical evaluation. We have evaluated the safety and usefulness of etomidate in identifying the epileptic zone by measuring bioelectrical brain activity and cerebral blood flow (CBF). We studied 13 men and 9 women under presurgical evaluation for temporal lobe epilepsy. We applied etomidate (0.1 mg/kg) while patients were monitored by video-electroencephalography (VEEG) with foramen ovale electrodes. In a subset of 15 patients, we also measured CBF with single photon emission computed tomography (SPECT). (1) Etomidate induced seizures in 2 of 22 patients. (2) The main side-effects observed were myoclonus (14 of 20) and moderate pain (3 of 20). (3) No changes in capillary oxygen saturation, respiration, or heart rate were observed. (4) Irritative activity specifically increased in the temporal mesial and lateral areas. No spikes were observed in other areas, aside from those observed under baseline conditions. (5) Irritative activity induced by etomidate correctly lateralized the ictal onset zone in 19 of 20 patients. In addition, the two etomidate-induced seizures appeared in the same regions as spontaneous ones. (6) The kinetics of pharmacologically induced activity was higher in the region of the ictal-onset zone. (7) Etomidate increased the CBF in the basal ganglia and especially in the posterior hippocampus of the temporal mesial region contralateral to the ictal-onset zone. Etomidate activation is a safe, specific, and quick test that can be used to identify the epileptic region in patients evaluated as candidates for temporal lobe epilepsy surgery.

  12. Paradigmas, valores e educação Paradigms, values and education

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    Denis Domeneghetti Badia

    2009-08-01

    Full Text Available O texto levanta os perfis epistemológico e socianalítico da questão paradigmática. Mauss evidenciara o moule affectif das noções científicas de força e causa. Posteriormente Baudouin falaria na indução arquetípica das noções e a antropologia do imaginário de Durand concluiria pela indução arquetipal do conceito pela imagem. Chegava-se, assim, ao desvendamento do substrato inconsciente das ideações, de um substrato regido pela catexis vetorializada, traduzindo-se nos valores como cerne das ideações. É o famoso a priori emotivo. Portanto, no texto, questionam-se dois mitos, esteios da ciência clássica: o mito da objetividade científica e o da neutralidade axiológica. Destaca, assim, a falácia da existência de uma ruptura epistemológica entre ciência e ideologia. A partir daí, as ideações tornam-se ideologias, sobretudo nas ciências do homem e nas ciências da educação que, ademais, tornam-se suporte de uma disfarçada luta ideológica, na qual, num "colonialismo cognitivo", as estratégias de conhecimento dissimulam as de preconceito. Entretanto, assumir a realidade desse suporte fantasmanalítico e ideológico propicia uma tarefa educativa salutar: os paradigmas tornam-se fantasias e, nessa relativização crítica, podem ser usados como um campo de objetos transicionais coletivos num ludismo cultural e educativo. No policulturalismo da sociedade contemporânea, o "politeísmo de valores" de Weber transforma-se num "politeísmo epistemológico", regido pelo "relativismo ontológico" de Feyerabend e por uma ética do pragmatismo. Articulando cultura, organização e educação, a antropologia das organizações educativas e a culturanálise de grupos de Paula Carvalho traduzem as heurísticas dessa dialética transicional.The text draws the epistemological and socioanalytic profiles of the paradigmatic question. Mauss evinced the moule affectif of the scientific notions of force and cause. Later, Baudouin would

  13. Dinamika Tata Kelola Kebijakan Industri Penyiaran dan Telekomunikasi Indonesia Menuju Konvergensi: Sebuah Studi Paradigma Interpretatif

    Directory of Open Access Journals (Sweden)

    Vience Mutiara Rumata

    2017-03-01

    Konvergensi antara penyiaran dan telekomunikasi di Indonesia tidak terhindarkan seiring dengan perkembangan teknologi informasi dan komunikasi (TIK serta ketatnya persaingan dalam industri keduanya. Kedua industri telah mengintegrasi TIK sebagai nilai tambah dari layanan ataupun produk yang ditawarkannya. Meski demikian, tata kelola kedua industri ini masih terpisah yakni melalui UU Penyiaran tahun 2002 dan UU Telekomunikasi tahun 1999. Di saat RUU konvergensi telematika belum menemukan titik terang, regulator berupaya merevisi kedua UU tersebut. Studi ini merupakan penelitian deskriptif kualitatif dengan kerangka paradigma interpretatif dengan berlandaskan teori neo-institusionalisme, yakni historical institutionalism. Studi ini bertujuan untuk memahami relasi kekuasaan serta pandangan para pemangku kebijakan dalam mengatur industri penyiaran dan telekomunikasi di era konvergensi. Teknik pengumpulan data dilakukan dengan cara wawancara mendalam kepada narasumber yang dipilih secara purposif yakni Kemkominfo, KPI, BRTI, dan DPR, selama Januari-Februari 2015. Setiap institusi memiliki path dependence yang berbeda antar satu dengan yang lain, sehingga membentuk pola distribusi kekuasan berbeda dalam prosedur pembuatan kebijakan. Proposal revisi UU baik dari Kemkominfo dan KPI tidak mengatur hal-hal yang berkaitan dengan konvergensi. Akan tetapi, perebutan otoritas antar kedua institusi tersebut justru menjadi fokus dalam proposal tersebut. Kemkominfo, sebagai inisiator UU Telekomunikasi, berencana untuk mengubah revisi UU tersebut menjadi UU konvergensi. Fokus utama revisi tersebut adalah upaya untuk memfasilitasi interkoneksi dan internetworking dalam infrastruktur digital sebagai fondasi ekosistem konvergensi.     Abstract The convergence between broadcasting and telecommunication in Indonesia is envitable as the growing information and communication technology and the growing competition in both industries. These industries have integrated ICT as part of their

  14. Quantum Temporal Imaging

    OpenAIRE

    Tsang, Mankei; Psaltis, Demetri

    2006-01-01

    The concept of quantum temporal imaging is proposed to manipulate the temporal correlation of entangled photons. In particular, we show that time correlation and anticorrelation can be converted to each other using quantum temporal imaging.

  15. Fabricação digital no Brasil e as possibilidades de mudança de paradigma no setor da construção civil

    Directory of Open Access Journals (Sweden)

    Marina Ferreira Borges

    Full Text Available Resumo A proposta deste trabalho é analisar as possibilidades trazidas pelas tecnologias digitais emergentes em projeto arquitetônico e produção no canteiro para uma mudança de paradigma no setor da construção civil. Como metodologia propõe-se utilizar teóricos da economia evolucionista, que colocam a inovação como um agente central para as mudanças de paradigmas, para visualizar as conexões entre firmas existentes no paradigma atual, a manufatura e as conexões que poderiam ser estabelecidas para um novo paradigma de produção por meio da fabricação digital. Para isso também será analisado o papel da universidade e seu potencial de inovação, tanto no sentido de desenvolver tecnologia de produtos, quanto de contextualizar a tecnologia que está sendo importada para um contexto regional, desenvolvendo processos de produção emancipatórios para a construção civil.

  16. ¿Hacia un paradigma cosmopolita? : pluralismo juridico, ciudadanía y resolución de conflictos. [Reseña

    OpenAIRE

    López-Bello, H. (Héctor)

    2009-01-01

    Reseña de: Nuria BELLOSO MARTÍN, Alfonso DE JULIOS-CAMPUZANO (coords,), ¿Hacia un paradigma cosmopolita? : pluralismo juridico, ciudadanía y resolución de conflictos. Instituto Internacional de Sociología Jurídica de Oñati, Dykinson, Madrid, 2008, 365 pp.

  17. Revision del proceso de la administracion estrategica, estudio del paradigma de estrategia, estructura y equifinalidad: una investigacion empirica en empresas en noreste de Mexico

    Directory of Open Access Journals (Sweden)

    Aguirre H.

    2005-01-01

    Full Text Available Esta investigación busca comprobar empíricamente el paradigma entre estrategiaestructura y equifinalidad en empresas del noreste de México. Se llevó al cabo un estudio a través de la aplicación de cuestionarios a negocios de esa parte del país. Se consideró como variable independiente la existencia del modelo de Chandler acerca de que la “estructura organizacional sigue a la estrategia”. La variable dependiente, se establece como la obtención de resultados equifinales (igualmente finales, con o sin la existencia del paradigma de estrategia-estructura. Dos contribuciones emergen de este estudio. La primera consiste en haber encontrado que efectivamente existe una relación entre estrategia y estructura en las empresas investigadas. La segunda, y más importante, es que se evidenció, con prueba empírica, el paradigma de equifinalidad. Se necesita mayor investigación para poder determinar las razones para el funcionamiento de este paradigma. La naturaleza holística de la Administración Estratégica puede ser la que explique el éxito final, “sin importar los inicios”.

  18. Assistência à mulher climatérica: novos paradigmas Atención a la mujer climatérica: nuevos paradigmas Assistance to the climacteric woman: new paradigms

    Directory of Open Access Journals (Sweden)

    Dino Roberto Soares De Lorenzi

    2009-04-01

    Full Text Available O envelhecimento populacional é uma realidade demográfica brasileira. Como conseqüência, espera-se, nos próximos anos, um aumento progressivo na procura dos serviços de saúde por mulheres com queixas relacionadas ao climatério. Paralelamente, a assistência ao climatério tem passado por uma modificação de paradigmas, impondo aos profissionais de saúde uma mudança de atitude. Reconhece-se que o climatério é influenciado tanto por fatores biológicos, como por fatores psicossociais e culturais, cujo conhecimento é fundamental para uma assistência mais qualificada e humanizada. Este artigo propõe refletir sobre as mudanças de paradigmas na assistência ao climatério, destacando a multidisciplinaridade e interdisciplinaridade, no sentido acolher melhor essa parcela da população e proporcionar-lhe um cuidado integral e individualizado, aproximando o saber da sensibilidade, voltado a uma melhor qualidade vida.Envejecimiento poblacional es una realidad demográfica brazilian. Consecuentementese espera un aumento progresivo de la búsqueda en los servicios de salud del país por mujeres con quejas relacionadas al climaterio. La asistencia al climaterio ha pasado por un cambio de paradigmas que han impuesto a los profesionales de la salud. El climaterio es influenciado por factores biológicos, factores psicosociales y culturales, cuyo conocimiento es fundamental para la planificación de una asistencia. Artículo se propone reflexionar sobre los cambios de paradigmas, el abordaje multidisciplinario e interdisciplinario, en el sentido de recibir mejor esta parcela de la población y proporcionarle un cuidado integral e individualizado, aproximando el saber de la sensibilidad, y el tener como objetivo a una mejor calidad de vida.Population aging is a demographic reality for Brazil. Consequently, in the next years it is expected a progressive increase in seeking health care services in the country by women with complaints related to

  19. Minimally invasive surgical approaches for temporal lobe epilepsy

    Science.gov (United States)

    Chang, Edward F.; Englot, Dario J.; Vadera, Sumeet

    2016-01-01

    Surgery can be a highly effective treatment for medically refractory temporal lobe epilepsy (TLE). The emergence of minimally invasive resective and nonresective treatment options has led to interest in epilepsy surgery among patients and providers. Nevertheless, not all procedures are appropriate for all patients, and it is critical to consider seizure outcomes with each of these approaches, as seizure freedom is the greatest predictor of patient quality of life. Standard anterior temporal lobectomy (ATL) remains the gold standard in the treatment of TLE, with seizure freedom resulting in 60–80% of patients. It is currently the only resective epilepsy surgery supported by randomized controlled trials and offers the best protection against lateral temporal seizure onset. Selective amygdalohippocampectomy techniques preserve the lateral cortex and temporal stem to varying degrees and can result in favorable rates of seizure freedom but the risk of recurrent seizures appears slightly greater than with ATL, and it is not clear whether neuropsychological outcomes are improved with selective approaches. Stereotactic radiosurgery presents an opportunity to avoid surgery altogether, with seizure outcomes now under investigation. Stereotactic laser thermo-ablation allows destruction of the mesial temporal structures with low complication rates and minimal recovery time, and outcomes are also under study. Finally, while neuromodulatory devices such as responsive neurostimulation, vagus nerve stimulation, and deep brain stimulation have a role in the treatment of certain patients, these remain palliative procedures for those who are not candidates for resection or ablation, as complete seizure freedom rates are low. Further development and investigation of both established and novel strategies for the surgical treatment of TLE will be critical moving forward, given the significant burden of this disease. PMID:26017774

  20. Familial temporal lobe epilepsy due to focal cortical dysplasia type IIIa.

    Science.gov (United States)

    Fabera, Petr; Krijtova, Hana; Tomasek, Martin; Krysl, David; Zamecnik, Josef; Mohapl, Milan; Jiruska, Premysl; Marusic, Petr

    2015-09-01

    Focal cortical dysplasia (FCD) represents a common cause of refractory epilepsy. It is considered a sporadic disorder, but its occasional familial occurrence suggests the involvement of genetic mechanisms. Siblings with intractable epilepsy were referred for epilepsy surgery evaluation. Both patients were examined using video-EEG monitoring, MRI examination and PET imaging. They underwent left anteromedial temporal lobe resection. Electroclinical features pointed to left temporal lobe epilepsy and MRI examination revealed typical signs of left-sided hippocampal sclerosis and increased white matter signal intensity in the left temporal pole. PET examination confirmed interictal hypometabolism in the left temporal lobe. Histopathological examination of resected tissue demonstrated the presence FCD type IIIa, i.e. hippocampal sclerosis and focal cortical dysplasia in the left temporal pole. We present a unique case of refractory mesial temporal lobe epilepsy in siblings, characterized by an identical clinical profile and histopathology of FCD type IIIa, who were successfully treated by epilepsy surgery. The presence of such a high concordance between the clinical and morphological data, together with the occurrence of epilepsy and febrile seizures in three generations of the family pedigree points towards a possible genetic nature of the observed FCD type IIIa. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  1. El nuevo paradigma de las ciencias y la teoría de gestión

    Directory of Open Access Journals (Sweden)

    Iván Alonso Montoya

    2016-05-01

    Full Text Available El presente artículo hace una revisión del cambio de paradigma desde la ciencia positiva a un enfoque más complejo de la misma, mediante un recorrido a través de diferentes autores y sus concepciones para llegar a nuevos enfoques más coherentes con los nuevos aportes desde diferentes áreas del conocimiento, como la física, la química y la biología. A partir del desarrollo histórico de la ciencia se muestra cómo ésta ha tenido que ajustar su método hacia uno más coherente con las nuevas problemáticas por modelar.

