Suplementacao de omega 3 em pessoas com epilepsia submetidas a um programa regular de hemidialise: veio para ficar

Among the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP), higher frequency of seizures is a very consistent issue. Furthermore, it has been established that hemodialysis-associated seizure is a complication of the dialysis procedure. Thus, since a possible relation between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program should not be neglected, we propose in this paper that omega-3 fatty acids offer opportunities for prevention of sudden cardiac death or improved treatment in people with epilepsy under the regular hemodialysis program.Dentre os fatores de risco sugeridos para a morte súbita inesperada em epilepsia (SUDEP), maior frequência de crises epilépticas é uma questão muito consistente. Além disso, tem sido estabelecido que as crises epilépticas associadas à hemodiálise são uma complicação do procedimento dialítico. Desse modo, como a existência de uma possível associação entre as alterações cardiovasculares e a SUDEP entre indivíduos com insuficiência renal crônica em tratamento dialítico não deve ser negligenciada, foi proposto neste artigo que o ômega 3 pode atuar na prevenção da morte súbita cardíaca ou melhorar o tratamento de pessoas com epilepsia inseridas em um programa regular de hemodiálise.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de Neurologia ExperimentalUNIFESP-EPM Departamento de FisiologiaUniversidade Presbiteriana Mackenzie Programa de Pos-Graduacao em Disturbios do Desenvolvimento do Centro de Ciencias Biologicas e da SaudeUNIFESP, EPM, Disciplina de Neurologia ExperimentalUNIFESP, EPM Depto. de FisiologiaSciEL

Altered anxiety-related and abnormal social behaviors in rats exposed to early life seizures

Neonatal seizures are the most common manifestation of neurological dysfunction in the neonate. the prognosis of neonatal seizures is highly variable, and the controversy remains whether the severity, duration, or frequency of seizures may contribute to brain damage independently of its etiology. Animal data indicates that seizures during development are associated with a high probability of long-term adverse effects such as learning and memory impairment, behavioral changes and even epilepsy, which is strongly age dependent, as well as the severity, duration, and frequency of seizures. in preliminary studies, we demonstrated that adolescent male rats exposed to one-single neonatal status epilepticus (SE) episode showed social behavior impairment, and we proposed the model as relevant for studies of developmental disorders. Based on these facts, the goal of this study was to verify the existence of a persistent deficit and if the anxiety-related behavior could be associated with that impairment. To do so, male Wistar rats at 9 days postnatal were submitted to a single episode of SE by pilocarpine injection (380 mg/kg, i.p.) and control animals received saline (0.9%, 0.1 mL/10 g). It was possible to demonstrate that in adulthood, animals exposed to neonatal Se displayed low preference for social novelty, anxiety-related behavior, and increased stereotyped behavior in anxiogenic environment with no locomotor activity changes. On the balance, these data suggests that neonatal Se in rodents leads to altered anxiety-related and abnormal social behaviors.MACKPESQUISAFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Presbyterian Mackenzie Univ, Neurobiol Lab, Dev Disabil Grad Program, BR-01302907 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Neurol & Neurosurg, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Neurol & Neurosurg, São Paulo, BrazilWeb of Scienc

Sudden unexpected death in epilepsy: an important concern

Epilepsy is one of the most common neurologic problems worldwide. Unfortunately, individuals with epilepsy are at higher risk of death than the general population, and sudden unexpected death in epilepsy is the most important direct epilepsy-related cause of death. In this review article, our research group focused on the risk factors, mechanisms and preventative measures obtained from clinical and experimental studies on sudden unexpected death in epilepsy

Promessa do ômega-3 contra a morte súbita em epilepsia: até segunda ordem, continua inocente, até que se prove o contrário

