الفهرس 
Historical BackgroundOnly 14 pages are availabe for public view
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Abstract
Epilepsy is the third most common chronic brain disorder.
Despite progress in pharmacological and surgical treatments of
epilepsy, relatively little is known about the processes leading to
the generation of individual seizures, and about the mechanisms
whereby a healthy brain is rendered epileptic. These gaps in our
knowledge hamper the development of better preventive
treatments and cures for the 30% of epilepsy cases that prove
resistant to current therapies.
In recent years, an increasing body of evidence has indicated that
there is a complex relationship between epilepsy and the immune
system. Abnormalities in expression of cytokines and immune
cells have been observed in patients with epilepsy and in animal
models.
Moreover, epileptogenesis which can be defined as persistent
brain changes leading to spontaneous seizures, is thought to
comprise complex interactions between genetic and
environmental factors. Recently, the role of inflammation has
attracted great attention in the pathophysiology of epileptogenesis
with subsequent activation of innate immune mechanisms that
leads to persistence of an uncontrolled inflammatory state in the
brain.
This study prospectively examined 40 patients with TLE, half of
which are refractory TLE, from Ain-Shams University Hospital
and Ain-Shams University Specialized Hospital to identify the
role of inflammation in intractable temporal lobe epilepsy through
detection of cytokine level in serum of patients with intractable
temporal lobe epilepsy and to asses the pattern of cytokine
response in relation to long term effects of seizure frequency,
Summary
128
seizure type and duration of epilepsy in intractable temporal lobe
epilepsy.
We measured the plasma level of IL-6 at baseline for all patients
participating in the study as well as 20 healthy volunteers and
within 24h after seizure in the refractory group.
We found that the baseline IL-6 was significantly high in epileptic
patients compared to healthy volunteers.
We also found that there was a significant rise in the plasma level
of IL-6 in the 24 hours postictally (mean= 61.4 pg/ml) compared
to the baseline serum level (mean= 25.3 pg/ml).
Patients with controlled TLE had higher level of baseline IL-6
(mean= 46.3 pg/ml) compared to patients in the refractory group
(mean= 25.3 pg/ml) but not statistically significant.
The level of IL-6 after motor seizure (simple motor and
hypermotor) tend to be significantly high compared to non motor
seizures (dialeptic and autonomic).
Also patients who experienced motor seizures had significantly
higher mean baseline IL-6 compared to patients with non motor
seizures.
We found that the postictal IL-6 was significantly high in patients
with long standing duration of illness (more than 5 years)
compared to patients within duration of illness less than 5 years.
But we didn`t find significant association between the baseline
IL-6 and the duration of illness.
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129
Also we didn`t find a significant association between the
frequency of seizures and the baseline IL-6 levels.
Lastly there was no significant association between the baseline
IL-6 and the lateralization of the epileptic focus in the EEG.