Particularites de l’epilepsie au cours des maladies inflammatoires du systeme nerveux central

Introduction : Les crises épileptiques (CE) font partie des manifestations neurologiques des maladies inflammatoires (MI). Elles constituent un tournant évolutif grave de la maladie. Objectifs : Nous avons évalué les particularités sémiologiques, électriques, radiologiques, thérapeutiques et évolutives de l’épilepsie au cours des MI du système nerveux central (SNC). Nous avons également discuté les mécanismes physiopathologiques de l’épilepsie ainsi que les facteurs prédictifs de survenue de CE chez ces patients. Méthodes : C’est une étude rétrospective incluant les patients suivis pour épilepsie dans le cadre d’une MI du SNC. Tous nos patients ont bénéficié d’une imagerie cérébrale. Résultat : Nous avons colligé 32 patients (11 avec sclérose en plaque, 6 avec maladie de Behcet et 15 avec lupus érythémateux disséminé). Le délai des CE au cours des MI était de 3,2 ans. Elles étaient généralisées dans 62,5 % des cas. L’IRM a montré des lésions sous corticales et des lésions du tronc cérébral respectivement dans 71,8 % et 25% des cas. Une thrombose veineuse cérébrale était diagnostiquée chez 3 malades. L’EEG a objectivé des ondes lentes dans 34% des cas, et des anomalies paroxystiques chez 3 patients. Le phénobarbital était le traitement le plus prescrit. Le contrôle des CE était obtenu dans la majorité des cas. Conclusion : La survenue des CE au cours des MI pose un problème de prise en charge. Un diagnostic précoce et un traitement de l’épilepsie permettent de contrôler ces crises afin d’éviter les états de mal épileptiques qui mettent en jeu le pronostic vital des patients. Mots clés: Epilepsie, Facteurs de risque, Maladies inflammatoires  Particularities of epilepsy associated with inflammatory diseases of the central nervous systemIntroduction: The frequency of the central nervous system involvement in autoimmune disorders is very variable. Seizures are among the most common neurological manifestations, and can be occasionally the presenting symptom.Methods: All files of 32 patients with autoimmune disorder diagnosed with epilepsy were evaluated retrospectively (11 with multiple sclerosis, 6 with Behcet disease, and 15 systemic lupus erythematosus). The demographic data, clinical findings including seizures, EEG and neuroimaging findings were reviewed. Results: The sex ratio was 0.45 (10H / 22F). Seizures started 3.2 years after the onset of the inflammatory diseases. They were during either the first or following neurological attacks in 68.7% of cases. 20 patients (62,5%) had only generalized tonic-clonic seizures. Brain magnetic resonance imaging (MRI) was performed to all patients. Sub-cortical and brainstem lesions were identified respectively in 71,8 % and 25%. MRI revealed cerebral sinus thrombosis in three patients. The EEG revealed focal epileptiform discharges in three patients. In 12 patients (34%) slow waves were seen. Antiepileptic drugs were prescribed in all cases (phenobarbital :53%, valproic acid: 31%, Carbamazepine: 15%). A sufficient control of seizures was obtained in most cases. Conclusion: Seizures often complicate systemic autoimmune disorders through a variety of mechanisms. A better understanding of the mechanisms of epileptogenesis in those patients could lead to targeted treatments and better outcomes. Key words: Epilepsy, inflammatory disease, risk factor

Heterogeneous photocatalytic degradation of ibuprofen in ultrapure water, municipal and pharmaceutical industry wastewaters using a UV-LEDs/TiO2 system

Degradation and mineralization of ibuprofen (IBU) were investigated using Ultraviolet (UV) Light Emitting Diodes (LEDs) in TiO2 photocatalysis. Samples of ultrapure water (UP) and a secondary treated effluent of a municipal wastewater treatment plant (WWTP), both spiked with IBU, as well as a highly concentrated IBU (230 mg L−1) pharmaceutical industry wastewater (PIWW), were tested in the TiO2/UV-LED system. Three operating parameters, namely, pH, catalyst load and number of LEDs were optimized. The process efficiency was evaluated in terms of IBU removal using high performance liquid chromatography (HPLC) and ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). Additionally, the mineralization was investigated by determining the dissolved organic carbon (DOC) content. The chemical structures of transformation products were proposed based on the data obtained using liquid chromatography with a high resolution mass spectrometer ion trap/time-of-flight (LC-MS-IT-TOF). A possible pathway of IBU degradation was accordingly suggested. Bioassays were performed using the marine bacterium Vibrio fischeri to evaluate the potential acute toxicity of original and treated wastewaters. TiO2 heterogeneous photocatalysis was efficient to remove IBU from UP and from PIWW, and less efficient in treating the wastewater from the municipal WWTP. The acute toxicity decreased by ca. 40% after treatment, regardless of the studied matrix.Financial support for this work was provided by project “AIProcMat@N2020 – Advanced Industrial Processes and Materials for a Sustainable Northern Region of Portugal 2020”, with the reference NORTE-01-0145-FEDER-000006, supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and of Project POCI-01-0145-FEDER-006984 – Associate Laboratory LSRE-LCM funded by ERDF through COMPETE2020 – Programa Operacional Competitividade e Internacionalização (POCI) – and by national funds through FCT - Fundação para a Ciência e a Tecnologia. LMPM and AMTS acknowledge the FCT Investigator program (IF/01248/2014 and IF/01501/2013, respectively), with financing from the European Social Fund and the Human Potential Operational Program. ARR and NFFM acknowledge the research grants from FCT (Ref. SFRH/BPD/101703/2014 and PD/BD/114318/2016, respectively), with financing from the European Social Fund and the Human Potential Operational Programme. NJ acknowledges the support of the Tunisian Ministry of Higher Education and Scientific Research and Sfax University in the form of an International Travel Grant, which enabled him to perform this work. The authors are grateful to Dr. Sven Vedder (Shimadzu Europa) for the LC-MS-IT-TOF analyse