  2. Estudio cronológico de paradigmas para el diseño de almacenes de datos

    Directory of Open Access Journals (Sweden)

    Ania Cravero Leal

    2012-05-01

    Full Text Available Los almacenes de datos deben homogeneizar e integrar la información de las diversas áreas de una organización con el fin de extraer conocimiento relevante para la toma de decisiones. Su desarrollo no es tarea fácil, por lo cual se han desarrollado varios enfoques que se pueden clasificar de acuerdo con la forma como se obtienen los requisitos de información: impulsados por la oferta, por la demanda, e híbridos. Este estudio ofrece un marco conceptual y un estudio cronológico de los estos enfoques conforme al paradigma utilizado, lo que proporciona un amplio marco para comprender de mejor manera el estado actual en el área de los almacenes de datos, así como su evolución.

  3. Long-term seizure, cognitive, and psychiatric outcome following trans-middle temporal gyrus amygdalohippocampectomy and standard temporal lobectomy.

    Science.gov (United States)

    Bujarski, Krzysztof A; Hirashima, Fuyuki; Roberts, David W; Jobst, Barbara C; Gilbert, Karen L; Roth, Robert M; Flashman, Laura A; McDonald, Brenna C; Saykin, Andrew J; Scott, Rod C; Dinnerstein, Eric; Preston, Julie; Williamson, Peter D; Thadani, Vijay M

    2013-07-01

    Previous comparisons of standard temporal lobectomy (STL) and selective amygdalohippocampectomy (SelAH) have been limited by inadequate long-term follow-up, variable definitions of favorable outcome, and inadequate consideration of psychiatric comorbidities. The authors performed a retrospective analysis of seizure, cognitive, and psychiatric outcomes in a noncontemporaneous cohort of 69 patients with unilateral refractory temporal lobe epilepsy and MRI evidence of mesial temporal sclerosis after either an STL or an SelAH and examined seizure, cognitive, and psychiatric outcomes. The mean duration of follow-up for STL was 9.7 years (range 1-18 years), and for trans-middle temporal gyrus SelAH (mtg-SelAH) it was 6.85 years (range 1-15 years). There was no significant difference in seizure outcome when "favorable" was defined as time to loss of Engel Class I or II status; better seizure outcome was seen in the STL group when "favorable" was defined as time to loss of Engel Class IA status (p=0.034). Further analysis revealed a higher occurrence of seizures solely during attempted medication withdrawal in the mtg-SelAH group than in the STL group (p=0.016). The authors found no significant difference in the effect of surgery type on any cognitive and most psychiatric variables. Standard temporal lobectomy was associated with significantly higher scores on assessment of postsurgical paranoia (p=0.048). Overall, few differences in seizure, cognitive, and psychiatric outcome were found between STL and mtg-SelAH on long-term follow-up. Longer exposure to medication side effects after mtg-SelAH may adversely affect quality of life but is unlikely to cause additional functional impairment. In patients with high levels of presurgical psychiatric disease, mtg-SelAH may be the preferred surgery type.

  4. Nuevo paradigma, nuevo contexto institucional: el caso de la política farmacéutica

    Directory of Open Access Journals (Sweden)

    Laura Chaqués Bonafont

    2011-05-01

    Full Text Available El objetivo de este estudio es explicar cómo y por qué cambia la política farmacéutica española en la última década. En el se argumenta la relevancia de las instituciones como variables explicativa de la dinámica del cambio en las políticas siguiendo el esquema teórico planteado por el análisis de redes y la teoría del equilibrio interrumpido desarrollada por Baumgartner y Jones. La adopción de un nuevo paradigma en torno al medicamento –el uso racional del medicamento— no puede ser entendido únicamente como una respuesta a situaciones de crisis, cambios en el sistema político y/o la consolidación de ideas nuevas defendidas por activos emprendedores políticos. El análisis de la institucionalización de las relaciones de poder en torno a la política farmacéutica (o policy network es importante para explicar por qué los cambios en la política farmacéutica se producen de forma gradual como resultado de una negociación entre el Estado con la industria farmacéutica y las farmacias. Asimismo, se argumenta cómo la adopción de un paradigma nuevo en la política farmacéutica, se produce de forma paralela a un cambio en la estructura institucional de la política. En 2008 la política farmacéutica se gestiona a través de una red más abierta y plural, en la que los expertos tienen mayor peso en la toma de decisiones.

  5. El devenir de la modernidad: crisis del paradigma y acercamiento a una nueva epistemología social

    Directory of Open Access Journals (Sweden)

    Fernando Garrido Ferradanes

    2003-10-01

    Full Text Available En la primera parte del artículo desarrollaremos la tesis de la muerte de la modernidad por obra y gracia de su éxito absoluto. Por otra parte, creemos necesario, así mismo, realizar un análisis de la sociedad en la que nos vemos inmersos, la sociedad de la información, que realizaremos en la segunda parte del artículo. Nuestro argumento es que la globalización es una consecuencia de la modernidad, es más: supone el culmen, el éxito, el triunfo del proyecto modernizador. La modernidad se irradia desde Occidente y debido a su lógica interna es eminentemente expansionista. Ahora bien, cuando esa expansión es total la modernidad estalla, muere victima de su propio éxito. Todo esto se ve agudizado por un cambio de Paradigma, del Paradigma Industrial al Informacional, lo que nos legitima para hablar de la entrada en la Sociedad de la Información, donde la información es el motor de la engranaje, donde el conocimiento se refracta continuamente y se emplea en la re-generación de si mismo. En esta sociedad surge un nuevo actor social: La empresa-red, cuyo crecimiento, expansión y generalización implica el socavamiento de los Estado-nación, principales actores de la modernidad. En el presente artículo explicaremos y analizaremos el argumento anteriormente citado, y encontraremos que las consecuencias de la modernidad se han convertido en las características de la globalización: riesgo, información y reflexividad. A la luz de los teóricos actuales más relevantes intentaremos analizar este proceso de cambio social radical.

  6. Quantification of mu and non-mu opiate receptors in temporal lobe epilepsy using positron emission tomography.

    Science.gov (United States)

    Mayberg, H S; Sadzot, B; Meltzer, C C; Fisher, R S; Lesser, R P; Dannals, R F; Lever, J R; Wilson, A A; Ravert, H T; Wagner, H N

    1991-07-01

    Alterations in a variety of neurotransmitter systems have been identified in experimental models of epilepsy and in brain tissue from patients with intractable temporal lobe seizures. The availability of new high-affinity radioligands permits the study of some neuroreceptors in vivo with positron emission tomography (PET). We previously characterized the in vivo binding of 11C-carfentanil, a potent and selective mu opiate receptor agonist, and described increases in 11C-carfentanil binding in the temporal neocortex of patients with unilateral temporal lobe epilepsy. These studies have been extended to 11C-diprenorphine, which labels mu, kappa, and delta opiate receptor subtypes. Paired measurements of opiate receptor binding were performed with PET using 11C-carfentanil and 11C-diprenorphine in patients with unilateral temporal lobe seizures. Carfentanil binding, reflecting changes in mu opiate receptors, was increased in the temporal neocortex and decreased in the amygdala on the side of the epileptic focus. Diprenorphine binding, reflecting mu as well as non-mu opiate subtypes, was not significantly different among regions in the focus and nonfocus temporal lobes. Regional glucose metabolism, measured using 18F-2-fluoro-2-deoxyglucose, was decreased in the mesial and lateral aspects of the temporal lobe ipsilateral to the epileptogenic focus. The variation in pattern of carfentanil and diprenorphine binding supports a differential regulation of opiate subtypes in unilateral temporal lobe epilepsy.

  7. Towards General Temporal Aggregation

    DEFF Research Database (Denmark)

    Boehlen, Michael H.; Gamper, Johann; Jensen, Christian Søndergaard

    2008-01-01

    associated with the management of temporal data. Indeed, temporal aggregation is complex and among the most difficult, and thus interesting, temporal functionality to support. This paper presents a general framework for temporal aggregation that accommodates existing kinds of aggregation, and it identifies...

  8. Recovery from emotion recognition impairment after temporal lobectomy

    Directory of Open Access Journals (Sweden)

    Francesca eBenuzzi

    2014-06-01

    Full Text Available Mesial temporal lobe epilepsy (MTLE can be associated with emotion recognition impairment that can be particularly severe in patients with early onset seizures (1-3. Whereas there is growing evidence that memory and language can improve in seizure-free patients after anterior temporal lobectomy (ATL (4, the effects of surgery on emotional processing are still unknown. We used functional magnetic resonance imaging (fMRI to investigate short-term reorganization of networks engaged in facial emotion recognition in MTLE patients. Behavioral and fMRI data were collected from six patients before and after ATL. During the fMRI scan, patients were asked to make a gender decision on fearful and neutral faces. Behavioral data demonstrated that two patients with early-onset right MTLE were impaired in fear recognition while fMRI results showed they lacked specific activations for fearful faces. Post-ATL behavioral data showed improved emotion recognition ability, while fMRI demonstrated the recruitment of a functional network for fearful face processing. Our results suggest that ATL elicited brain plasticity mechanisms allowing behavioral and fMRI improvement in emotion recognition.

  9. Memory assessment in patients with temporal lobe epilepsy to predict memory impairment after surgery: A systematic review.

    Science.gov (United States)

    Parra-Díaz, P; García-Casares, N

    2017-04-19

    Given that surgical treatment of refractory mesial temporal lobe epilepsy may cause memory impairment, determining which patients are eligible for surgery is essential. However, there is little agreement on which presurgical memory assessment methods are best able to predict memory outcome after surgery and identify those patients with a greater risk of surgery-induced memory decline. We conducted a systematic literature review to determine which presurgical memory assessment methods best predict memory outcome. The literature search of PubMed gathered articles published between January 2005 and December 2015 addressing pre- and postsurgical memory assessment in mesial temporal lobe epilepsy patients by means of neuropsychological testing, functional MRI, and other neuroimaging techniques. We obtained 178 articles, 31 of which were included in our review. Most of the studies used neuropsychological tests and fMRI; these methods are considered to have the greatest predictive ability for memory impairment. Other less frequently used techniques included the Wada test and FDG-PET. Current evidence supports performing a presurgical assessment of memory function using both neuropsychological tests and functional MRI to predict memory outcome after surgery. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Localization of musicogenic epilepsy to Heschl's gyrus and superior temporal plane: case report.

    Science.gov (United States)

    Nagahama, Yasunori; Kovach, Christopher K; Ciliberto, Michael; Joshi, Charuta; Rhone, Ariane E; Vesole, Adam; Gander, Phillip E; Nourski, Kirill V; Oya, Hiroyuki; Howard, Matthew A; Kawasaki, Hiroto; Dlouhy, Brian J

    2017-09-15

    Musicogenic epilepsy (ME) is an extremely rare form of the disorder that is provoked by listening to or playing music, and it has been localized to the temporal lobe. The number of reported cases of ME in which intracranial electroencephalography (iEEG) has been used for seizure focus localization is extremely small, especially with coverage of the superior temporal plane (STP) and specifically, Heschl's gyrus (HG). The authors describe the case of a 17-year-old boy with a history of medically intractable ME who underwent iEEG monitoring that involved significant frontotemporal coverage as well as coverage of the STP with an HG depth electrode anteriorly and a planum temporale depth electrode posteriorly. Five seizures occurred during the monitoring period, and a seizure onset zone was localized to HG and the STP. The patient subsequently underwent right temporal neocortical resection, involving the STP and including HG, with preservation of the mesial temporal structures. The patient remains seizure free 1 year postoperatively. To the authors' knowledge, this is the first reported case of ME in which the seizure focus has been localized to HG and the STP with iEEG monitoring. The authors review the literature on iEEG findings in ME, explain their approach to HG depth electrode placement, and discuss the utility of STP depth electrodes in temporal lobe epilepsy.

  11. Sequential {sup 123}I-iododexetimide scans in temporal lobe epilepsy: comparison with neuroimaging scans (MR imaging and {sup 18}F-FDG PET imaging)

    Energy Technology Data Exchange (ETDEWEB)

    Mohamed, Armin [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); Royal Prince Alfred Hospital, Comprehensive Epilepsy Service, Camperdown, NSW (Australia); University of Sydney, Faculty of Medicine, Sydney, NSW (Australia); Eberl, Stefan; Henderson, David; Beveridge, Scott; Constable, Chris [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); Fulham, Michael J. [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); Kassiou, Michael [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); University of Sydney, Department of Pharmacology, Sydney, NSW (Australia); Zaman, Aysha [University of Sydney, Faculty of Medicine, Sydney, NSW (Australia); Lo, Sing Kai [University of Sydney, Institute of International Health, Sydney, NSW (Australia)

    2005-02-01

    Muscarinic acetylcholine receptors (mAChRs) play an important role in the generation of seizures. Single-photon emission computed tomography (SPECT) with {sup 123}I-iododexetimide (IDEX) depicts tracer uptake by mAChRs. Our aims were to: (a) determine the optimum time for interictal IDEX SPECT imaging; (b) determine the accuracy of IDEX scans in the localisation of seizure foci when compared with video EEG and MR imaging in patients with temporal lobe epilepsy (TLE); (c) characterise the distribution of IDEX binding in the temporal lobes and (d) compare IDEX SPECT and {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in identifying seizure foci. We performed sequential scans using IDEX SPECT imaging at 0, 3, 6 and 24 h in 12 consecutive patients with refractory TLE undergoing assessment for epilepsy surgery. Visual and region of interest analyses of the mesial, lateral and polar regions of the temporal lobes were used to compare IDEX SPECT, FDG PET and MR imaging in seizure onset localisation. The 6-h IDEX scan (92%; {kappa}=0.83, p=0.003) was superior to the 0-h (36%; {kappa}=0.01, p>0.05), 3-h (55%; {kappa}=0.13, p>0.05) and 24-h IDEX scans in identifying the temporal lobe of seizure origin. The 6-h IDEX scan correctly predicted the temporal lobe of seizure origin in two patients who required intracranial EEG recordings to define the seizure onset. Reduced ligand binding was most marked at the temporal pole and mesial temporal structures. IDEX SPECT was superior to interictal FDG PET (75%; {kappa}=0.66, p=0.023) in seizure onset localisation. MR imaging was non-localising in two patients in whom it was normal and in another patient in whom there was bilateral symmetrical hippocampal atrophy. The 6-h IDEX SPECT scan is a viable alternative to FDG PET imaging in seizure onset localisation in TLE. (orig.)

