A method for the diagnosis of epilepsy

 

(57) Abstract:

The invention relates to medicine, namely neurosurgery, neurology and psychotria and can be used for examination of patients with suspected epilepsy. The spinal ganglia of chicken embryo is placed in the cerebrospinal fluid of the patient and assess the growth factor processes sensitive neurons of the spinal ganglia. With the increased activity of the growth factor to 20% refer a patient at risk of disease, epilepsy, and with the increased activity of the growth factor of more than 20% of diagnosed epilepsy. The method improves the accuracy of diagnosis and to detect disease at early stages of development.

The invention relates to medicine, namely, neurosurgery, neurology and psychiatry and can be used for examination of patients with suspected epilepsy.

Known electrophysiological methods of diagnosis of epilepsy, for example, electrocorticography (ECOG), which consists in the abstraction of brain potentials from the surface of the cortex [1], and how electrocorticography (Ascog), which consists in the abstraction of biopotentials using immersed in brain tissue electrogoniometers only during neurosurgical operations. Therefore, these methods of diagnosis of epilepsy have the following disadvantages: limited use, trauma, reduction of information content due to the influence of artifacts due to anesthesia and surgery, the inability of early diagnosis of the disease, the rare execution of surgical interventions for epilepsy in the brain.

Most widely for the diagnosis of epilepsy is applied the method of electroencephalography (EEG), including cutaneous diversion of brain potentials, we adopted for the prototype [3]. This method is not sufficiently precise and reliable, as characterized by the variability of biorhythmic brain even for a short period of time, different variability from record to record in the electroencephalogram local manifestations, smesimosti local EEG manifestations in relation to craniocerebral topography, possible the appearance of the electroencephalogram characteristic of epilepsy changes in patients with other diseases of the Central nervous system, significant effect on the results of EEG studies accept patients with epilepsy anticonvulsants.

Recently dedicated a lot of nizkorodov selected Levi-Montalcini [4] nerve growth factor, have a significant effect on the recovery of individual elements of the nervous tissue. When various organic lesions of the Central nervous system, for example, in Parkinson's disease, there is a change in content neuroradiologia factor in brain tissue that can serve as a basis for possible extensions of the laboratory diagnosis of certain diseases of the Central nervous system. In this regard, the organotypic cultures of nervous tissue is one of the most convenient experimental model to study under strictly controlled conditions of various biologically active substances that have a noticeable effect on the nervous trophism.

The invention is directed to a method of diagnosing epilepsy, providing increased accuracy of the method, and the detection of the disease in the early stages of the disease and identify risk groups among the surveyed patients about suspected epilepsy.

To do this, the spinal ganglia of chicken embryo is placed in the cerebrospinal fluid of the patient and assess the growth factor processes sensitive neurons of the spinal ganglia of chicken embryo. With the increased activity of the growth factor to 20% refer patient in gr is.

The study of the spinal ganglia of chicken embryo (organotypic culture), which responds to any physical and chemical effects increased his sensitive processes or suppression of such growth, allowing it to effectively assess the level of neurotrophic factors in liquid media epilepsy patients (in this case elected cerebrospinal fluid). Assessment of extent of disease epilepsy on the severity of the growth sensitivity of the processes of the spinal ganglia of chicken embryo and provides high reliability of the diagnosis, as well as its visibility.

The claimed method differs from the prototype in that place the spinal ganglia of chicken embryo in the cerebrospinal fluid of the patient and assess the growth factor processes sensitive neurons of the spinal ganglia of chicken embryo and increase the activity factor of 20% refer a patient at risk of disease, epilepsy, and with the increased activity of the growth factor of more than 20% of diagnosed epilepsy.

The method is as follows: spinal ganglion 10-12-day-old chick embryos allocated under the microscope, placed on the top glass substrate of the call is in the drum at a temperature of 37.6oC. the culture medium is prepared as follows: 35% eagle medium, 36% Hanks solution, 25% whey fruit cow, 5% chicken embryo extract, which add insulin to 1.2%, glucose and 1.5%, glutamine 0,36%, penicillin 300 thousand UNITS. In this environment then add the cerebrospinal fluid of a patient at a dilution of 1:10 (1 ml cerebrospinal fluid 10 ml of culture medium).

Control explants are developing in an environment without adding cerebrospinal fluid.

The degree of growth of the Explant is estimated at 3-5 days using the index definition (criterion) square, which is calculated as the ratio of the total area of the Explant with the growth area to the original area of the spinal ganglion.

