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The role of parvalbumin interneurons in seizure initiation, propagation and termination in a mouse model of focal cortical dysplasia of type II
Populová, Jana ; Řehořová, Monika (advisor) ; Kirdajová, Denisa (referee)
Focal cortical dysplasia is a structural and functional malformation of cortical development caused by mutations in mTOR signalling cascade that can result in pharmacoresistant epilepsy. Parvalbumin interneurons are probably the most important inhibition force in the brain that can help to stop epileptic seizures and it is possible that there are changes in function of these interneurons that are dependent on focal cortical dysplasia. This thesis had the aim to create a murine model of focal cortical dysplasia type II with labeled parvalbumin interneurons. This model was created by injecting plasmid with mutated mTOR gene during in utero electroporation. Cranial window implantation was then performed over created lesion together with calcium indicator injection for measuring neuronal activity under two-photon microscope. Our results confirm the same morphological characteristics as other studies has shown and also occurence of spontaneous seizures. We have shown statistically significant differences in size of pyramidal neurons depending on lesional or non-lesional position. For parvalbumin interneurons there was no such difference. Counting these two types of neurons in lesion and outside of lesion shown a trend towards reduced numbers in lesion, however it was not significant. Data from...
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The Effect of early treatment on psychomotor development in children with epileptic encephalopathy
Beňová, Barbora ; Kršek, Pavel (advisor) ; Příhodová, Iva (referee) ; Aulická, Štefania (referee)
Children with focal intractable epilepsy caused by MCD, FCD and TSC are in a high risk of development of cognitive delay, as a result of both drug resistant epilepsy and genetically determined abnormal structure of the neuronal networks. Epilepsy surgery represents an established and safe treatment method of focal drug resistant epilepsy, and increases the chances for these patients to be rid of epileptic seizures, anti-epileptic medication and cognitive comorbidities. Current data on genetic background of focal MCD and FCD and their comorbidities provide space to expand the diagnostic process in epilepsy surgery candidates. However, available information on genetic causes of MCD and FCD do not allow us to infer prognostic estimates on chances of seizure freedom and optimal cognitive development. Future studies should elucidate these uncertainties.
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Optimizing of epilepsy surgery in paediatric patients
Bělohlávková, Anežka ; Kršek, Pavel (advisor) ; Doležalová, Irena (referee) ; Vojtěch, Zdeněk (referee)
Optimizing of Epilepsy Surgery in Paediatric Patients Abstract Epilepsy surgery represents an effective treatment of intractable focal epilepsy. The presented work aims to describe the state of the art and enhance diagnostic and therapeutic algorithm in paediatric patients. The ultimate goal is to improve the outcome of surgeries. The work depicts the evolution of the paediatric epilepsy surgery program in Motol Epilepsy Center over the course of years 2000-2017. Complexity of patients (younger age, epileptogenic zone in proximity of eloquent cortex, multifocal MRI findings) and surgeries (hemispherotomy) alike increased over time. However, the outcomes in terms of postoperative seizure-freedom and complications remained stable. Cognitive abilities of patients improved by 9.1 IQ/DQ points one year after surgery. Patients with preexisting intellectual deficit reached the most significant increase. We developed a novel paradigm of intraoperative cortical electrical stimulation mapping. Furthermore, we introduced a technique employing visual detection of SEEG electrodes during the surgery. These procedures aim to achieve a complete resection while avoiding complications. We developed and standardized Czech versions of questionnaires IPES a QOLIE-AD-48 assessing quality of life in children with epilepsy. We...
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Causes of epilepsy due to disorders of cortical development of the brain
Populová, Jana ; Řehořová, Monika (advisor) ; Růžička, Jiří (referee)
Malformation of cortical development are an important cause of childhood epilepsy. It is estimated that up to 40% of these cases are medication-resistant. Pathophysiological mechanisms involved in the development of epilepsy are unknown. Identification of new type of genes associated with MCD leads to development of new experimental models recapilute human clinical symptoms. Aim of this study is to summarize information on current progress in this area obtained from MCD experimental models. These informations will help us better understand epileptogenesis. Keywords: malformation of cortical development, epilepsy, focal cortical dysplasia, epileptogenesis
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The Effect of early treatment on psychomotor development in children with epileptic encephalopathy
Beňová, Barbora ; Kršek, Pavel (advisor) ; Příhodová, Iva (referee) ; Aulická, Štefania (referee)
Children with focal intractable epilepsy caused by MCD, FCD and TSC are in a high risk of development of cognitive delay, as a result of both drug resistant epilepsy and genetically determined abnormal structure of the neuronal networks. Epilepsy surgery represents an established and safe treatment method of focal drug resistant epilepsy, and increases the chances for these patients to be rid of epileptic seizures, anti-epileptic medication and cognitive comorbidities. Current data on genetic background of focal MCD and FCD and their comorbidities provide space to expand the diagnostic process in epilepsy surgery candidates. However, available information on genetic causes of MCD and FCD do not allow us to infer prognostic estimates on chances of seizure freedom and optimal cognitive development. Future studies should elucidate these uncertainties.
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Case study of intracranial EEG records of patients with focal cortical dysplasia type I and II
Balach, J. ; Ježdík, P. ; Čmejla, R. ; Kršek, P. ; Jiruška, Přemysl
In this study we try to find out if it is possible to differentiate type of focal cortical dysplasia by features obtained from intracranial EEG. We compare occurrence and rates of three biomarkers present in epilepsy in patients with focal cortical dysplasia type I and II. Case study is made on long term night records of 6 pediatric patients. Detection of interictal epileptiform discharges and high-frequency oscillations is made by automated algorithms, delta brush are marked visually. Position of lesion and electrodes inside were obtained from MRI. In individual rates were not found difference on significant level. No major significance were found, but as promising seem to be ratio inside to outside rates of high-frequency oscillations and presence of delta brush, which were found only in patients with focal cortical dysplasia type II.
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