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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2021; 79(12): 1084-1089
DOI: 10.1590/0004-282X-ANP-2021-0003
Articles

Relationship of white matter hyperintensities with clinical features of seizures in patients with epilepsy

A relação das hiperintensidades da substância branca com as características clínicas das crises em pacientes com epilepsia
Ferda Ilgen USLU 
1   Bezmialem Vakıf University, Medical Faculty, Department of Neurology, Fatih, İstanbul, Turkey.
,
Elif ÇETINTAŞ 
2   Bezmialem Vakıf University, Medical Faculty, Fatih, İstanbul, Turkey.
,
İsmail YURTSEVEN 
3   Bezmialem Vakıf University, Medical Faculty, Department of Radiology, Fatih, İstanbul, Turkey.
,
Alpay ALKAN 
3   Bezmialem Vakıf University, Medical Faculty, Department of Radiology, Fatih, İstanbul, Turkey.
,
Mehmet KOLUKISA 
1   Bezmialem Vakıf University, Medical Faculty, Department of Neurology, Fatih, İstanbul, Turkey.
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ABSTRACT

Background: Although epilepsy is primarily known as a cortical disorder, there is growing body of research demonstrating white matter alterations in patients with epilepsy. Objective: To investigate the prevalence of white matter hyperintensities (WMH) and its association with seizure characteristics in patients with epilepsy. Methods: The prevalence of WMH in 94 patients with epilepsy and 41 healthy controls were compared. Within the patient sample, the relationship between the presence of WMH and type of epilepsy, frequency of seizures, duration of disease and the number of antiepileptic medications were investigated. Results: The mean age and sex were not different between patients and healthy controls (p>0.2). WMH was present in 27.7% of patients and in 14.6% of healthy controls. Diagnosis of epilepsy was independently associated with the presence of WMH (ß=3.09, 95%CI 1.06-9.0, p=0.039). Patients with focal epilepsy had higher prevalence of WMH (35.5%) than patients with generalized epilepsy (14.7%). The presence of WMH was associated with older age but not with seizure characteristics. Conclusions: WMH is more common in patients with focal epilepsy than healthy controls. The presence of WMH is associated with older age, but not with seizure characteristics.

RESUMO

Antecedentes: Embora a epilepsia seja principalmente conhecida como um distúrbio cortical, há um crescente corpo de pesquisas que demonstra alterações na substância branca em pacientes com epilepsia. Objetivo: Investigar a prevalência de hiperintensidades da substância branca (WMH) e sua associação com características das crises em pacientes com epilepsia. Métodos: A prevalência de WMH em 94 pacientes com epilepsia e 41 controles saudáveis foi comparada. Na amostra de pacientes, foi investigada a relação entre a presença de WMH e o tipo de epilepsia, a frequência das crises, a duração da doença e o número de medicamentos antiepilépticos. Resultados: A média de idade e o sexo não diferiram entre pacientes e controles saudáveis (p>0,2). WMH estava presente em 27,7% dos pacientes, enquanto em 14,6% dos controles saudáveis. O diagnóstico de epilepsia foi independentemente associado à presença de WMH (ß=3,09, IC95% 1,06-9,0, p=0,039). Pacientes com epilepsia focal apresentaram maior prevalência de WMH (35,5%) do que pacientes com epilepsia generalizada (14,7%). A presença de WMH foi associada à idade avançada, mas não a características das crises. Conclusões: Pacientes com epilepsia focal têm WMH mais comum do que controles saudáveis. A presença de WMH está associada à idade avançada, mas não a características das crises epilépticas.

Keywords:

Epilepsy - White Matter - Epilepsies, Partial - Epilepsy, Generalized

Palavras-chave:

Epilepsia - Substância Branca - Epilepsias Parciais - Epilepsia Generalizada

Authors’ contributions:

FİU: designed, directed, and coordinated the study, analyzed data and wrote the paper; EÇ: acquisition of clinical and MRI data; İY: performed radiologic analyses; AA, MK: data interpretation, revising the article.




Publikationsverlauf

Eingereicht: 12. Januar 2021

Angenommen: 30. April 2021

Artikel online veröffentlicht:
07. Juni 2023

© 2021. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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