Efficacy and tolerability of vigabatrin in West syndrome

West syndrome (WS) is a severe epileptic encephalopathy of childhood, characterized by spasms, developmental deterioration and hipsarhythymia. Objective: To evaluate the safety and efficacy of vigabatrin (VGB) in the treatment of WS. Method: We evaluated every patient diagnosed with WS seen at the pediatric epilepsy clinic and exposed to VGB. Patients were interviewed according to a semistructured questionnaire and we analyzed gender, age, etiology (cryptogenic or symptomatic), associated diseases, age of seizure onset, neuroimaging findings, EEG prior and after VGB, use of other antiepileptic drugs, time for seizure control, electroretinogram, visual complaints, adverse events and family history of epilepsy. Results: Twenty-three patients were evaluated, 16 boys, ages ranging from 1.25 years to 11.5 years (mean=5y3m). Sixteen (69.5%) patients were seizure free, five (22%) had partial seizure control and in two (8.5%) there was no improvement. Only one patient presented gabaergic retinopathy. Six (26%) patients presented adverse events: somnolence, aggressivity or retinopathy. Patients with seizure onset after 6 months of age presented better results after VGB introduction (p 0.05). After VGB, no patient presented hipsarrhythymia and 50% had a normal EEG. Conclusion: Although VGB may be associated with serious adverse events such as gabaergic retinopathy, our results show that it should be considered in the treatment of WS.632B46947

Genetic and cytological diversity in cherry tree accessions ( Eugenia involucrata DC) in Rio Grande do Sul

This study aimed to evaluate the genetic and cytological diversity and stability of 35 cherry tree accessions collected in Rio Grande do Sul. We used 15 RAPD (Random Amplified Polymorphic DNA) molecular markers and performed cytological analysis and number count of anthers. Analyses of genetic diversity allowed the separation of accessions into four groups, resulting in an average of 8.93 bands per primer amplified, 7.89 polymorphic bands, 88.08% of polymorphism and 86% of genetic similarity. Cytological analyses of gametic cells allowed for the characterization of accessions as diploids with n=11. In these, the average of meiotic cells considered normal was 82.12%; average pollen viability was 92.44% and in vitro germination was 40.26%; the average number of anthers was 161.85 anthers/flowers. Therefore, the accessions evaluated showed high genetic similarity and cytological stability and can be used in commercial plantations or hybridizations

Distribution of regional gray matter abnormalities in a pediatric population with temporal lobe epilepsy and correlation with neuropsychological performance

Objective. The goals of the work described here were to determine if hippocampal and extrahippocampal atrophy in children with temporal lobe epilepsy (TLE) follows a pattern similar to that in adult patients, and to assess the clinical and neuropsychological relevance of regional brain atrophy in pediatric TLE. Methods. Children with symptomatic TLE (n = 14: 9 with mesial TLE due to hippocampal atrophy and 5 with TLE due to neocortical lesions), healthy children (n = 14), and 9 adults with mesial temporal lobe epilepsy (MTLE) were compared using voxel-based morphometry (VBM) of brain magnetic resonance imaging (MRI). The children underwent a comprehensive neuropsychological battery. Results. Children with MTLE with unilateral hippocampal atrophy (n = 9) exhibited a significant reduction in gray matter in the hippocampus ipsilateral to the seizure origin and significant atrophy in the ipsilateral cingulate gyrus and contralateral middle frontal lobe. Children with TLE (n = 14) exhibited a significant reduction in the gray matter of the ipsilateral hippocampus and parahippocampal gyrus. There was a correlation between gray matter volume in children with TLE and scores on several neuropsychological tests. Atrophy in pediatric patients with MTLE was less extensive than that in adults, and involved the hippocampi and the frontal cortex. Conclusions. Similar to adult MTLE, pediatric MTLE is associated with hippocampal and extrahippocampal cell loss. However, children display less intense quantifiable gray matter atrophy, which affects predominantly frontal lobe areas. There was a significant association between volume of gray matter in medial temporal and frontal regions and scores on neuropsychological tests. In childhood, TLE and the concomitant cognitive/behavior disturbances are the result of a damaged neural network. (C) 2007 Elsevier Inc. All rights reserved.11455856