  12. Sequential 123I-iododexetimide scans in temporal lobe epilepsy: comparison with neuroimaging scans (MR imaging and 18F-FDG PET imaging)

    International Nuclear Information System (INIS)

    Mohamed, Armin; Eberl, Stefan; Henderson, David; Beveridge, Scott; Constable, Chris; Fulham, Michael J.; Kassiou, Michael; Zaman, Aysha; Lo, Sing Kai

    2005-01-01

    Muscarinic acetylcholine receptors (mAChRs) play an important role in the generation of seizures. Single-photon emission computed tomography (SPECT) with 123 I-iododexetimide (IDEX) depicts tracer uptake by mAChRs. Our aims were to: (a) determine the optimum time for interictal IDEX SPECT imaging; (b) determine the accuracy of IDEX scans in the localisation of seizure foci when compared with video EEG and MR imaging in patients with temporal lobe epilepsy (TLE); (c) characterise the distribution of IDEX binding in the temporal lobes and (d) compare IDEX SPECT and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in identifying seizure foci. We performed sequential scans using IDEX SPECT imaging at 0, 3, 6 and 24 h in 12 consecutive patients with refractory TLE undergoing assessment for epilepsy surgery. Visual and region of interest analyses of the mesial, lateral and polar regions of the temporal lobes were used to compare IDEX SPECT, FDG PET and MR imaging in seizure onset localisation. The 6-h IDEX scan (92%; κ=0.83, p=0.003) was superior to the 0-h (36%; κ=0.01, p>0.05), 3-h (55%; κ=0.13, p>0.05) and 24-h IDEX scans in identifying the temporal lobe of seizure origin. The 6-h IDEX scan correctly predicted the temporal lobe of seizure origin in two patients who required intracranial EEG recordings to define the seizure onset. Reduced ligand binding was most marked at the temporal pole and mesial temporal structures. IDEX SPECT was superior to interictal FDG PET (75%; κ=0.66, p=0.023) in seizure onset localisation. MR imaging was non-localising in two patients in whom it was normal and in another patient in whom there was bilateral symmetrical hippocampal atrophy. The 6-h IDEX SPECT scan is a viable alternative to FDG PET imaging in seizure onset localisation in TLE. (orig.)

  13. Paradigmas ambientais nos relatos de sustentabilidade de organizações do setor de energia elétrica.

    Directory of Open Access Journals (Sweden)

    Sabrina Soares da Silva

    2011-06-01

    Full Text Available O objetivo deste estudo foi compreender os significados atribuídos à sustentabilidade nas organizações e como eles se relacionam com os paradigmas ambientais compartilhados. Abordaram-se o antropocentrismo, em suas vertentes individualista e coletivista, o ecocentrismo, também individualista e coletivista, e a sustentabilidade-centrismo. Foi feita uma análise qualitativa descritiva, fundamentada na análise de conteúdo dos relatórios de sustentabilidade e de alguns discursos disponíveis nos endereços eletrônicos de três organizações do setor de geração e distribuição de energia. Os significados atribuídos à sustentabilidade estão associados, em sua maior parte, ao paradigma antropocêntrico individualista, não tendo sido observado um rompimento com a busca por atender unicamente aos interesses dos proprietários das organizações. Nessa visão, relacionouse sustentabilidade a conceitos como os de crescimento, rentabilidade, liderança ou boas práticas de governança nas organizações. Também na vertente individualista, mas se aproximando do ecocentrismo, associou-se a sustentabilidade ao cumprimento da legislação ambiental e à ecoeficiência. Observaram-se posicionamentos ligados ao antropocentrismo, mas com alguma proximidade com sua vertente coletivista, quando a sustentabilidade é vista como diferentes formas de investimentos e programas sociais e responsabilidade social. De maneira similar, a associação com a responsabilidade socioambiental também buscou uma visão mais coletivista, mas intentando não restringir suas preocupações apenas à humanidade, mas também às outras formas de vida. Ainda que tais significados busquem, de alguma maneira, expressar preocupações coletivistas, ainda não seria equivalente a dizer que a organização é sustentável. Nenhum dos significados atribuídos à sustentabilidade remete a seu sentido original, associado à superação da dicotomia entre humanidade e natureza

  14. EL PARADIGMA CIENTÍFICO DE LAS CIENCIAS AGRARIAS: UNA REFLEXION THE SCIENTIFIC PARADIGM OF AGRARIAN SCIENCES: A REFLECTION

    Directory of Open Access Journals (Sweden)

    León Darío Vélez Vargas

    2004-06-01

    Full Text Available A partir de los retos que hoy propone la sociedad, la ciencia, la tecnología y los contextos regionales, nacionales e internacionales, en los que se desenvuelve la agricultura y la ruralidad, se plantea que los paradigmas que han sustentado las ciencias y profesiones agropecuarias, sus reglas y procedimientos, son insuficientes para enfrentarlos y resolverlos, integralmente. La evidencia empírica desborda los marcos teóricos y supuestos desde los cuales estos desafíos son analizados y se formulan las soluciones. Se propone que para enfrentar exitosamente los nuevos retos y contextos, se requiere de nuevos paradigmas que definan un conjunto nuclear de fundamentos científicos e ingenieriles y una unidad mínima de estudio y trabajo. Esta unidad mínima debe permitir, desde una percepción sistémica y armónica, la identificación y análisis de los factores que intervienen en los procesos productivos y su contextos, el trabajo de las disciplinas y la formulación de preguntas y necesidades. En las ciencias agrarias, este cambio de paradigma puede estar representado en el enfoque agroecosistémico, el cual permite: a ordenar jerárquicamente la unidad de trabajo e investigación y sus niveles de interacción; b presentar el proceso productivo como una resultante del efecto integrado de factores socioeconómicos, ecológicos, culturales, científicos y tecnológicos; c la identificación integral de los problemas y soluciones; d el quiebre de los limites disciplinarios; e y responder a las demandas de una agricultura sostenible, competitiva, multifuncional y con equidad.Based on the challenges that are offered today by society, science, technology, and the regional, national and international contexts in which agriculture and rurality are unfolding, it is argued that the paradigms that have sustained the agricultural sciences and professions and their rules and protocols are insufficient for confronting and solving them in an integral fashion

  15. La virtualización de la educación superior en América Latina: entre tendencias y paradigmas

    Directory of Open Access Journals (Sweden)

    María Elena Chan Núñez

    2016-01-01

    Full Text Available El artículo presenta un acercamiento al campo de conocimiento sobre la virtualización de la Educación Superior en América Latina, a partir de la revisión de sus fundamentos y tendencias expuestos en publicaciones emitidas en los últimos diez años por organismos y autores clave para la región. Se expone un modelo analítico que permite reconocer algunas relaciones y oposiciones entre concepciones y prácticas enunciadas en los documentos de referencia. A partir del análisis de los resultados de esos diferentes ejercicios de interés prospectivo, se reflexiona sobre la convergencia entre un paradigma de gestión de la innovación educativa para el fortalecimiento institucional, y un paradigma eco sistémico sobre las TIC que ofrece diferentes escenarios futuribles.

  16. Estudio del desarrollo de los paradigmas procesales Penales en el Perú desde la postura Epistemológica de Tomas Kuhn – 2015

    OpenAIRE

    Humpiri Nuñez, Jimy

    2015-01-01

    La presente investigación lleva como título Estudio del desarrollo de los paradigmas procesales penales en el Perú desde la postura epistemológica de Tomas Kuhn - 2015; para ello se desarrolló la mmetodología histórica – lógica, utilizando un instrumento y técnica del análisis documental, y una lógica inductiva ceñida en el paradigma cualitativo y la estructura epistemológica de las revoluciones científicas de Tomas Kuhn; planteándose el problema ¿ Podría llegarse a consider...

  17. Endodontic management of mandibular third molar with three mesial roots using spiral computed tomography scan as a diagnostic aid: a case report.

    Science.gov (United States)

    Tomar, Deepak; Dhingra, Anil; Tomer, Anil; Sharma, Shalini; Sharma, Vivek; Miglani, Anjali

    2013-05-01

    Aberrant root canal anatomy is diagnostically and clinically challenging for clinicians. The most common root canal configuration of human molars is 2 roots and 3 canals, but various combinations may still exist. Third molars are known to have the most unusual anatomy among human teeth. Restorative, prosthetic, and orthodontic considerations often require endodontic treatment of third molars in order for them to be retained as functional components of the dental arch. The present case report demonstrates unusual root canal morphology of the mandibular third molar. Roentgenographic examination, which included spiral CT scan, revealed 3 separate mesial roots in tooth #48 with 3 independent canals and 3 canal orifices, indicating an endodontic rarity. The present case report puts impetus on exploration of additional canals using advanced diagnostic aids, such as spiral computed tomography, which can have a huge impact on the successful outcome of endodontic therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Efficacy of ultrasonic activation of NaOCl and orange oil in removing filling material from mesial canals of mandibular molars with and without isthmus

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    Mirela Sangoi BARRETO

    2015-01-01

    Full Text Available Objectives The aim of this study was to evaluate the volume of remaining filling material after passive ultrasonic irrigation (PUI of sodium hypochlorite (NaOCl and orange oil in mesial canals of mandibular molars, with and without isthmus. Material and Methods Thirty mesial roots of mandibular molars were divided according to the presence or absence of isthmus. Canals were prepared and filled (Micro-CT #1. Filling was removed using rotary instruments, and specimens were sub-divided into three groups according to the irrigation procedures: Conventional – conventional irrigation with NaOCl, PUI/NaOCl – PUI of NaOCl (three activations, 20 seconds each, and PUI/orange oil – PUI of orange oil (Micro-CT#2. Specimens were enlarged using the X2 and X3 ProTaper Next instruments and submitted to the same irrigation protocols (Micro-CT #3. Results No differences were found between the experimental groups in each stage of assessment (P>0.05. The volume of residual filling material was similar to that in Micro-CT #2 and Micro-CT #3, but lower than that observed in Micro-CT #1 (P<0.05. When groups were pooled according to the presence or absence of an isthmus, volume of residual filling material was higher in specimens presenting isthmus (P<0.05. Conclusions PUI of NaOCl or orange oil did not improve filling removal. Isthmus consists in an anatomical obstacle that impairs the removal of filling material.

  19. Apical Root Canal Morphology of Mesial Roots of Mandibular First Molar Teeth with Vertucci Type II Configuration by Means of Micro-Computed Tomography.

    Science.gov (United States)

    Keleş, Ali; Keskin, Cangül

    2017-03-01

    The aim of this study was to assess the features of the apical root canal anatomy and its relation to the level at which 2 separate root canals merge in the mesial roots of the mandibular first molars with Vertucci type II canal configuration by using micro-computed tomography analysis. The anatomic features of the apical 3 mm of root canals in 83 mesial roots of mandibular first molar teeth were investigated by micro-computed tomography and software imaging according to the level at which 2 separate root canals merge. The most apical slice where a visible root canal was detectable was recorded as 0 level. The specimens from where 2 root canals rejoin at within 3 mm from the 0 level were then assigned to group 1 (n = 37), whereas the specimens from where root canals rejoin 3-9 mm from the 0 level were assigned to group 2 (n = 46). Data were presented by using descriptive statistics and Mann-Whitney U tests, with the significance level set at 5%. In all specimens the long oval type of cross-sectional shape increased from 50.9% at 1 mm to 80.5% at 3 mm. Group 1 presented significantly higher major diameter values compared with group 2 (P  .05) between groups. Group 2 displayed significantly higher roundness values than group 1 (P < .05). A long oval root cross section of apical root canal anatomy is more prevalent in roots for which 2 root canals merge within apical 3 mm of root canals. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  20. Análisis del Comportamiento de Robots Móviles con RNA. Un Acercamiento desde el Paradigma Reactivo

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    Alejandro Hossian

    2013-02-01

    Full Text Available Por medio de la navegación es posible guiar el curso de un robot móvil a través de un entorno con presencia de obstáculos. Se conocen diferentes esquemas para llevar a cabo esta tarea, pero todos ellos tienen el objetivo común de dirigir el vehículo hacia su destino de la manera más segura y eficiente posible. La capacidad de reacción que pueda poseer el robot cuando se encuentra ante situaciones inesperadas, debe constituir su cualidad más distintiva para desenvolverse eficazmente en el entorno donde este deba operar, lo cual indica el grado de autonomía que este posee. La navegación robótica es aplicable a múltiples disciplinas y entornos industriales; y en este sentido, la aplicación de la Inteligencia Artificial a través de las diferentes tecnologías inteligentes que la componen (redes neuronales, algoritmos genéticos y aprendizaje automático entre otras cobra un gran protagonismo dentro del campo de la Robótica Cognitiva para su desarrollo. El objetivo principal del presente trabajo se focaliza en el análisis y presentación de resultados de investigación en técnicas de navegación robótica, que se han obtenidos en base a experimentos llevados a cabo mediante la aplicación de la tecnología de las redes neuronales artificiales, las cuales concentran las mejores características del paradigma reactivo en lo que se refiere a la navegación autónoma de robots. En el presente artículo se evalúa la efectividad y el desempeño de este paradigma mediante la aplicación de una red neuronal de arquitectura sencilla, obteniendo conclusiones en lo que respecta a la conducta deseada del robot y comparándola con la que manifiesta en su desempeño. Los parámetros que se analizan para esta evaluación están relacionados con la evitación de obstáculos, velocidad de respuesta, optimización de las trayectorias que adopta y el logro de los objetivos.

  1. Paradigma. Hacia el diseño y desarrollo de algoritmos y sistemas de control para clonación artificial en procesos industriales.

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    Jairo Amador

    2004-11-01

    Full Text Available Haciendo uso de Ia tecnología inteligente basada en la lógica difusa, las redes neuronales y los algoritmos genéticos, se pretende plantear un paradigma para la clonación artificial de dispositivos en procesos industriales, específicamente para sensores, los cuales deberán replicar las mismas o mejores funciones de los dispositivos reales mediante la evolución des comportamiento.