The present paper highlighted the importance of the recommended levels of fish consumption or omega-3 supplementation in order to minimize the frequency of seizures in people with uncontrolled epilepsy and, especially, to reduce the occurrence of sudden unexpected death in epilepsy (SUDEP).O presente trabalho destacou a importância dos níveis recomendados de consumo de peixe ou suplementação de ômega-3 com o intuito de minimizar a frequência de crises epilépticas em pessoas com epilepsia refratária e, especialmente, de reduzir a ocorrência de morte súbita inesperada em epilepsia (SUDEP).Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Departamento de MedicinaUniversidade Presbiteriana Mackenzie Programa de Pós-graduação em Distúrbios do DesenvolvimentoUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Departamento de FisiologiaUniversidade de São Paulo Faculdade de Medicina Hospital das ClínicasUNIFESP, EPM, Depto. de MedicinaUNIFESP, EPM, Depto. de FisiologiaSciEL

Exercício físico em ratos com epilepsia como fator protetor contra crises epilépticas: evidencias de estudos em animais

People with epilepsy have been discouraged from participating in physical activity due to the fear that it will exacerbate seizures. Clinical and animal studies indicate a reduction of seizure frequency as well as decrease susceptibility to subsequently evoked seizures after an exercise program. Analyses from experimental studies of animals with epilepsy submitted to physical training programs were performed. In all studies the physical training was able to reduce the number of spontaneous seizures in rats with epilepsy. Seizure occurrence during exercise was relatively absent in the majority of studies. No death was found in animals with epilepsy during 1680 h of exercise. Based on these results it is plausible encouraging persons with epilepsy to non-pharmacological treatments and preventative measures such as physical exercise.Pessoas com epilepsia têm sido desencorajadas da prática de atividade física por receio do exercício físico exacerbar as crises epilépticas. Estudos clínicos e em animais mostram uma redução da frequência de crises, assim como diminuição da susceptibilidade a crises subseqüentes após programa de exercício físico. Neste estudo realizamos uma análise de estudos experimentais de animais com epilepsia submetidos a programas de exercício físico. Em todos os estudos, o treinamento físico foi capaz de reduzir o número de crises espontâneas em ratos com epilepsia. A ocorrência de crises durante o exercício físico foi relativamente ausente na maioria dos estudos. Nenhuma morte foi encontrada em animais com epilepsia durante 1680 h de exercício físico. Baseados nestes resultados parece aceitável encorajar as pessoas com epilepsia a tratamentos não farmacológicos e medidas preventivas como o exercício físico.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de FisiologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de Neurologia ExperimentalUniversidade de São Paulo Faculdade de Medicina de Ribeirão Preto Departamento de Neurologia, Psiquiatria e Psicologia MédicaUniversidade Presbiteriana Mackenzie Centro de Ciências Biológicas e da SaúdeUNIFESP, EPM, Depto. de FisiologiaUNIFESP, EPM, Disciplina de Neurologia ExperimentalSciEL

Activation and involvement of the lateral-posterior nucleus of the thalamus after a single generalized tonic-clonic seizure

The lateral-posterior thalamic nuclei (LP) have been shown to play an important role in controlling epileptic activity. in addition, thalamic atrophy and neuronal loss have been observed in epilepsy. the objective of this study was to investigate whether lateral-posterior neuronal activation may be observed shortly after a single generalized seizure in rats submitted to the pilocarpine model of epilepsy. the results showed an increased lateral-posterior activation as soon as the seizure occurred, suggesting that neuronal loss in the thalamus is not only the consequence of chronic epilepsy. (C) 2013 Elsevier Inc. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Dept Expt Neurol, São Paulo, BrazilUniv Presbiteriana Mackenzie, Neurobiol Lab, Programa Posgrad Disturbios Desenvolvimento, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Dept Fisiol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Dept Expt Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Dept Fisiol, São Paulo, BrazilWeb of Scienc

Sudden unexpected death in children with epilepsy: the many faces of fungal pathogenicity

