ObjectiveTo confirm that conduction of the epileptiform discharge activity out of the cranium can by reduce the seizure and consequence neuron injury, and introduce the novel micro invasive neurosurgical approach to epileptic therapy. MethodsTo build penicillin-induced neocortical epilepsy rat (n=60, 4 groups, 15 per group, including control group, conducting group, pseudo-conduction group and model control group). The specialized self-made conducting electrode was used to building conducting epileptic rat model. The epileptiform discharges were recorded by EEG with deep needle electrode for 2 hours under anesthesia, and seizures were monitored by video for 48 hours in waking. At last, the apoptosis ratio of neocortex was tested with flow cytometer. ResultsWe built 41 (91.1%) penicillin-induced neocortical epilepsy rats successfully. The mean frequency of total epileptiform discharges and frequency of diffused epileptiform discharges in EEG in conducting group were significantly less than the numbers in model control group and pseudo-conduction group(P < 0.01). However, significant difference was not found in times of focal epileptiform discharges among 3 test groups. During video monitoring, significant difference presented in the frequency of clinical seizure between conducting group and model control group or pseudo-conducting group. Furthermore, apoptosis ratios of neuron in conducting group was significantly less than the other two groups (P < 0.001). ConclusionsConducting the epileptiform discharge activity out of the cranium can prevent the seizure and reduce epileptiform discharge and apoptosis ratio of neocortex in neocortical epilepsy rats.
ObjectivesTo study surgical outcomes and safety of unilateral anterior temporal lobectomy (ATL) in patients with intractable bilateral temporal lobe epilepsy (TLE) and dominant seizure-onset in unilateral temporal lobe. MethodsTwenty three carefully selected patients with bilaterial TLE and dominant seizure-onset in unilateral temporal lobe were enrolled and divided into surgery and medicine groups according to the treatment.Seizure control were recorded for 2 to 5 years.Changes of full scale of intelligence quotient(IQ),and overall quality of life (QOL),percentage of therapeutic satisfaction,and surgical complications were analyzed 2 years after enrolling. ResultsFavor seizure control (Engel Class I and Class Ⅱ) reached 66.7% (10/15),60% (9/15),and 50% (5/10) at 1,2 and 5 years follow-up after unilateral ATL respectively,the percentages in medicine group is 12.5%,0% and 0% accordingly,and there were significant differences in seizures controls between patients with unilateral ATL and cases with medicine.Significantly differences were also found in changes of patients'QOL and full scale IQ at 2 years follow-up between surgery and medicine groups,and average score of overall QOL improved 5.27±6.45 in surgery group,and declined 1.40±3.58 in medicine group.In ATL group,patients with short preoperative history of seizure presented more favor seizure control than those with long preoperative history,and patients with favor seizure control and short preoperative history of seizure had more chance to improve QOL and IQ after ATL. ConclusionIntracranial EEG is vital in diagnosis of bilateral TLE.Unilateral ATL presents favor seizure control and did not render serious memory and IQ injury in carefully selected patients with true bilateral TLE and dominant seizure-onset in unilateral temporal lobe.