Clinical, electroencephalographic, and behavioral features of temporal lobe epilepsy in childhood

This study describes the clinical, electroencephalographic, and behavioral features of 36 children with temporal lobe epilepsy. Patients were divided into two groups: group A, with 6 patients (< 6 years), and group B, with 30 patients (6-18 years). Statistical analysis was performed considering the significance level of.05. Regarding the clinical features of the focal seizures, motor components were more frequently seen in children younger than 6 years of age (P < .01), whereas automatisms were more frequently seen in patients older than 6 years of age (P < .05). Associated myoclonic seizures were more frequent in the younger age group (P < .01). Behavioral disorders such as hyperactivity and aggressiveness and speech delay were more common in the younger age group (P < .05). Temporal lobe epilepsy in children younger than 6 years of age is more frequently associated with motor components, myoclonic seizures, behavioral disorders, and speech delay. Conversely, temporal lobe epilepsy in older patients has frequent automatisms.19641842

Effectiveness of clobazam as add-on therapy in children with refractory focal epilepsy

The objective of this study was to evaluate the safety and efficacy of clobazam in children with refractory focal epilepsy. We investigated 100 consecutive patients concerning etiology of epilepsy, previously used antiepileptic drugs, seizure frequency and adverse events. Clobazam was introduced as add-on therapy in patients with previous failure of at least two monotherapies. Mean age was eight years-old and 39 patients were girls. Clobazam mean dosage was 23.6 mg/day. Mean use of clobazam was 18.6 months. Twenty-two patients had adverse events. Twenty-six patients became seizure-free, 11 had an improvement of > 75% and in 58 there was no modification in seizure frequency. Five patients had an increase in seizure frequency. Clobazam efficacy lasted for more than one year in 42% of the seizure-free patients. Clobazam seems to be safe and effective in the treatment of focal epilepsy in childhood and should be considered in patients with refractory seizures.643B70571

Propagação da pitangueira através da enxertia de garfagem Surinam cherry propagation through grafting

A pitangueira é uma frutífera nativa com potencial para exploração comercial. Entretanto, os métodos de propagação mais comuns não são satisfatórios para a multiplicação desta espécie em larga escala. O objetivo do trabalho foi o de avaliar o uso do método de enxertia de garfagem no topo, em fenda cheia e dupla fenda, bem como a melhor época para a realização desta prática (julho, agosto e setembro), nas condições do Sul do Brasil. O experimento foi conduzido no ano de 2005, na Embrapa Clima Temperado, Pelotas-RS. O delineamento foi o inteiramente casualizado, em esquema fatorial 2 x 3 (tipo de garfagem x época de enxertia), com 5 repetições. Conclui-se que a enxertia de garfagem no topo, em fenda cheia e/ou em dupla fenda, pode ser utilizada para a propagação vegetativa da pitangueira durante o inverno, sendo que a enxertia de garfagem em fenda cheia proporcionou melhores percentuais de pegamento dos enxertos (60,0%) do que a garfagem em dupla fenda (44,2%). Quanto à época, os melhores percentuais foram obtidos no mês de setembro, com 67,5% de pegamento dos enxertos, seguido pelo mês de agosto e julho, com 51,3% e 37,5%, respectivamente.<br>The Surinam cherry is a native fruit from Brazil with a great potential for commercial production. However, the common clonal propagation methods have not given a high percentage of success. The present work had the aim to test the use of two types of grafting: cleft graft and wedge graft as well as the best time to use this technique (July, August and September), under Southern Brazil conditions. The experiment was carried out at EMBRAPA Clima Temperado, in Pelotas, RS, in the year of 2005. The experimental design was completely randomized arranged as a 2x3 factorial plan (type of grafting x time), with 5 replications . It was concluded that both types of grafting could be used, during the winter time, for asexual propagation of Surinam cherry. Cleft grafting had the highest percentage of survival (60%) when compared to the wedge grafting (44.2%). The highest percentage of grafting success was obtained in September with 67.5%, followed by the months of August and July, with 51.3% and 37.5%, respectively