Chronic dysfunction of blood-brain barrier in patients with post-encephalitic/encephalopathic epilepsy
| Autor: | Katsumi Imai, Taikan Oboshi, Tokito Yamaguchi, Takayoshi Koike, Hirowo Omatsu, Hideyuki Otani, Shinsaku Yoshitomi, Asako Horino, Yukitoshi Takahashi, Hideo Shigematsu, Hiroko Ikeda, Yushi Inoue, Tomokazu Kimizu |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Drug Resistant Epilepsy medicine.medical_specialty Adolescent Encephalopathy Serum albumin Blood–brain barrier Gastroenterology Young Adult 03 medical and health sciences Epilepsy 0302 clinical medicine Cerebrospinal fluid Internal medicine medicine Humans In patient Child Serum Albumin Retrospective Studies biology business.industry Albumin General Medicine medicine.disease 030104 developmental biology medicine.anatomical_structure Neurology Blood-Brain Barrier Child Preschool biology.protein Encephalitis Female Neurology (clinical) Encephalopathic epilepsy business Biomarkers 030217 neurology & neurosurgery |
| Zdroj: | Seizure. 63:85-90 |
| ISSN: | 1059-1311 |
| DOI: | 10.1016/j.seizure.2018.11.005 |
| Popis: | Purpose This study aimed to elucidate the characteristics and effects of chronic blood-brain barrier (BBB) dysfunction in patients with post-encephalitic/encephalopathic epilepsy (PEE), using brain images and the cerebral spinal fluid (CSF)/serum albumin ratio (albumin quotient, QAlb) as a marker of BBB function. Methods We examined the albumin levels in CSF and serum samples from 312 patients with refractory epilepsy in our center between 2004 and 2015. Sixty samples from patients with PEE and 97 samples from age- and sex-matched disease controls (DC) were evaluated. We classified PEE patients into a widespread lesion group and a focal lesion group by severity on brain magnetic resonance images in the chronic phase after acute encephalitis/encephalopathy. Results Median QAlb was higher in PEE than in DC [median (range) ×10 3 : PEE 3.6 (1.0–10.3) versus DC 2.7 (1.0–6.7), p = 0.007]. In a linear regression analysis of the relationship between QAlb and patient's age at CSF examination or duration of epilepsy, the slope of the regression line was greater in PEE than in DC. Furthermore, in patients under ten years of age, linear regression analysis of QAlb versus seizure frequency showed a weak but positive correlation. Among PEE patients, seizure frequency was higher in the widespread lesion group than in the focal lesion group [300 (4–3000) versus 30 (1–1500) seizures/month, p Conclusion Our study suggests that patients with PEE have more severe BBB dysfunction, and that the BBB dysfunction is associated with refractory epilepsy. |
| Databáze: | OpenAIRE |
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