In these cases, perform vasovasostomy microscopy in vivo and in preparations stained with methylene blue, hematoxylineosin and silver impregnation method for Bilovskom-gross. With the increased activity of the growth factor to 20% refer a patient at risk of disease, epilepsy, and with the increased activity of the growth factor of more than 20% of diagnosed epilepsy.

This method examined 56 patients, including epilepsy - 33, brain tumors - 10, effects of h is emery - extracts from the histories.

Example 1. Patient C-h, 5 years, and. b. 588-92, he enrolled in the Department of neurosurgery children the Polenov research neurosurgical Institute them. Professor A. L. Polenov about frequent epileptic seizures, which began at 6-months of age. Initially, during the year there was a generalized convulsive seizures, and then joined them simple partial motor seizures, which are repeated up to 10 times a day now. History of birth trauma.

The patient with a comprehensive survey. In neurological status revealed a left-sided deep hemiparesis. There is a marked delay in mental development. On pneumoencephalogram ventricular system expanded, the right lateral ventricle wider left, cracks intrathecal space is made uneven in places marked cystic expansion. Data EEG indicate local changes in the parietal-temporal-occipital derivations of the right hemisphere of the brain.

When the diagnosis of the claimed method by evaluating the effect of cerebrospinal fluid of the patient on the ganglion chicken embryo has been a strengthening of growth processes of his sensitive neurons by 104% compared with the counter Patient X, 9 years, and. b. 27-90, 1750-91, he enrolled in the Department of neurosurgery children the Polenov research neurosurgical Institute them. Professor A. L. Polenov about headaches, anxiety, reducing memory and behaviour change. Sick with 7 years. The disease began with the attack of emotional arousal, then began to emerge paroxysms of causeless fear with a frequency of up to 15 times per month, worried about the headache and loss of memory. History was marked hypoxia and birth trauma.

The patient with a comprehensive survey. In neurological status revealed mild right-sided pyramidal symptoms in the form of increased tendon and periosteal reflexes. In the mental status marked affective flash and illusory-hallucinatory experiences amid increasing memory loss. On pneumoencephalogram ventricular system moderately widened subarachnoid space filled with air quite well and evenly, there are katowickie expansion. Data EEG indicate diffuse changes of brain potentials with a predominance of the right hemisphere, with the involvement of brain stem structures.

When the diagnosis of the claimed method by evaluating the actions of splenic its neurons by 20% compared with control, that allows you to diagnose the presence of the risk factor of the disease epilepsy.

Example 3. Patient R-s, 1 year, 3 months, and. b. 1847-90, he enrolled in the Department of neurosurgery children the Polenov research neurosurgical Institute them. Professor A. L. Polenov in the absence of movements in the legs, with violations functions of pelvic organs. Ill since birth, was born with spinal cord herniation of the lumbar-sacral spine.

The patient with a comprehensive survey with application of neurosurgical diagnostic complex. Exhibited the following diagnosis. Combined malformations of the Central nervous system. Congenital lumbar hernia lumbar-sacral spine at the level of the third lumbar and first sacral vertebrae (myeloradiculitis). Soamsawali hydrocephalus.

When the diagnosis of the claimed method by evaluating the effect of cerebrospinal fluid of the patient on the ganglion chicken embryo revealed no growth stimulation processes sensitive neurons, which indicates the absence in this case of the disease epilepsy.

The proposed method is highly accurate, is simple, does not require sophisticated equipment to conduct recom the run method allows to detect the disease at different stages of the disease, and to determine the risk group among the surveyed patients about suspected epilepsy.

Literature:

1. Cretin Y. G., Guselnikov, C. N. Techniques and methods of electroencephalography. - L.: Nauka, 1971, S. 71.

2. Physiological methods in clinical practice. - L.: Medicine, 1966, S. 316.

3. Stepanova T. S. proceedings of LNHI them. Professor A. L. Polenov. Neurosurgery, I. VI. - L.: 1977, S. 88.

4. Galunov Century. N. Growth factor nerve tissue. - Minsk: 1984, S. 214.

A method for the diagnosis of epilepsy, characterized in that place the spinal ganglia of chicken embryo in culture medium with cerebrospinal fluid of a patient at a dilution of 1 : 10, appreciate the neurotrophic activity of the cerebrospinal fluid of the patient according to the degree of growth processes sensitive neurons of the spinal ganglia on area index, which is calculated as the ratio of the total area of the Explant with an area of growth processes to the original area of the spinal ganglion and with increasing neurotrophic activity to 20% refer a patient at risk of the disease of epilepsy, with an increase in neurotrophic activity of more than 20% of diagnosed epilepsy.

 

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