  2. O paradigma dos novos movimentos sociais para a defesa dos direitos da criança e do adolescente – breves análises

    OpenAIRE

    Caldas, Paula da Silva; UNIABEU

    2012-01-01

    This article aims to bring up the debate about the paradigm that has been built taking into consideration the new social movements in defense of the rights of children and adolescents in the contemporary scene, bringing the backdrop of the implementation of important spaces coordination, participation, deliberation and mobilization of civil society in an attempt to execution of public policies for children and youth. O presente artigo visa a trazer à tona o debate acerca do paradigma que t...

  3. Relaciones de aprendizaje significativo entre dos paradigmas de programación a partir de dos lenguajes de programación

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    Omar Iván Trejos Buriticá

    2014-04-01

    Full Text Available Una de las dificultades que, con frecuencia, se presenta en los currículos de Ingeniería de Sistemas es el hecho de que se establecen pocas relaciones entre lo que los estudiantes han aprendido en una asignatura de programación y lo que van a aprender en otra. Este artículo plantea una propuesta para que se puedan establecer, desde la primera sesión, relaciones entre el paradigma de programación funcional (utilizando DrScheme como instancia tecnológica y el paradigma de programación estructurada (utilizando DevC++ en su arista estructurada como lenguaje de programación. Se plantean las experiencias recogidas al respecto de la aplicación de esta estrategia y, sobre los resultados se presentan algunas reflexiones que pueden enriquecer el desarrollo de la línea de programación en los programas de Ingeniería a partir de las relaciones que se pueden establecer tanto entre paradigmas de programación como entre los lenguajes de programación con miras a que el camino de aprendizaje de estos sea mucho más simple.

  4. ESTUDOS ORGANIZACIONAIS: UMA RELAÇÃO ENTRE PARADIGMAS, METANARRATIVAS, PONTOS DE INTERSEÇÃO E SEGMENTAÇÕES TEÓRICAS

    Directory of Open Access Journals (Sweden)

    Rafael Borim de Souza

    2011-12-01

    Full Text Available Este artigo foi realizado com o objetivo de identificar um quadro de análise que contemplasse o relacionamento entre paradigmas, metanarrativas, pontos de interseção e segmentações teóricas relacionados aos estudos organizacionais. Foi realizada uma pesquisa qualitativa, exploratória e bibliográfica. Para que a viabilidade de realização do estudo fosse garantida foram adotados como referências os paradigmas apresentados por Burrell e Morgan (1979, as metanarrativas e os pontos de interseção defendidos por Reed (2007 e a segmentação teórica proposta por Marsden e Townley (2001. Foi possível observar que os pontos de interseção propostos por Reed (2007 confluem de uma segmentação teórica defendida por Marsden e Townley (2001 entre teorias organizacionais normais e teorias organizacionais contranormais, as quais englobam todas as metanarrativas interpretativas de Reed (2007, que por sua vez são compreendidas pelos paradigmas de Burrell e Morgan (1979.

  5. Elementos do paradigma sociocrítico nas práticas do cuidado de enfermagem: revisão integrativa

    Directory of Open Access Journals (Sweden)

    Silvana Ceolin

    2017-11-01

    Full Text Available RESUMO Objetivo: Analisar as evidências disponíveis nas teses brasileiras sobre os elementos do paradigma sociocrítico na construção do conhecimento e das práticas do cuidado de enfermagem. Método: Revisão integrativa de literatura realizada no Banco de Teses da Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior e na Biblioteca Digital Brasileira de Teses e Dissertações. Resultados: De um montante de 320 teses, somente 19 apresentaram elementos do paradigma sociocrítico em sua construção, dentre os quais se destacaram o emprego de investigações participativas (principalmente pesquisa-ação, que apresentam interação entre pesquisador e participantes; o uso de técnicas de coleta de dados como grupos focais e círculos de cultura; e referenciais teóricos que permitem analisar os fenômenos em sua complexidade. Conclusão: O suporte do paradigma sociocrítico atribui à enfermagem o caráter de uma ciência prática e a serviço da comunidade, comprometida com a transformação social a partir do empoderamento das pessoas.

  6. Posdisciplina una aventura metodológica en tiempos de nuevos paradigmas. Una mirada sobre el espacio público.

    Directory of Open Access Journals (Sweden)

    Elsa Laurelli

    2014-12-01

    Full Text Available El nuevo siglo se caracteriza por la innovación de nuevos paradigmas lo cual está significando aventurarse en la búsqueda de nuevos caminos para interpretar al espacio público, no solo como un espacio abierto, verde y de uso común aun para los que están en “situación de calle”, sino como un espacio de reproducción física, económica y social, de esparcimiento, de memoria, de símbolos colectivos y de lucha de la sociedad. Esta aventura implica desarrollar y relacionar conceptos, metodologías y saberes de distinto origen poniendo énfasis en los problemas a resolver y no en los límites disciplinares que podrían cercenarlos. La naturaleza social del espacio público y el desafío de una mirada crítica tanto de las políticas públicas como de las prácticas de diferentes agentes en el proceso de construcción del espacio urbano, son fuentes de nuevos temas, problemas y espacios de reflexión en la “sociedad pos”.

  7. Aleitamento materno: instintivo? Natural? O paradigma biológico x os direitos reprodutivos em discussão

    Directory of Open Access Journals (Sweden)

    Kátia Fernanda Alves Moreira

    2002-12-01

    Full Text Available O objetivo deste ensaio foi refletir sobre a naturalização do aleitamento, inserindo o campo da amamentação na esfera dos direitos da mulher, procurando desconstruir o paradigma que biologiza o corpo feminino para as funções maternas, em especial para a amamentação, à luz dos direitos reprodutivos. Na discussão salientamos a importância das ações de incentivo ao aleitamento materno estarem embasadas na noção de direitos reprodutivos, o que permitirá aos profissionais de saúde compreenderem os significados da amamentação no marco de vida da mulher e de seu cotidiano. Propomos no final que os direitos reprodutivos direcionem as ações de incentivo ao aleitamento materno desenvolvidas pelos profissionais de saúde, na perspectiva de resgatar a visibilidade da mulher enquanto sujeito principal desta prática.

  8. Paradigmas administrativos, ética e intervenção do Estado na economia: o caso de Portugal

    Directory of Open Access Journals (Sweden)

    João Bilhim

    2015-12-01

    Full Text Available Muita atenção tem sido dada na literatura administrativa e organizacional aos valores que guiam o comportamento organizacional e de gestão pública e privada. Todavia, o separador de águas entre a gestão pública e a privada manteve-se ao longo do tempo, com altos e baixos, como ponto controverso na literatura específica da administração e políticas públicas e do direito administrativo. A influência da Nova Gestão Pública (NGP na reforma administrativa em Portugal é amplamente reconhecida em Portugal. Foram muitos os governos que, nos países da oecd, tomaram iniciativas idênticas. Há porém uma diferença acentuada entre a reforma administrativa dos países anglófonos e a dos países da Europa continental. Ora, tal diferença parece radicar no papel que o direito administrativo tem nestes países europeus e que não tem nos sistemas de Common Law. Este artigo quer contribuir para o debate da existência de dois paradigmas administrativos onde a separação entre gestão privada e pública parece colocar-se de forma diferenciada e a ética assume distinta ponderação.

  9. También Yavé bajo el nuevo paradigma arqueológico-bíblico

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    José Maria Vigil

    2016-06-01

    Full Text Available El llamado «nuevo paradigma arqueológico bíblico» verá consolidado el aprecio que le tengan la teología y las ciencias de la religión en la medida en que sus descubrimientos se vayan aplicando a los principales temas bíblicos, histórico-religiosos y teológicos. Una de estas aplicaciones es la que acaba de darse en un modo significativo con la publicación del libro de Thomas Römer, L’invention de Dieu, que viene a ser en este momento el mejor resumen de los hallazgos –y cuestionamientos– que la nueva arqueología puede aportarnos hoy acerca del Dios bíblico.En un primer momento, este artículo resume las novedades más destacadas de la nueva visión sobre el Dios bíblico desde la perspectiva de la nueva arqueología, tal como aparecen en el libro de Römer, y en un segundo momento trata de poner de relieve algunas consecuencias y sugerencias, tanto en el plano teórico cuanto en el práctico-pedagógico.

  10. Funcionalismo y paradigmas sociológicos. Anotaciones críticas a un libro de Jacques Coenen-Huther

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    LUIS ENRIQUE ALONSO

    1987-01-01

    Full Text Available En el libro de Jacques Coenen-Huther Le Fonctionnalisme en sociologie: et après? (El Funcionalismo en sociología: ¿y luego? (1984, que se basa en su tesis doctoral, el autor repasa los puntos principales del funcionalismo, que dominaron la Sociología desde la Segunda Guerra Mundial hasta finales de los años 60. Examina la definición de funcionalismo, su relación con la causalidad, y diversas nociones de la función. Discute los paradigmas de los factores sociales y de la acción social, y presenta una evaluación de varios puntos sobre acuerdo y divergencia del funcionalismo con otras tradiciones sociológicas. Coenen-Huther ofrece una síntesis bien documentada de algunos problemas centrales en Sociología. Algunas críticas se hacen a su tratamiento del marxismo y el socialismo, y a su escasa atención a algunas influencias importantes en teoría sociológica, como son el psicoanálisis, el estructuralismo, y el behaviorismo

  11. Judicialización de las internaciones psiquiátricas involuntarias: nuevos paradigmas y responsabilidad judicial.

    Directory of Open Access Journals (Sweden)

    Claudia Elizabeth Zalazar

    2014-09-01

    Full Text Available La nueva ley de salud mental en la República Argentina que regula la protección de los derechos de las personas con padecimiento mental, ha sentado como un paradigma fundamental la desjudicialización del sistema, entendido en un doble sentido: como una limitación de las facultades judiciales a la hora de evaluar la posibilidad de dicha medida restrictiva, la que sólo debe ser aplicada como último recurso terapéutico tras una valoración interdisciplinaria y en segundo lugar como control efectivo que la duración de dicha internación sea por el menor tiempo posible; siempre a la luz de la protección de los derechos humanos de dicho paciente. Si bien la normativa nacional se ajusta a los principios de las normas internacionales la misma no ha sido acompañada por políticas de salud mental que garanticen en la práctica su cumplimiento, ocasionando distorsiones en su aplicación, que deben ser corregidas; con la consiguiente responsabilidad del Estado de manera general y del Poder Judicial en forma particular ya que es en definitiva el que tiene que bregar por el cumplimiento de dicha ley.

  12. Paradigmas para o Ensino da Composição Musical nos séculos XX e XXI

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    Liduino Pitombeira

    2011-05-01

    Full Text Available Neste artigo, são examinados seis textos do século XX, paradigmáticos para o ensino da composição: [1] Learning to Compose, de Larry Austin e Thomas Clark, [2] Materials and Techniques of Twentieth-Century Music, de Stefan Kostka, [3] Techniques of Twentieth-Century Composition, de Leon Dallin, [4] Creative Music Composition, de Margaret Lucy Wilkins, [5] Techniques of the Contemporary Composer, de David Cope e [6] Simple Composition, de Charles Wuorinen. Busca-se, através desse exame, sintetizar os conceitos centrais e os enfoques pedagógicos, bem como revelar conexões com a teoria e a história. Propõe-se, então, uma discussão sobre as possíveis perspectivas no ensino da composição, face ao estabelecimento cada vez maior de abordagens texturais, espectrais, ultracomplexas e sistêmicas no campo da composição musical.

  13. Paradigma preventivo e lógica identitária nas abordagens sobre o Hip Hop

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    Rodrigo Lages e Silva

    2008-06-01

    Full Text Available Este artigo faz uma revisão das pesquisas acadêmicas sobre o Hip Hop, apontando a preponderância do conceito de identidade nas referidas teorizações. Neste sentido, pretende-se contextualizar a ascensão do conceito de identidade nas visões sobre o Hip Hop, em direção a sua conjugação com o conceito de cidadania. Tal lógica identitária está intimamente ligada à construção da noção de categorias desviantes. Forjada sob o pano de fundo da urbanização, a lógica identitária é a expressão acadêmica de uma racionalidade a que denominamos de paradigma preventivo, cuja função é antecipar-se a uma eventual potência violenta que os jovens moradores de periferia representariam. Portanto, trata-se de entender a fabricação do subúrbio e da juventude como problema social, analisando, assim, as concepções que dão sustentação aos ideais corretivos e moralizantes que as abordagens sobre o Hip Hop expressam através de uma ênfase nos seus benefícios identitários.