Epilepsy is one of the most prevalent neurological diseases worldwide. the mortality rates are considerably higher in people with epilepsy than would be expected in a healthy population and sudden unexpected death in epilepsy (SUDEP) is the most frequent epilepsy-related category of death. Most children had seizures before the occurrence of the fatal event and autonomic dysfunction has been proposed as mechanisms of sudden death in this population. Is this sense, we raise the question whether is there a possible relationship between SUDEP in children and fungal pathogenicity. Indeed, the role of fungal pathogenicity in the establishment of epilepsy and even in cases of SUDEP has an interesting role in this scenario. Moreover, maternal infections during pregnancy have been associated with an increased risk for several brain disorders, however, this fact is still considered uncertain with respect to epilepsy.Based on this information and considering that maternal-fetal yeast infection is directly associated with an increased risk for epilepsy in childhood and that some patients have medically intractable epilepsy, the chances of these children suffering a fatal event cannot be overlooked by healthcare professionals. Thus, as exact knowledge regarding this association is lacking, some possibilities could be evaluated, and more emphasis on translational research would contribute to further progress to the knowledge of SUDEP. (C) 2012 Elsevier B.V. All rights reserved.Universidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Disciplina Neurol Expt, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Dept Psicobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Disciplina Doencas Infecciosas, Dept Med, São Paulo, BrazilUPM, Neurobiol Lab, Programa Posgrad Disturbios Desenvolvimento, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Disciplina Neurol Expt, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Dept Psicobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med UNIFESP EPM, Disciplina Doencas Infecciosas, Dept Med, São Paulo, BrazilWeb of Scienc

Qualitative study of hippocampal formation in hypertensive rats with epilepsy

The aim of our study was to investigate the hippocampus and dentate gyrus neuropathological features of spontaneous hypertensive rats (SHR) with epilepsy. METHOD: Animals were randomly divided into 4 groups: control Wistar, Wistar with epilepsy, control SHR and SHR with epilepsy. The pilocarpine model of epilepsy was used in this experiement. After spontaneous recurrent seizures, all animals were perfused and their brains processed for histological analysis through Nissl and neo-Timm methods. RESULTS: In the Wistar rats with epilepsy we observed cell loss in hippocampal subfields CA1, CA3 and hilus of the dentate gyrus when compared with control animals. In the SHR with epilepsy we observed hippocampal formation atrophy with ventricular dilatation. No morphological alterations were observed in SHR and Wistar control rats. The neo-Timm staining of hippocampal formation has shown supragranular sprouting in Wistar and SHR with epilepsy. CONCLUSION: We found neuropathological alterations in hippocampal formation in Wistar with epilepsy and SHR with epilepsy, suggesting that epilepsy per se or associated to hypertention are able to cause neuronal damage.O objetivo deste estudo foi avaliar qualitativamente o hipocampo e o giro dentado de ratos espontaneamente hipertensos (SHR) com epilepsia. MÉTODO: Os animais foram divididos em 4 grupos: Wistar controle, Wistar com epilepsia, SHR controle e SHR com epilepsia. Para indução da epilepsia, utilizamos o modelo da pilocarpina. Após os animais apresentarem crises espontâneas e recorrentes, o tecido cerebral dos animais foi encaminhado para análise histológica através dos métodos de Nissl e neo-Timm. RESULTADOS: Nos animais Wistar e SHR controle submetidos à coloração de Nissl observamos a manutenção das camadas celulares da formação hipocampal. Nos animais Wistar com epilepsia verificamos intensa morte neuronal na região CA1 e CA3 do hipocampo e no hilo do giro dentado. Nos animais SHR com epilepsia verificou-se a presença de atrofia hipocampal com dilatação do sistema ventricular. A coloração de neo-Timm revelou a presença de brotamento supragranular em todos os animais com epilepsia. CONCLUSÃO: Foram encontradas alterações neuropatológicas na citoarquitetura hipocampal nos animais Wistar com epilepsia e SHR com epilepsia, demonstrando que a epilepsia isoladamente ou associadamente à hipertensão são capazes de causar destruição neuronal.UNIFESP-EPMUniversidade de Mogi das Cruzes Universidade de Mogi das Cruzes Laboratório de NeurociênciasCentro Universitário São CamiloUNIFESP, EPMSciEL

Ocorrência de crises epilépticas em pacientes com insuficiência renal crônica em programa dialítico regular

