LUIZ HENRIQUE MARTINS CASTRO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Neurologia, Faculdade de Medicina - Docente
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
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Resultados de Busca
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- Gender and age influence in daytime and nighttime seizure occurrence in epilepsy associated with mesial temporal sclerosis(2015) PASSARELLI, Valmir; CASTRO, Luiz Henrique MartinsObjectives: The aim of this study was to analyze the daytime and nighttime seizure distribution during video-EEG monitoring in patients with epilepsy associated with unilateral mesial temporal sclerosis (MTS) and the role of gender, age, and lesion side on 24-hour seizure distribution. Methods: We studied 167 consecutive adult (age >= 16 years) patients with epilepsy associated with unilateral mesial temporal sclerosis that had three or more recorded seizures during continuous video-EEG monitoring with a minimum recording time period of 24 h. Seizure onset time was classified according to occurrence in six 4-hour periods. Results: Seven hundred thirty-five seizures were evaluated. We observed two higher seizure occurrence periods: 08: 01-12: 00 (p = 0.001) and 16: 01-20: 00 (p = 0.03). Significantly fewer seizures were observed between 0: 01 and 4: 00 (p = 0.01). Nonuniform seizure distribution was noted in women (p < 0.0001), in young patients (less than 45 years of age) (p < 0.0001), and in both patients with left (p = 0.03) and patients with right mesial temporal sclerosis (p = 0.008). Men presented uniform seizure occurrence distribution (p = 0.15). Women had fewer seizures than expected and fewer seizures than men between 0: 01-04: 00 (p < 0.0001 and p = 0.0015, respectively) and 04: 01-08: 00 (p = 0.01 and p = 0.03, respectively). Young patients (age b 45 years) had two seizure occurrence peaks, 08: 01-12: 00 (p = 0.016) and 16: 01-20: 00 (p = 0.004). Middle-aged/old patients (>= 45 years) had only one seizure occurrence peak, 08: 01-12: 00 (p = 0.012). Young patients had more seizures than middle-aged/old patients between 16: 01-20: 00 (p = 0.04). No differences were noted between left and right MTS. Significance: We observed two seizure occurrence peaks: morning and late afternoon/evening. We encountered variations in daytime and nighttime seizure distribution according to gender and age, but not according to side of MTS. Future studies are needed to confirm these findings and to unravel the neurobiological substrate underlying daytime and nighttime variations of seizure occurrence in different age groups and between genders.
- Validity and reliability of the Portuguese version of the Epilepsy Medication Treatment Complexity Index for Brazil(2011) FERRARI, Carla Maria Maluf; CASTRO, Luiz Henrique Martins; SETTERVALL, Cristina Helena Costanti; MOURA, Rosimary Maria de; COUTINHO, Pollyana Aurichio; OSHIRO, Iolanda Eiko Shirota; ALVES, Roseane Batista; SOUSA, Regina Marcia Cardoso deWe evaluated the reliability and validity of a Brazilian-Portuguese version of the Epilepsy Medication Treatment Complexity Index (EMTCI). Interrater reliability was evaluated with the intraclass correlation coefficient (ICC), and validity was evaluated by correlation of mean EMTCI scores with the following variables: number of antiepileptic drugs (AEDs), seizure control, patients' perception of seizure control, and adherence to the therapeutic regimen as measured with the Morisky scale. We studied patients with epilepsy followed in a tertiary university-based hospital outpatient clinic setting, aged 18 years or older, independent in daily living activities, and without cognitive impairment or active psychiatric disease. ICCs ranged from 0.721 to 0.999. Mean EMTCI scores were significantly correlated with the variables assessed. Higher EMTCI scores were associated with an increasing number of AEDs, uncontrolled seizures, patients' perception of lack of seizure control, and poorer adherence to the therapeutic regimen. The results indicate that the Brazilian-Portuguese EMTCI is reliable and valid to be applied clinically in the country. The Brazilian-Portuguese EMTCI version may be a useful tool in developing strategies to minimize treatment complexity, possibly improving seizure control and quality of life in people with epilepsy in our milieu.
- Emotional trauma and abuse in patients with psychogenic nonepileptic seizures(2011) PROENCA, Inah Carolina Galatro Faria; CASTRO, Luiz Henrique Martins; JORGE, Carmen Lisa; MARCHETTI, Renato LuizA history of childhood trauma and the presence of dissociative phenomena are considered to be the most important risk factors for psychogenic nonepileptic seizure disorder (PNESD). This case-control study investigated 20 patients with PNESD and 20 with temporal lobe epilepsy (TLE) diagnosed by video/EEG monitoring who were matched for gender and age. Patients with both conditions were not included in the study. Groups were evaluated for age at onset and at diagnosis, worst lifetime weekly seizure frequency, trauma history, and presence of dissociative phenomena. Age at onset (P = 0.007) and age at diagnosis (P < 0.001) were significantly higher in the PNESD group than the control group, as were the scores on the Dissociative Experiences Scale (P < 0.001) and Childhood Trauma Questionnaire (P = 0.014). Only the differences in scores on the Childhood Trauma Questionnaire subscales Emotional Neglect (P = 0.013) and Emotional Abuse (P = 0.014) reached statistical significance. Dissociative phenomena and a reported history of childhood trauma are more common in patients with PNESD than in those with TLE. However, only emotional neglect and abuse were associated with PNESD in this study.
- The intracarotid etomidate Wada test: A 54-patient series(2014) PASSARELLI, Valmir; PINTO, Lecio F.; JORGE, Carmen L.; PUGLIA, Paulo; ADDA, Carla C.; WEN, Hung-Tzu; CASTRO, Luiz H.Hemispheric language dominance and isolated hemispheric memory function evaluation can be undertaken with the intracarotid injection of a general anesthetic agent (Wada test). Amobarbital has been traditionally used as the anesthetic agent, but legal and commercial constraints limit its use. We evaluated the use of etomidate as an alternative agent for the Wada test in a series of 54 consecutive adult patients with mesial temporal sclerosis undergoing presurgical evaluation for epilepsy surgery. Language lateralization and hemispheric memory function evaluation were successfully achieved in all cases. Side effects (somnolence, tremor, and dystonia) were infrequent, minor, and transient and did not require interruption of the procedure. Etomidate appears to be a safe and effective alternative agent to amobarbital in the Wada test. Similarly to the amobarbital Wada test, the ability of the etomidate Wada test to predict postoperative memory decline remains unclear.