  14. Extratemporal hypometabolism on FDG PET in temporal lobe epilepsy as a predictor of seizure outcome after temporal lobectomy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Young; Kim, Sun Jung; Kim, Byung-Tae; Kim, Sang Eun [Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, 135-710, Kangnam-ku, Seoul (Korea); Hong, Seung Bong; Seo, Dae Won [Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea); Hong, Seung Chyul [Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea)

    2003-04-01

    We investigated the relationship between the presence of extratemporal hypometabolism on fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) and seizure outcome after temporal lobectomy in patients with medically intractable temporal lobe epilepsy (TLE). In 47 patients with intractable unilateral mesial TLE, regional metabolic changes on FDG PET images obtained during the 2 months preceding anterior temporal lobectomy were compared with postoperative seizure outcome. Postoperative seizure outcome was evaluated with a mean follow-up period of 6.1{+-}0.6 years (range 5.2-7.2 years). Forty-two (89%) of the 47 patients achieved a good postoperative seizure outcome (Engel class I or II). All patients had hypometabolism in the temporal cortex ipsilateral to the epileptogenic region on FDG PET scans. Fourteen (78%) of the 18 patients with hypometabolism only in the ipsilateral temporal cortex were completely seizure free (Engel class Ia) after surgery. In contrast, five (45%) of the 11 patients with extratemporal cortical hypometabolism confined to the ipsilateral cerebral hemisphere and only four (22%) of the 18 patients with hypometabolism in the contralateral cerebral cortex were completely seizure free after surgery. The postoperative seizure-free rates were significantly different across the three groups of patients with different cortical metabolic patterns (P<0.005). Furthermore, all of the nine patients with a non-class I outcome (Engel class II-IV) had extratemporal (including contralateral temporal) cortical hypometabolism. Thalamic hypometabolism was noted in 20 (43%) of the 47 patients (ipsilateral in 12, bilateral in 8). Sixteen (59%) of the 27 patients with normal thalamic metabolism were completely seizure free after surgery, while only seven (35%) of the 20 patients with thalamic hypometabolism became completely seizure free (P<0.05). Multivariate analysis revealed that among variables including clinical, EEG, magnetic resonance imaging

  15. Extratemporal hypometabolism on FDG PET in temporal lobe epilepsy as a predictor of seizure outcome after temporal lobectomy

    International Nuclear Information System (INIS)

    Choi, Joon Young; Kim, Sun Jung; Kim, Byung-Tae; Kim, Sang Eun; Hong, Seung Bong; Seo, Dae Won; Hong, Seung Chyul

    2003-01-01

    We investigated the relationship between the presence of extratemporal hypometabolism on fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) and seizure outcome after temporal lobectomy in patients with medically intractable temporal lobe epilepsy (TLE). In 47 patients with intractable unilateral mesial TLE, regional metabolic changes on FDG PET images obtained during the 2 months preceding anterior temporal lobectomy were compared with postoperative seizure outcome. Postoperative seizure outcome was evaluated with a mean follow-up period of 6.1±0.6 years (range 5.2-7.2 years). Forty-two (89%) of the 47 patients achieved a good postoperative seizure outcome (Engel class I or II). All patients had hypometabolism in the temporal cortex ipsilateral to the epileptogenic region on FDG PET scans. Fourteen (78%) of the 18 patients with hypometabolism only in the ipsilateral temporal cortex were completely seizure free (Engel class Ia) after surgery. In contrast, five (45%) of the 11 patients with extratemporal cortical hypometabolism confined to the ipsilateral cerebral hemisphere and only four (22%) of the 18 patients with hypometabolism in the contralateral cerebral cortex were completely seizure free after surgery. The postoperative seizure-free rates were significantly different across the three groups of patients with different cortical metabolic patterns (P<0.005). Furthermore, all of the nine patients with a non-class I outcome (Engel class II-IV) had extratemporal (including contralateral temporal) cortical hypometabolism. Thalamic hypometabolism was noted in 20 (43%) of the 47 patients (ipsilateral in 12, bilateral in 8). Sixteen (59%) of the 27 patients with normal thalamic metabolism were completely seizure free after surgery, while only seven (35%) of the 20 patients with thalamic hypometabolism became completely seizure free (P<0.05). Multivariate analysis revealed that among variables including clinical, EEG, magnetic resonance imaging

  16. Proton MR spectroscopy in patients with acute temporal lobe seizures.

    Science.gov (United States)

    Castillo, M; Smith, J K; Kwock, L

    2001-01-01

    Decreases in N-acetyl aspartate (NAA) as seen by proton MR spectroscopy are found in hippocampal sclerosis, and elevated levels of lipids/lactate have been observed after electroconvulsive therapy. Our purpose was to determine whether increased levels of lipids/lactate are found in patients with acute seizures of hippocampal origin. Seventeen patients with known temporal lobe epilepsy underwent proton MR spectroscopy of the mesial temporal lobes within 24 hours of their last seizure. Four of them were restudied when they were seizure-free. Five healthy individuals were used as control subjects. All MR spectroscopy studies were obtained using a single-voxel technique with TEs of 135 and 270. The relationship between the presence of lipids/lactate and seizures was tested using Fisher's exact test. Mean and standard deviations for NAA/creatine (Cr) were obtained in the hippocampi in patients with seizures on initial and follow-up studies and these values were compared with those in the control subjects. Seizure lateralization was obtained in 15 patients. Of the 17 seizure locations that involved hippocampi, 16 showed lipids/lactate by proton MR spectroscopy. Of the 13 hippocampi not directly affected by seizures, 10 showed no lipids/lactate and three showed lipids/lactate. The relationship between lipids/lactate and seizure location was confirmed. A comparison of NAA/Cr ratios for the involved hippocampi with those in control subjects showed significant differences on initial MR spectroscopy; however, no significant difference was found between acute and follow-up NAA/Cr ratios in hippocampi affected by seizures. Lipids/lactate were present in the hippocampi of patients with acute seizures and decreased when the patients were seizure-free. Thus, lipids/lactate may be a sensitive marker for acute temporal lobe seizures.

  17. Subtle pathological changes in neocortical temporal lobe epilepsy.

    Science.gov (United States)

    Ochoa, Juan G; Hentgarden, Diana; Paulzak, Audrey; Ogden, Melissa; Pryson, Richard; Lamle, Markus; Rusyniak, Walter G

    2017-06-01

    This was a prospective observational study to correlate the clinical symptoms, electrophysiology, imaging, and surgical pathology of patients with temporal lobe epilepsy (TLE) without hippocampal sclerosis. We selected consecutive patients with TLE and normal MRI undergoing temporal lobe resection between April and September 2015. Clinical features, imaging, and functional data were reviewed. Intracranial monitoring and language mapping were performed when it was required according to our team recommendation. Prior to hippocampal resection, intraoperative electrocorticography was performed using depth electrodes in the amygdala and the hippocampus. The resected hippocampus was sent for pathological analysis. Five patients with diagnosis with non-lesional TLE were included. We did not find distinctive clinical features that could be a characteristic of non-lesional TLE. The mean follow-up was 13.2months (11-15months); 80% of patients achieved Engel Class I outcome. There was no distinctive electrographic findings in these patients. Histopathologic analysis was negative for mesial temporal sclerosis. A second blinded independent neuropathologist with expertise in epilepsy found ILAE type I focal cortical dysplasia in the parahippocampal gyrus in all patients. A third independent neuropathologist reported changes in layer 2 with larger pyramidal neurons in 4 cases but concluded that none of these cases met the diagnostic criteria of FCD. Subtle pathological changes could be associated with a parahippocampal epileptic zone and should be investigated in patients with MRI-negative TLE. This study also highlights the lack of interobserver reliability for the diagnosis of mild cortical dysplasia. Finally, selective amygdalo-hippocampectomy or laser ablation of the hippocampus may not control intractable epilepsy in this specific population. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Paradigma socio-cognitivo en la Red Social Dreamcatchers en Cuba = Socio-cognitive paradigm in the Social Network Dreamcatchers in Cuba

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    Natali de la Caridad Sosa Pérez

    2017-06-01

    Full Text Available La Ciencia de la Información en su nacimiento científico está influenciada por dos aspectos fundamentales, uno es el contexto de las tecnologías y el otro es su carácter interdisciplinario. La misma aparece con el propósito de centrar su atención en la información, y la convierte en su objeto de estudio. De ahí que en su desarrollo epistemológico, los paradigmas trazan el camino de estudio y práctica de la información, reflejan el contexto en la que se va desarrollando y cómo este al unísono influye en el desarrollo de esta ciencia. El paradigma socio-cognitivo, en la actualidad, se despliega bajo un contexto diferente, de redes sociales, donde las relaciones entre las personas se manifiestan de forma diferente y por tanto sus comportamientos, necesidades adquieren otra dimensión. Precisamente el tema de la investigación es el paradigma socio-cognitivo contextualizado en la red social Dreamcatchers de Cuba, con el objetivo de reconocer la presencia del paradigma socio-cognitivo en la misma. Como resultado fue el análisis del paradigma socio-cognitivo en la red social Dreamcatchers a partir de los indicadores propuestos donde se reconoció la influencia de la comunidad en las personas, a partir del análisis estadístico de la información y del software Ucinet. = Since its origin, Information Science has been influenced by two fundamental aspects: The context of the technologies and its interdisciplinary character with the purpose of focusing attention in information hence becoming its study object. In the epistemological development, paradigms map the way to study and practice information reflecting the context in which it develops and likewise influencing the development of this science. Nowadays, the socio-cognitive paradigm happens in a somehow different context: Social networks, where relationships among people, their behaviors and needs acquire another dimension. This research subject is the presence of the socio

  19. Epilepsy surgery in drug resistant temporal lobe epilepsy associated with neuronal antibodies.

    Science.gov (United States)

    Carreño, Mar; Bien, Christian G; Asadi-Pooya, Ali A; Sperling, Michael; Marusic, Petr; Elisak, Martin; Pimentel, Jose; Wehner, Tim; Mohanraj, Rajiv; Uranga, Juan; Gómez-Ibáñez, Asier; Villanueva, Vicente; Gil, Francisco; Donaire, Antonio; Bargalló, Nuria; Rumià, Jordi; Roldán, Pedro; Setoain, Xavier; Pintor, Luis; Boget, Teresa; Bailles, Eva; Falip, Mercè; Aparicio, Javier; Dalmau, Josep; Graus, Francesc

    2017-01-01

    We assessed the outcome of patients with drug resistant epilepsy and neuronal antibodies who underwent epilepsy surgery. Retrospective study, information collected with a questionnaire sent to epilepsy surgery centers. Thirteen patients identified, with antibodies to GAD (8), Ma2 (2), Hu (1), LGI1 (1) or CASPR2 (1). Mean age at seizure onset: 23 years. Five patients had an encephalitic phase. Three had testicular tumors and five had autoimmune diseases. All had drug resistant temporal lobe epilepsy (median: 20 seizures/month). MRI showed unilateral temporal lobe abnormalities (mainly hippocampal sclerosis) in 9 patients, bilateral abnormalities in 3, and was normal in 1. Surgical procedures included anteromesial temporal lobectomy (10 patients), selective amygdalohippocampectomy (1), temporal pole resection (1) and radiofrequency ablation of mesial structures (1). Perivascular lymphocytic infiltrates were seen in 7/12 patients. One year outcome available in all patients, at 3 years in 9. At last visit 5/13 patients (38.5%) (with Ma2, Hu, LGI1, and 2 GAD antibodies) were in Engel's classes I or II. Epilepsy surgery may be an option for patients with drug resistant seizures associated with neuronal antibodies. Outcome seems to be worse than that expected in other etiologies, even in the presence of unilateral HS. Intracranial EEG may be required in some patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Cognitive consequences of coexisting temporal lobe developmental malformations and hippocampal sclerosis.

    Science.gov (United States)

    Martin, R; Dowler, R; Gilliam, F; Faught, E; Morawetz, R; Kuzniecky, R

    1999-09-11

    To characterize patterns of cognitive functioning in a well-defined group of patients with MRI-identified coexisting left temporal lobe developmental malformations (TLDM) and mesial temporal sclerosis (MTS), and to examine neuropsychological outcome in this dual-pathology group following epilepsy surgery. Cognitive functioning in patients with left TLDM and MTS (n = 15) was compared with patients with isolated left MTS (n = 40). TLDM and MTS were identified by high-quality MRI protocol. Patients were administered a battery of neuropsychology tests as part of their presurgical workup for possible epilepsy surgery. Unilateral temporal lobe resection was performed on 10 of the dual-pathology patients and 34 of the isolated MTS patients. Postoperative cognitive performance was also assessed. Both groups displayed impairments in verbal and visual memory, language, and academic achievement. Performance on measures of psychometric intelligence, executive function, and attention were not impaired and were similar between groups. Presence of dual pathology was associated with a significantly less efficient verbal encoding strategy on the word list learning task. Postoperatively, declines were noted for both groups across tasks of verbal memory and language. Groups were not different significantly in terms of neuropsychological outcome after surgery. Patients with coexisting TLDM and MTS have impaired cognitive functioning similar to MTS patients-in particular, with regard to episodic memory and language deficits. Temporal lobe resection produces similar cognitive changes in both groups.

  1. Effects of dual pathology on cognitive outcome following left anterior temporal lobectomy for treatment of epilepsy.

    Science.gov (United States)

    Prayson, B E; Prayson, R A; Kubu, C S; Bingaman, W; Najm, I M; Busch, R M

    2013-09-01

    The objective of this retrospective study was to determine if dual pathology [DUAL - focal cortical dysplasia (FCD) and mesial temporal sclerosis (MTS)] in patients with left temporal lobe epilepsy is associated with greater risk for cognitive decline following temporal lobectomy than single pathology (MTS only). Sixty-three adults (Mage=36.5years, female: 52.4%) who underwent left anterior temporal lobectomy for treatment of epilepsy (MTS=28; DUAL=35) completed preoperative and postoperative neuropsychological evaluations. The base rate of dual pathology was 55.5%. Repeated measures ANOVAs yielded significant 2-way interactions (group×time) on most measures of language and memory with generally moderate effect sizes. Specifically, patients with MTS only demonstrated postoperative declines, while those with dual pathology remained unchanged or improved. Results suggest that dual pathology may be associated with better cognitive outcome following epilepsy surgery than MTS alone, possibly reflecting limited functionality of the resected tissue or intrahemispheric reorganization of function in the context of a developmental lesion. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Temporal lobe developmental malformations and epilepsy: dual pathology and bilateral hippocampal abnormalities.

    Science.gov (United States)

    Ho, S S; Kuzniecky, R I; Gilliam, F; Faught, E; Morawetz, R

    1998-03-01

    Temporal lobe developmental malformations (TLDM) with focal cortical dysplasia and balloon cells may coexist with mesial temporal sclerosis. The true incidence of this dual pathology is unknown. Our aim was to assess the frequency of amygdala (AM)-hippocampal abnormality in a homogeneous population with this specific developmental malformation. MRI-based volumetry of the AM and hippocampal formation (HF) in 30 patients with unilateral TLDM and intractable partial epilepsy was performed. A volume normalization process defined a normal range of HF and AM volumes in control subjects, and enabled the detection of bilateral volume loss. Normalized volumes detected HF atrophy in 26 patients (nine unilateral and 17 bilateral) and AM atrophy in 18 patients (three unilateral and 15 bilateral). Visual analysis detected unilateral HF abnormality in 21 patients and bilateral abnormality in two. When compared with a group of patients with temporal lobe epilepsy and pure hippocampal sclerosis (N = 92), where volumetry revealed bilateral HF atrophy in 18%, a significant difference in the frequency of bilateral HF atrophy was found (p Dual pathology is frequent in patients with TLDM (87%), and the AM-HF abnormality is often bilateral (57%). Our data suggest that more widespread and potentially epileptogenic lesions coexist with visibly detectable unilateral TLDM. This has implications for the selection of patients for temporal lobe surgery and may influence surgical strategies.