Hemodialysis-associated seizure is a complication of hemodialysis. This report describes the occurrence of seizures in patients with end stage renal disease on dialysis therapy at the Nephrology Institute of Mogi das Cruzes, São Paulo State, Brazil. A retrospective medical history of 189 patients was reviewed to investigate the occurrence of convulsive seizures during dialytic program. Seven patients with history of seizures were selected but five of them were included in our study. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Three patients presented seizure just during the dialysis (unique seizure) and one of them presented convulsive status epilepticus. The two other patients had already presented seizures prior the beginning of dialysis. We conclude that seizures in renal failure could be considered as occasional events that do not usually become chronic.Convulsões durante o tratamento dialítico podem constituir uma complicação da hemodiálise. Esse artigo descreve a ocorrência de crises em pacientes em estágio final de insuficiência renal crônica sob tratamento dialítico no Instituto de Nefrologia de Mogi das Cruzes, São Paulo, Brasil. Foram revistos os prontuários de 189 pacientes, com o objetivo de investigar a ocorrência de crises convulsivas durante o tratamento dialítico. Dos sete pacientes selecionados com história de crises, cinco concordaram em participar de nosso estudo. Três pacientes apresentaram crises generalizadas tônico-clônicas, um apresentou crise parcial com generalização subseqüente e um apresentou crise inclassificada. Três pacientes apresentaram crises apenas durante o processo dialítico (crise única) sendo que um deles apresentou status epilepticus convulsivo. Os outros dois pacientes já haviam apresentado crises antes do início do tratamento dialítico. Nós concluímos que as crises convulsivas que ocorrem em pacientes com falência renal podem ser consideradas como eventos ocasionais e que usualmente não se tornam crônicas.Universidade de Mogi das Cruzes Núcleo de Pesquisas Tecnológicas Laboratório de NeurociênciasUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Laboratório de Neurologia ExperimentalInstituto de Nefrologia de Mogi das CruzesUNIFESP, EPM, Laboratório de Neurologia ExperimentalSciEL

Fish Oil Supplementation Reduces Heart Levels of Interleukin-6 in Rats with Chronic Inflammation due to Epilepsy

Sudden unexpected death in epilepsy (SUDEP) is a major cause of premature death related to epilepsy. The causes of SUDEP remain unknown, but cardiac arrhythmias and asphyxia have been suggested as a major mechanism of this event. Inflammation has been implicated in the pathogenesis of both epilepsy and ventricular arrhythmia, with interleukin-6 (IL-6) being recognized as a crucial orchestrator of inflammatory states. Our group previously reported that levels of IL-6 were increased in the hearts of epileptic rats. In this scenario, anti-inflammatory actions are among the beneficial effects of fish oil dietary supplementation. This investigation revealed that elevated levels of IL-6 in the heart were markedly reduced in epileptic rats that were treated in the long-term with fish oil, suggesting protective anti-inflammatory actions against dangerously high levels of IL-6. Based on these findings, our results suggest beneficial effects of long-term intake of fish oil in reducing the inflammation associated with chronic epilepsy.FAPESPCAPESCNPqFAPESP/CNPq/MCT-Instituto Nacional de Neurociencia TranslacionalFAPEMIGCEPID/FAPESPUniv Fed Sao Paulo, Escola Paulista Med, Disciplina Neurociencia, UNIFESP, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Dept Fisiol, UNIFESP, Sao Paulo, BrazilUniv Fed Sao Joao Del Rei UFSJ, Dept Engn Biossistemas, Sao Joao Del Rei, BrazilUniv Presbiteriana Mackenzie, Programa Posgrad Disturbios Desenvolvimento, Ctr Ciencias Biol & Saude, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Disciplina Neurociencia, UNIFESP, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Dept Fisiol, UNIFESP, Sao Paulo, BrazilFAPESPCAPESCNPqFAPESP/CNPq/MCT-Instituto Nacional de Neurociencia TranslacionalFAPEMIGCEPID/FAPESPWeb of Scienc