  3. Los estudios de herencia cultural como una alternativa a la arqueología científica o a la patrimonialización de los dioses: del paradigma de la ruptura al de la continuidad

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    Wilhelm Londoño

    2013-10-01

    Full Text Available En las últimas dos décadas varios arqueólogos han reflexionado sobre la problemática relación de la arqueología con la construcción de comunidades imaginadas nacionales. En estas reflexiones el balance ha señalado que la arqueología ha sido funcional a un proyecto nacionalista que ubicó la alteridad en una dimensión temporal distanciada del presente. En este sentido la se legitimó como una disciplina encargada de dar cuenta del pasado (ruptura. A pesar del peso que tiene esta imagen dentro del imaginario, cada vez más comunidades locales están reclamando, no sólo un papel más activo en esta maquinaria de representación  del pasado, sino controles más efectivos sobre los espacios donde se practica la arqueología. Estas peticiones han sido, en muchos casos, legitimadas por el reconocimiento sobre las maneras como el colonialismo impelió a las comunidades locales a desprenderse de prácticas rituales celebradas sobre espacios y objetos específicos (continuidad. Dentro de este escenario ha emergido un nuevo paradigma que busca no saber lo que  ocurrió en el pasado, sino los medios a través de los cuales se desplegaron dispositivos del olvido (efecto de  colonialismo. En este artículo se desea hablar de este campo que puede ser definido  como “estudios de herencia cultural”.

  4. A educação em enfermagem à luz do paradigma da complexidade La educación en enfermería bajo el paradigma de la complejidad Nursing education in the light of the complexity paradigm

    Directory of Open Access Journals (Sweden)

    Ana Lúcia da Silva

    2007-09-01

    Full Text Available Os objetivos desta pesquisa foram reconhecer, interpretar e discutir temas oriundos dos discursos de docentes de um Curso de Graduação em Enfermagem, como fontes orientadoras para um ensino-aprendizagem humanizado, à luz da Teoria da Complexidade defendida por Edgar Morin. Tratase de pesquisa qualitativa, tipo exploratória e analítica. Buscou-se verificar princípios do paradigma da complexidade por meio da análise de conteúdo, modalidade temática , em discursos de onze docentes, obtidos no ano de 2004. Os temas encontrados foram: ensinar: responsabilidade do docente; unir saberes: ligações e interrelações para o enfrentamento da realidade; ensinar a complexidade humana; estimular a criatividade e a curiosidade; enfrentar as incertezas: construindo o conhecimento contínuo e dinâmico da vida; viver o processo ensino-aprendizagem por meio da transdisciplinaridade e ensinar a cidadania. Este estudo nos mostrou que é possível fazer acontecer um ensino superior pautado na condição humana, na solidariedade e na interligação dos saberes.Los objetivos de esta investigación han sido los de reconocer, interpretar y discutir temas oriundos de los discursos de docentes de un Curso de Graduación en Enfermería, como fuentes de orientación para una enseñanzaaprendizaje humanizados bajo la Teoría de la Complejidad defendida por Edgar Morin. Se trata de una investigación cualitativa, tipo exploratoria y analítica. Se buscó verificar principios del paradigma de la complejidad a través del análisis de contenido , modalidad temática en discursos de once docentes, obtenidos en el año de 2004. Los temas encontrados han sido: enseñar: responsabilidad del docente; unir sabidurías: relaciones e interrelaciones para hacer frente a la realidad; enseñar la complejidad humana; estimular la creatividad y la curiosidad; hacer frente a la incertidumbre: construyendo el conocimiento continuado y dinámico de la vida; vivir el proceso de ense

  5. Advances in temporal logic

    CERN Document Server

    Fisher, Michael; Gabbay, Dov; Gough, Graham

    2000-01-01

    Time is a fascinating subject that has captured mankind's imagination from ancient times to the present. It has been, and continues to be studied across a wide range of disciplines, from the natural sciences to philosophy and logic. More than two decades ago, Pnueli in a seminal work showed the value of temporal logic in the specification and verification of computer programs. Today, a strong, vibrant international research community exists in the broad community of computer science and AI. This volume presents a number of articles from leading researchers containing state-of-the-art results in such areas as pure temporal/modal logic, specification and verification, temporal databases, temporal aspects in AI, tense and aspect in natural language, and temporal theorem proving. Earlier versions of some of the articles were given at the most recent International Conference on Temporal Logic, University of Manchester, UK. Readership: Any student of the area - postgraduate, postdoctoral or even research professor ...

  6. Territorio, identidades y consumo: reflexiones en torno a la construcción de nuevos paradigmas en el desarrollo

    Directory of Open Access Journals (Sweden)

    Sebastián Carenzo

    2007-12-01

    Full Text Available La incorporación del enfoque territorial constituye el común denominador de las propuestas más recientes generadas en el campo del desarrollo rural. En ellas se advierte un inusitado interés por aquellos particularismos asociados al territorio, que se extiende más allá de sus características económicas, ecológicas y geográficas, para incorporar los aspectos sociales y culturales que otorgan singularidad a un determinado espacio. El presente trabajo representa una primera aproximación al análisis crítico de las denominadas "identidades territoriales", para luego discutir el alcance de este concepto en relación con el accionar de agencias de desarrollo que promueven la producción y comercialización de artesanías indígenas. Finalmente se presentan algunas reflexiones en torno a la cuestión de las "identidades territoriales" en la construcción de nuevos paradigmas sobre el desarrollo rural.A aproximação territorial constitui o denominador comum das propostas mais recentes geradas no campo do desenvolvimento rural. Neles um interesse incomum por aqueles particularismos associados ao território, além de suas características econômicas, ecologicas e geográfico é observado, para incorporar os aspectos sociais e culturais que concedem o singularidade a o espaço. O presente trabalho constitui uma primeira aproximação à análise crítica das "identidades territoriais", para discutir logo o alcance deste conceito com relação às ações das agências do desenvolvimento que trabalham na promoção do artesanato indígena Finalmente nós apresentamos algumas reflexões com relação ao debate na identidade territorial na construção de novos paradigmas no desenvolvimento rural.Territorial approaches constitute a common denominator in recent proposals of rural development studies. An unusual interest by particularisms associated to territory, that extends beyond it's economic, ecological and geographic characteristics is

  7. Indeterministic Temporal Logic

    Directory of Open Access Journals (Sweden)

    Trzęsicki Kazimierz

    2015-09-01

    Full Text Available The questions od determinism, causality, and freedom have been the main philosophical problems debated since the beginning of temporal logic. The issue of the logical value of sentences about the future was stated by Aristotle in the famous tomorrow sea-battle passage. The question has inspired Łukasiewicz’s idea of many-valued logics and was a motive of A. N. Prior’s considerations about the logic of tenses. In the scheme of temporal logic there are different solutions to the problem. In the paper we consider indeterministic temporal logic based on the idea of temporal worlds and the relation of accessibility between them.

  8. El paradigma del neuromarketing a la luz de su producción científica

    Directory of Open Access Journals (Sweden)

    Juan Victoria

    2015-08-01

    Full Text Available La comunidad científica internacional ha encontrado en la neurociencia aplicada a las ciencias del comportamiento una relativa y reciente inquietud teóricamente multidisciplinar. De entre todas las propuestas, destaca la del neuromarketing como la más paradigmática, al tiempo que es referenciada especialmente en el ámbito profesional divulgativo. Es por ello, que el objetivo del presente artículo consiste en estudiar la producción científica de impacto relacionada con el paradigma del Neuromarketing. Se analiza su desarrollo, desde el prisma de la bibliometría de la producción científica registrada en la base de datos Scopus, específicamente relacionada con el neuromarketing. La hipótesis general, plantea que este surge a partir de dos disciplinas inconexas, lo que conlleva a una alta dispersión en su producción científica y es un hándicap de auténtica multidisciplinariedad. Asimismo, se realiza un análisis reticular de co-palabras con Vosviewer. En particular, se afirma que la relación con la comunicación -considerada esta como disciplina científica- es inexistente, denunciando una inflación terminológica precisamente allí donde hay déficit de investigación. Otras conclusiones del estudio hacen referencia con el creciente -ya importante en 2013- número de artículos publicados acerca de neuromarketing en los últimos años, concentrándose la mayor parte de la producción en áreas aplicadas, como son la Economía, la Empresa y las Ciencias Sociales.

  9. TIC, desarrollo y educación: sociedades en transformación y paradigmas de cambio en Bolivia

    Directory of Open Access Journals (Sweden)

    Pablo Andrés Rivero

    2013-02-01

    Full Text Available El desarrollo de tecnologías ha sido siempre parte de lahistoria de la humanidad. Sin embargo, las tecnologías de la información y lacomunicación (TIC hoy emergen explosivamente incorporándose como determinantesfactores mediadores de las relaciones humanas a toda escala. En esta radicaltransformación, el proceso educativo enfrenta dificultades y también enormesdesafíos. A partir de un marco situacional, donde se describen loscambios socioeconómicos y sociodemográficos importantes en el tejido socialboliviano –que por supuesto no son ajenos a las trasformaciones en el resto deLatinoamérica– este artículo indaga sobre las condiciones de posibilidadsociales, demográficas, y políticas para la gestión de la tecnología y lainformación de manera progresiva y sostenible en la educación, particularmenteenfocándose a la educación superior, que además incida en un masivo acceso yaprovechamiento de la información y contribuya a la genuina democratización,reduzca las asimetrías y contribuya al desarrollo económico sostenible enBolivia. La adopción institucional de principios colaborativos, lageneración de “infoestructuras” y la gestación de una “educación libre” apartir del desarrollo tecnológico son tres propuestas que este artículo ofrecepara comprender un nuevo paradigma educativo que genera sinergia hacia lainnovación y la creación de modelos innovadores de negocio, el desarrollotecnológico propio, mayores y mejores niveles de democratización de lasinformación y el desarrollo sustentable en el tránsito hacia “la sociedad delconocimiento”.

  10. Los paradigmas de redacción normativa como medio para alcanzar la seguridad: ¿una apuesta segura?

    Directory of Open Access Journals (Sweden)

    Fernando Centenera Sánchez-Seco

    2013-01-01

    Full Text Available En diferentes referencias que se ocupan de la redacción de normas, se considera que éstas deben tener un lenguaje sencillo, claro y preciso, para así poder ofrecer seguridad. Una primera aproximación a esta afirmación, partiendo de diferentes dimensiones de la seguridad, ofrece numerosos argumentos para corroborarla. Así acontece si analizamos la seguridad como cualidad del derecho (en lo que respecta a la certeza de orientación, la firmeza del derecho o su eficacia, como justicia formal (con las implicaciones que ello conlleva en los ámbitos de la libertad y la igualdad y como justicia material (en lo que respecta a la protección de los derechos fundamentales, por ejemplo. Sin embargo, un examen más detenido demuestra que también existen razones para pensar que los paradigmas de redacción señalados no siempre aportan seguridad, y que en determinadas circunstancias el lenguaje complejo, vago o impreciso puede resultar conveniente. Si esto es así, parece que convendría reformular la directriz señalada al comienzo. Para llevar a cabo esta labor, la teoría de la legislación ofrece numerosas herramientas sugerentes, que pueden dar cabida a las circunstancias señaladas. En este estudio se propone la puesta en práctica de un sistema de racionalidad capaz de dar cobertura a las circunstancias diagnosticadas, estructurado en diferentes niveles de racionalidad, donde tienen cabida tanto los aspectos lingüísticos, como aquellos relacionados con la seguridad. 

  11. ASSESSORIA JURÍDICA POPULAR UNIVERSITÁRIA: PARADIGMAS DO ACESSO À JUSTIÇA NO ESPAÇO GLOBALIZADO

    Directory of Open Access Journals (Sweden)

    Lucas Machado Fagundes

    2009-08-01

    Full Text Available O presente estudo trata, a partir da leitura de autores críticos em relação à ciência do direito e as ciências sociais, da função social do estudante de direito frente ao “fascismo social” resultado da sociedade globalizada e da prática de assessoria jurídica popular nas comunidades periféricas. O estudo formou-se a partir da análise bibliográfica de pesquisas em relação à temática, permeia desde os fatores e efeitos nefastos do processo de globalização até o seu modo de manifestação política através do direito. Destacamos ainda, como a ciência jurídica, desde os bancos de ensino até mesmo as práticas retóricas dos tribunais legitimam e/ou pouco fazem para mudar esta situação. Culminando ao final com a sugestão dos trabalhos de assessoria jurídica popular universitária como alternativa a esta situação fatídica, Tanto criando espaços de resistência e enfrentamento pelas camadas oprimidas pelo processo globalizante hegemônico, como pela luta de mudança no paradigma jurídico de ensino e prática do direito.

  12. A Crise de paradigmas e a ressignificação do conhecimento para o século XXI

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    Ana Maria Dalla Zen

    2010-12-01

    Full Text Available O artigo discute a produção do conhecimento no século XXI, a partir da crise entre o paradigma clássico e o emergente. Destaca a incompetência da ciência para a solução dos principais problemas decorrentes do avanço científico, em especial o fenômeno da exclusão social. Analisa o princípio da complexidade e a sua relação com a construção de uma nova ética para o futuro. Mostra a incapacidade da disciplinaridade para dar conta dos problemas decorrentes do avanço científico deste século. Enfatiza a interdisciplinaridade para um primeiro passo na solução dos mesmos e, como transposição paradigmática, valoriza o princípio da transdisciplinaridade. Propõe os conceitos de permacultura, desenvolvimento sustentável, biologia do conhecimento e ecologia social como ferramentas para concretizar a interdisciplinaridade na produção do conhecimento. Conclui que a expansão de formas de democracia participativa é uma alternativa de gestão pública útil para equacionar o problema da exclusão social. E que se trata de um mecanismo de participação popular que permite às comunidades atuarem no controle público do Estado e do governo, e podem criar novas perspectivas de vida pública.

  13. Rightward shift in temporal order judgements in the wake of the attentional blink

    Directory of Open Access Journals (Sweden)

    Mitchell Valdés-Sosa

    2008-01-01

    Full Text Available Cambio hacia la derecha en los juicios de orden temporal durante el parpadeo atencional. El orden temporal de dos eventos, cada uno de ellos presentado en un hemicampo visual diferente, puede ser juzgado correctamente por observadores típicos inclusive cuando la diferencia de tiempo entre las presentaciones sea muy pequeña. El presente trabajo analiza la influencia de un proceso endógeno sobre el juicio de orden temporal (JOT y nos muestra que la percepción del orden temporal está también afectada cuando los recursos atencionales disponibles son reducidos mediante un paradigma de parpadeo atencional (PA. A los participantes se les presentaron los siguientes estímulos: un primer estímulo visual (T1 en el centro de fijación y luego de un intervalo de tiempo variable (280 ó 1030 ms, un par de estímulos lateralizados (T2. Para la tarea dual con el intervalo de tiempo de 280 ms entre T1 y T2, la precisión en el JOT se deterioró, evidenciando un PA. Sin embargo, durante el PA en lugar de la asimetría favorable al lado izquierdo, aparece un significativo sesgo en contra de ese lado.

  14. Chondroblastoma of temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    Tanohta, K.; Noda, M.; Katoh, H.; Okazaki, A.; Sugiyama, S.; Maehara, T.; Onishi, S.; Tanida, T.

    1986-07-01

    The case of a 55-year-old female with chondroblastoma arising from the left temporal bone is presented. Although 10 cases of temporal chondroblastoma have been reported, this is the first in which plain radiography, pluridirectional tomography, computed tomography (CT) and angiography were performed. We discuss the clinical and radiological aspects of this rare tumor.

  15. Chondroblastoma of temporal bone

    International Nuclear Information System (INIS)

    Tanohta, K.; Noda, M.; Katoh, H.; Okazaki, A.; Sugiyama, S.; Maehara, T.; Onishi, S.; Tanida, T.

    1986-01-01

    The case of a 55-year-old female with chondroblastoma arising from the left temporal bone is presented. Although 10 cases of temporal chondroblastoma have been reported, this is the first in which plain radiography, pluridirectional tomography, computed tomography (CT) and angiography were performed. We discuss the clinical and radiological aspects of this rare tumor. (orig.)

  16. Brazilian children performance on Rey’s auditory verbal learning paradigm Desempenho de crianças brasileiras no paradigma de aprendizagem auditivo-verbal de Rey

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    Rosinda Martins Oliveira

    2008-03-01

    Full Text Available The Rey Auditory Verbal Learning paradigm is worldwide used in clinical and research settings. There is consensus about its psychometric robustessness and that its various scores provide relevant information about different aspects of memory and learning. However, there are only a few studies in Brazil employing this paradigm and none of them with children. This paper describes the performance of 119 Brazilian children in a version of Rey´s paradigm. The correlations between scores showed the internal consistency of this version. Also, the pattern of results observed was very similar to that observed in foreign studies with adults and children. There was correlation between age in months and recall scores, showing that age affects the rhythm of learning. These results were discussed based on the information processing theory.O paradigma de aprendizagem auditivo-verbal de Rey é utilizado em todo o mundo, tanto em pesquisa quanto na clínica. Há consenso sobre sua robustez psicométrica e de que seus vários escores fornecem informações relevantes sobre diferentes aspectos da memória e da aprendizagem. No entanto, existem apenas alguns poucos estudos no Brasil envolvendo este paradigma e nenhum deles com crianças. Este artigo descreve o desempenho de 119 crianças brasileiras em uma versão do paradigma de Rey. As correlações entre escores mostraram a consistência interna desta versão. Além disso, o padrão de resultados encontrado foi muito similar àquele observado em estudos estrangeiros com adultos e crianças. Verificou-se correlação entre idade em meses e os escores de evocação, mostrando que a idade afeta o ritmo de aprendizagem. Estes resultados foram discutidos a partir da teoria do processamento da informação.

  17. Dilema entre los paradigmas cualitativo y cuantitativo de la investigación.Necesidad de una visión distinta

    OpenAIRE

    Behar Rivero, Daniel Salomón

    2011-01-01

    Se reflexionó sobre la necesidad de analizar el dilema relacionado con la polarización de la discusión, en torno a la potencialidad de los enfoques cuantitativo y cualitativo, donde se destacó que el empleo de ambos procedimientos ayuda a corregir los errores propios de cada paradigma. También se enfatizó en que esta visión facilitará los cambios necesarios que deben operarse para la integración de la práctica metodológica del quehacer científico. Some thought was given to the necessity fo...

  18. Por uma nova interpretação das mudanças de paradigma na administração pública

    Directory of Open Access Journals (Sweden)

    Carolina Andion

    Full Text Available O objetivo deste ensaio é identificar e aprofundar a análise dos paradigmas presentes no campo teórico da administração pública no Brasil. Além de salientar as transformações, trata-se de demonstrar a continuidade paradigmática presente nos estudos do campo em questão. A hipótese central deste texto é de que, embora tenhamos assistido a mudanças paradigmáticas nas duas últimas décadas, o campo da administração pública ainda é dominado - assim como nas ciências sociais e na teoria de organizações - por uma concepção funcionalista da ciência. Para demonstrar essa hipótese, utilizamos a seguinte metodologia para construção do argumento epistemológico e consequentemente para elaboração deste ensaio: (i Partimos de um diálogo com o trabalho de Keinert (1994, 2000, fazendo uma leitura que aponta os limites e busca complementar o mesmo; (ii examinamos criticamente a trajetória do campo da administração pública no Brasil e as diferentes correntes teóricas que o compõem, com base no modelo de paradigmas construído por Burrell e Morgan (2008; (iii analisamos então quatro correntes principais que compõem hoje o campo, as quais denominamos de Estadocêntrica; Pluralista; Nova Administração Pública e Novo Serviço Público, caracterizando cada uma delas e identificando os paradigmas nos quais elas estão ancoradas. Para concluir, apresentamos uma síntese, demonstrando o predomínio do paradigma funcionalista no campo da administração pública brasileira e chamando a atenção para a necessidade de se pensar novos caminhos metateóricos pouco explorados (CALDAS, 2007, tendo como inspiração referenciais críticos e interpretativos.

  19. Um novo paradigma para a gestão de recursos hídricos A new paradigm for water resource management

    OpenAIRE

    Ivanildo Hespanhol

    2008-01-01

    A política de importar água de bacias cada vez mais distantes para satisfazer o crescimento da demanda teve início há mais de dois mil com os romanos, dando origem aos seus famosos aquedutos. Esse é o "velho paradigma" que persiste ainda hoje, resolvendo, precariamente, o problema de abastecimento de água de uma região, em detrimento daquela que a fornece. A transferência sistemática de grandes volumes de água de fontes distantes, gerando volumes adicionais de esgoto, não pode mais ser aceita...

  20. Processos não conscientes de produção de memórias falsas a partir do paradigma de associados convergentes

    OpenAIRE

    Rodrigues, Eduarda Pimentel

    2009-01-01

    Tese de doutoramento em Psicologia (área de conhecimento em Psicologia Experimental e Ciências Cognitivas) As memórias falsas, também designadas de distorções ou ilusões de memória, correspondem à recordação, parcial ou totalmente, alterada de acontecimentos passados (Roediger & McDermott, 2000). A produção de memórias falsas tem sido amplamente estudada com base num procedimento experimental de associados convergentes, mais conhecido por paradigma DRM (Deese/Roediger/McDermott...

  1. Economía y políticas culturales y comunicativas para el cambio social: una revisión de paradigmas

    OpenAIRE

    Ramón Zallo Elguezaba

    2009-01-01

    En este artículo, el autor explora la aplicación de los principios derivados de la Ilustración (la libertad y la igualdad material ante la justicia, la ética y la fraternidad) en los vigentes desarrollos culturales y comunicativos en el mundo así como acciones y políticas culturales para concretarlas. Para ello, analiza en qué ha cambiado el cuadro en el que se mueve la cultura en el mundo al tiempo y reinterpreta los viejos paradigmas, concretándolos de forma constructiva, superadora y comba...

  2. El nuevo paradigma genético y la naturaleza humana: Una perspectiva desde la bioética reflexiva y secular

    OpenAIRE

    Orlando, Mejía

    2005-01-01

    La genética se ha convertido en el área científica con mayores implicaciones bioéticas y sociales, debido al poder de transformación que tiene sobre lo que se ha considerado, hasta ahora, como la naturaleza humana. En este trabajo se propone analizar la relación entre el nuevo paradigma genético, la noción histórica de la esencia humana y los contemporáneos modelos antropocéntrico y evolutivo de la naturaleza humana. Utilizando elementos conceptuales que correspondan a una bioética reflexiva,...

  3. Electroclinical findings of minor motor events during sleep in temporal lobe epilepsy.

    Science.gov (United States)

    Giuliano, Loretta; Uccello, Denise; Fatuzzo, Daniela; Mainieri, Greta; Zappia, Mario; Sofia, Vito

    2017-07-01

    It is well known that sleep-related motor seizures can originate from the temporal lobe. However, little is known about the clinical features of minor motor manifestations during sleep in patients with temporal lobe epilepsy. The main objective of our study was to verify the existence of minor motor events during sleep in patients with mesial temporal lobe epilepsy (MTLE) and to define their clinical features and electroencephalography (EEG) correlations. We enrolled in the study patients with diagnosis of symptomatic MTLE and a group of healthy controls. All patients and controls underwent long-term video -EEG monitoring, including at least one night of nocturnal sleep. We analyzed all the movements recorded during nocturnal sleep of patients and controls and their electroencephalographic correlations. We analyzed the nocturnal sleep of 15 patients with symptomatic MTLE (8 males and 7 females; mean age ± standard deviation [SD]31.8 ± 14.9 years) and of 15 healthy controls (6 males and 9 females; mean age ± SD 32.8 ± 11.2 years). The analysis of movements during sleep revealed significant differences between groups, with the patients presenting significantly more movements in sleep than healthy controls (56.7 ± 39.2 vs. 15 ± 6.1; p Epilepsy.

  4. [Clinical and pathological definition of temporal medium epilepsy subtypes with hypocampic sclerosis].

    Science.gov (United States)

    Olivares-Granados, Gonzalo; Ríos-Pelegrina, Rosa María; Ruiz-Giménez, Jesús; Galdón-Castillo, Alberto; Escobar-Delgado, Teresa; García Del Moral, Raimundo

    Mesial temporal lobe epilepsy with hippocampal sclerosis is the most common cause of refractory epilepsy, and the most common indication for surgery. Although effective, surgery fails in up to 40% of patients. The objective of our study was to establish a correlation between the different histological subtypes of mesial temporal lobe epilepsy with hippocampal sclerosis and the prognosis, seizures control, side effects and anticonvulsivant drug withdrawal in patients with refractory epilepsy. Clinical histories and anatomopathological specimens of 228 patients with temporal epilepsy surgically obtained at our hospital between 1993 and 2014 were retrospectively analysed. All patients underwent a standard preoperative evaluation and anterior temporal resection (modified from Spencer). The anatomopathological study included the standard hematoxylin-eosin and immunohistochemical protocol, with special interest in the assessment of neuronal loss with NeuN. Seizure control was assessed according to the scale of results of the ILAE and Engel. The mean follow-up was 8.6 years (2-19). At 10 years after the intervention, 67.9% of patients were seizure-free (ILAE 1) and as many as 77.5% of the patients were seizure-free (Engel 1) at the end of the follow-up. The probability of not having a seizure (ILAE 1) after surgery at 2 (p=.042), 5 (p=.001) and 7 years (p=.22) was higher in classic and severe forms compared to isolated sclerosis CA1 and CA4 forms. Higher neuronal loss measured with the NeuN immunostain in CA1 was associated with better outcome in seizure management (multivariate analysis, p=.08). The presence of a personal history of epilepsy was associated with greater neuronal loss in CA1 (p=.028) and CA3 (p=.034), and the presence of psychic auras was related with greater neuronal loss in CA3 (p=.025). In our case, the probability of medication withdrawal was related to the presence of personal history (p=.003) and, inversely, to neuronal loss in CA1 (p=.036) and CA3

  5. Paradigmas de niñez y adolescencia y el trabajo infantil Childhood and adolescence paradigms and children's work

    Directory of Open Access Journals (Sweden)

    Valeria Anahi Moreyra

    2007-12-01

    Full Text Available El presente trabajo se desarrolla en el marco del Proyecto de Investigación "Protección integral de derechos de niñas, niños y adolescentes. El trabajo infantil. Representaciones y Prácticas de los trabajadores del "Programa contra la explotación sexual y el trabajo infantil". Realizado a partir de una Beca de Estímulo financiada por la Secretaría de Ciencia y Técnica de la Universidad de Buenos. El objetivo general de la investigación consiste en analizar las representaciones sociales (Souza Minayo; 1997 sobre el trabajo infantil (CNNyA; 2003, construidas por los trabajadores del citado programa. En este informe se describen los objetivos de la investigación en curso, la metodología empleada y se presentan los resultados obtenidos a través del relevamiento documental realizado. De acuerdo a estos resultados se ubican dos transiciones. Por un lado, aquella referida a los paradigmas de niñez y adolescencia. Por otro, a las conceptualizaciones acerca del trabajo infantil. Por último, se profundiza acerca de esta última problemática en relación a la pobreza.The current work is part of the investigation project "Integral protection of girls, boys and adolescent's rights. Children's work. Practices and representations of the "Program against sexual exploitation and children's work" professionals". The project is financed by an University of Buenos Aires' Science and Technique Secretary Stimulation Scholarship. This investigation proposes to analize children's work social representations, built by the above mentioned programme's professionals. In this report we will describe which this ongoing investigation's objectives are, the chosen methodology, as well as communicate the latest results, obtained through documentary research. In relation to these results, we point out two transitions. On one hand, that referred to the childhood and adolescence paradigms. On the other hand, that one related to children's work conceptualizations

  6. Otosclerosis: Temporal Bone Pathology.

    Science.gov (United States)

    Quesnel, Alicia M; Ishai, Reuven; McKenna, Michael J

    2018-04-01

    Otosclerosis is pathologically characterized by abnormal bony remodeling, which includes bone resorption, new bone deposition, and vascular proliferation in the temporal bone. Sensorineural hearing loss in otosclerosis is associated with extension of otosclerosis to the cochlear endosteum and deposition of collagen throughout the spiral ligament. Persistent or recurrent conductive hearing loss after stapedectomy has been associated with incomplete footplate fenestration, poor incus-prosthesis connection, and incus resorption in temporal bone specimens. Human temporal bone pathology has helped to define the role of computed tomography imaging for otosclerosis, confirming that computed tomography is highly sensitive for diagnosis, yet limited in assessing cochlear endosteal involvement. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Aplicación del paradigma socio cognitivo humanista y el desempeño docente en las escuelas de educación superior del comando de educación y doctrina del ejército

    OpenAIRE

    Llontop Sebastiani, César Segundo

    2015-01-01

    Esta tesis es una investigación con diseño cuasi experimental, acerca de la aplicación del paradigma socio cognitivo humanista y el desempeño docente en las Escuelas de Educación Superior del Comando de Educación y Doctrina del Ejército.Se hipotetiza que la aplicación del paradigma socio cognitivo humanista mejora significativamente el desempeño del personal docente de las Escuelas de Educación Superior del Comando de Educación y Doctrina del Ejército. En esta investigación se busca la unidad...

  8. Selective amygdalohippocampectomy versus standard temporal lobectomy in patients with mesiotemporal lobe epilepsy and unilateral hippocampal sclerosis: post-operative facial emotion recognition abilities.

    Science.gov (United States)

    Wendling, Anne-Sophie; Steinhoff, Bernhard J; Bodin, Frédéric; Staack, Anke M; Zentner, Josef; Scholly, Julia; Valenti, Maria-Paula; Schulze-Bonhage, Andreas; Hirsch, Edouard

    2015-03-01

    Surgical treatment of mesial temporal lobe epilepsy (mTLE) patients involves the removal either of the left or the right hippocampus. Since the mesial temporal lobe is responsible for emotion recognition abilities, we aimed to assess facial emotion recognition (FER) in two homogeneous patient cohorts that differed only in the administered surgery design since anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SAH) were performed independently of the underlying electroclinical conditions. The patient selection for the two respective surgical procedures was carried out retrospectively between 2000 and 2009 by two independent epilepsy centres, the Kork Epilepsy Centre, Germany and the University Hospital of Strasbourg, France. All included patients had presented with unilateral hippocampus sclerosis (HS) without associated dysplasia or white matter blurring and had become seizure-free postoperatively. Psychometric evaluation was carried out with the Ekman 60 Faces Test and screened for depression and psychosomatic symptoms with the SCL-90 R and the BDI. Thirty healthy volunteers participated as control subjects. Sixty patients were included, 27 had undergone SAH and 33 ATL. Patients and controls obtained comparable scores in FER for surprise, happiness, anger and sadness. Concerning fear and disgust the patient group scored significantly worse. Left-sided operations led to the the most pronounced impairment. The ATL group scored significantly worse for recognition of fear compared with SAH patients. Inversely, after SAH scores for disgust were significantly lower than after ATL, independently of the side of resection. Unilateral temporal damage impairs FER. Different neurosurgical procedures may affect FER differently. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Surgical Management and Long-Term Seizure Outcome After Surgery for Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformations.

    Science.gov (United States)

    Yang, Peng-Fan; Pei, Jia-Sheng; Jia, Yan-Zeng; Lin, Qiao; Xiao, Hui; Zhang, Ting-Ting; Zhong, Zhong-Hui

    2018-02-01

    Operative strategies for cerebral cavernous malformation (CCM)-associated temporal lobe epilepsy and timing of surgical intervention continue to be debated. This study aimed to establish an algorithm to evaluate the efficacy of surgical intervention strategies, to maximize positive surgical outcomes and minimize postsurgical neurologic deficits. 47 patients having undergone operation for CCM-associated temporal lobe epilepsy were retrospectively reviewed. They had received a diagnostic series for seizure localization, including long-term video electroencephalography (vEEG), high-resolution magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT). In patients with mesial temporal lobe CCMs, the involved structures (amygdala, hippocampus, or parahippocampal gyrus) were resected in addition to the lesions. Patients with neocortical epileptogenic CCM underwent extended lesionectomy guided by intraoperative electrocorticography; further performance of amygdalohippocampectomy depended on the extent of hippocampal epileptogenicity. The study cohort contained 28 patients with drug-resistant epilepsy (DRE), 12 with chronic epilepsy (CE), and 7 with sporadic seizure (SS). Normal temporal lobe metabolism was seen in 7/7 patients of the SS group. Hypometabolism was found in all patients with chronic disease except for those with posterior inferior and middle temporal gyrus cavernous malformations (CMs). Of the 31 patients with superficial neocortical CCM, 7 had normal PET without hippocampal sclerosis, 14 had ipsilateral temporal lobe hypometabolism without hippocampal sclerosis, and 10 had obvious hippocampal sclerosis and hypometabolism. Seizure freedom in DRE, CE, and SS was 82.1%, 75%, and 100%, respectively. A significant difference was found between lesion laterality and postoperative seizure control; the rate was lower in left-sided cases because of less aggressive resection. Our study demonstrates that the data from the

  10. Dimensões do paradigma qualitativo e os desafios em pesquisas de comunicação e movimentos sociais populares

    Directory of Open Access Journals (Sweden)

    Catarina Tereza Farias de Oliveira

    2015-03-01

    Full Text Available O artigo apresenta reflexões sobre o uso do paradigma qualitativo nas pesquisas sobre práticas comunicacionais e movimentos sociais populares, colocando em debate as perspectivas compreensivas e interventivas deste paradigma. Utiliza como referência para a reflexão as pesquisas das investigadoras em campo e a provocação que os objetos de pesquisa têm trazido para ambas em suas atuações no campo da investigação. A cartografia como método de pesquisa-intervenção é o lugar que o artigo propõe para repensar a hegemonia da postura compreensiva e interpretativa no século XX, inserindo as possibilidades de unir reflexividade, criatividade, compreensão e intervenção como parte de um atuar em campo nas pesquisas de comunicação e nas Ciências Sociais e Humanas.

  11. Las mediaciones. El paradigma y las metodologías que han innovado los estudios sociológicos y humanísticos

    Directory of Open Access Journals (Sweden)

    Revista Chasqui

    2011-09-01

    Full Text Available Manuel Martín Serrano, como es sabido, es el creador del paradigma de las Mediaciones. Lo presentó por primera vez en francés, en su tesis de Doctorado de Estado, "L'Ordre du Monde a travers la T.V. Structure du discours électronique", leída en l'Université Louis Pasteur de Strasbourg, en 1974. "El paradigma de las mediaciones es un desarrollo teórico y metodológico para trabajar en ese nivel del ajuste, en el que informar, conformar y transformar son procesos interdependientes" La difusión al público de habla hispana, se hizo en el libro La mediación social, cuya primera edición se demoró hasta 1977 porque las autorizaciones administrativas para su publicación no se concedieron hasta ese año. El profesor Miquel de Moragas nos recuerda que, en esos años, convertir los procesos de mediación social en objeto de estudio sociológico era una absoluta innovación.

  12. Transição do paradigma tecnológico e a inserção da economia brasileira em contexto global

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    Guilherme Nunes Pires

    2017-07-01

    Full Text Available O intuito do artigo é compreender como ocorreu a inserção da economia brasileira contemporânea diante da transição do paradigma fordista para o microeletrônico. Para isso, serão expostas as características da economia brasileira durante sua fase de industrialização e sob o paradigma metalomecânico-químico (1930-80. Com o processo de reestruturação produtiva global, iniciado nos anos 1980, a economia nacional apresentou queda elevada da participação da indústria no produto. Sua participação nas Cadeias Globais de Valor (CGV tem como papel predominante o fornecimento de produtos intensivos em recursos naturais e de baixo valor adicionado. Sintetiza-se que a estrutura produtiva interna do Brasil foi condicionada por sua posição no comércio internacional, seja em seu período áureo de industrialização ou nas décadas recentes, a complexidade produtiva se sujeitou à manutenção de exportações de bens não industriais ou de indústria de baixa intensidade tecnológica.

  13. Luces y sombras de dos paradigmas del americanismo español en la renovación del diálogo hispanoamericano (1909-1912

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    Dalla Corte, Gabriela

    2006-12-01

    Full Text Available Between 1909 and 1911, the Spanish Americanist movement was renewed by the initiative of the University of Oviedo and the Casa de América de Barcelona. Both institutions, respectively headed by Rafael Altamira and Rafael Vehils, were able to define two alternative paradigms to the Americanist action: the fisrt one defining a pattern of intellectual intervention led by the universities and the second one a way of economic intervention commanded by some associations. Both paradigms showed their innovative character by launching concrete proposals about all the aspects of Americanist action and proposing ways of balance between regional and state interests.

    Entre 1909 y 1911, el hispanoamericanismo español experimentó una renovación impulsada por iniciativas de la Universidad de Oviedo y la Casa de América de Barcelona. Ambas entidades, lideradas por Rafael Altamira y Rafael Vehils, lograron conformar dos paradigmas alternativos para la acción americanista. El primero definió una pauta de intervención fundamentalmente intelectual liderada por las universidades; el segundo, un modelo de intervención prioritariamente económico, ejecutado por asociaciones. Ambos paradigmas mostraron su carácter innovador al brindar propuestas concretas sobre casi todos los aspectos de la acción americanista y al proponer fórmulas que equilibren los intereses regionales y estatales.

  14. Hacia una nueva clasificación de los modelos pedagógicos: el pensamiento configuracional como paradigma científico y educativo del siglo xxi

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    Alexander Ortiz Ocaña

    2013-10-01

    Full Text Available En este trabajo, resultado del proyecto MODEPED: Identificación, caracterización y elaboración del modelo pedagógico de las instituciones educativas públicas del Caribe Colombiano, se hace una nueva clasificación de los modelos pedagógicos en cuatro grande grupos: la pedagogía tradicional (Ignacio Loyola; la escuela nueva (Jhon Dewey, Decroly, Cousinet; la tecnología educativa (B. F. Skinner y la escuela del desarrollo integral (E. Pichón Riviere, P. Freyre, L. S. Vigotsky, A. N. Leontiev, S. L. Rubinstein, A. R. Luria, V. Davidov, I. A. Galperin, L. Zankov, N. Talízina, C. Rogers, Hamachek, A. Maslow, J. Bruner, D. Ausubel, R. Sternberg, J. Piaget, R. Feuerstein, J. de Zubiría, M. de Zubiría. Finalmente, se propone una alternativa emergente, tanto para la investigación científica como para la educación. Se propone el paradigma científico neuroconfiguracional para hacer ciencia humana y social, y un nuevo paradigma educativo para el siglo XXI: el Pensamiento Configuracional (Alexander Ortiz. En este sentido, se define la noción de pensamiento configuracional y se proponen sus bases, sus dimensiones, particularidades, indicadores, estadios, proceso y requerimientos.    

  15. Petrobras e o preço dos combustíveis: os novos paradigmas da intervenção do estado na economia

    Directory of Open Access Journals (Sweden)

    Jonathan

    2014-12-01

    Full Text Available O objetivo do artigo é discutir os novos paradigmas da intervenção do estado na economia e a interação entre o público e privado no Estado Moderno. O trabalho será abordado a partir de um caso concreto: o controle de preços da gasolina pela Petróleo Brasileiro S/A (Petrobrás. Será proposto uma leitura crítica dos limites, descritivos e normativos, da complexa interação público-privado, existente na Sociedades de economia mista. Com intertextualidade e interdisciplinaridade será possível compreender a relação da Petrobrás com a intervenção do Estado no domínio econômico e a existência de um novo paradigma institucional apto a concretizar o desenvolvimento socioeconômico previsto na CF/88

  16. Nontraumatic temporal subcortical hemorrhage

    International Nuclear Information System (INIS)

    Weisberg, L.A.; Stazio, A.; Shamsnia, M.; Elliott, D.; Charity Hospital, New Orleans, LA

    1990-01-01

    Thirty patients with temporal hematomas were analyzed. Four with frontal extension survived. Of 6 with ganglionic extension, three had residual deficit. Of 8 with parietal extension, 4 had delayed deterioration and died, two patients recovered, and two with peritumoral hemorrhage due to glioblastoma multiforme died. Five patients with posterior temporal hematomas recovered. In 7 patients with basal-inferior temporal hematomas, angiography showed aneurysms in 3 cases, angiomas in 2 cases and no vascular lesion in 2 cases. Of 23 cases with negative angiography and no systemic cause for temporal hematoma, 12 patients were hypertensive and 11 were normotensive. Ten hypertensive patients without evidence of chronic vascular disease had the largest hematomas, extending into the parietal or ganglionic regions. Seven of these patients died; 3 had residual deficit. Eleven normotensive and two hypertensive patients with evidence of chronic vascular change had smaller hematomas. They survived with good functional recovery. (orig.)

  17. Temporal Lobe Seizure

    Science.gov (United States)

    ... functions, including having odd feelings — such as euphoria, deja vu or fear. Temporal lobe seizures are sometimes called ... sudden sense of unprovoked fear or joy A deja vu experience — a feeling that what's happening has happened ...

  18. SHEEP TEMPORAL BONE

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    Kesavan

    2016-03-01

    Full Text Available INTRODUCTION Human temporal bones are difficult to procure now a days due to various ethical issues. Sheep temporal bone is a good alternative due to morphological similarities, easy to procure and less cost. Many middle ear exercises can be done easily and handling of instruments is done in the procedures like myringoplasty, tympanoplasty, stapedotomy, facial nerve dissection and some middle ear implants. This is useful for resident training programme.

  19. Infomedicina: el nuevo paradigma

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    José Félix Patiño

    1999-01-01

    Full Text Available La revolución de la informática y de las comunicaciones representan para la ciencia biomédica un nuevo y esplendoroso panorama. El ejercicio de la profesión médica no es sino un manejo ordenado de la información y, en esencia, los servicios de salud son sistemas de información. La informática es un poderoso amplificador intelectual que permite un razonamiento médico más objetivo y racional.

  20. Paradigma Bahasa Pemrograman

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    Subandijo Subandijo

    2011-12-01

    Full Text Available This article discusses several paradigms used in developing computer programs which is varied from the classical – goto programming, until the modern one – object oriented programming. In addition, the main features of each paradigm, the advantages and disadvantages of each paradigm and the comparation of procedural programming, the object oriented programming, and an additional feature like generic programming for the object oriented programming are also discussed in this article.