ObjectiveThe purpose of this study was to investigate the autoimmune encephalitis (AE) seizure types and EEG characteristics and the value of diagnosis. MethodsFifteen AE patients were hospitalized in the Department of Neurology at the First Hospital of Jilin University from November 2012 to July 2014. Data from their clinical manifestations, seizure types, EEG characteristics and laboratory investigation were analyzed. ResultA total of 15 patients, 5 males and 10 females, aged 19-75 years were included. Eight cases of anti-NMDA receptor encephalitis, five cases of LGI1 receptor encephalitis and two cases of anti-Hu antibody encephalitis were diagnosed clinically.①Anti-NMDA receptor encephalitis:seven patients had seizures, which inclued complex partial seizure, generalized tonic-clonic seizure, simple partial seizure and status epilepticus.Three patients had extreme delta brush.②LGI1 receptor encephalitis:two cases had seizures, while four cases with FBDS. Sharp and slow waves with irregular delta waves appeared in bilateral temporal areas in EEG of three cases, while one case showed clinical seizure. Two cases detected "limb shaking and others" attack, but the corresponding EEG showed no abnormalities.③Anti-Hu antibody encephalitis:one case showed seizures, the EEG showed a lot of sharp and slow waves with irregular delta waves in bilateral temporal areas, while one case showed sharp and slow waves. ConclusionAnti-NMDA receptor encephalitis can present with various types of seizures and non-convulsive status epilepticus, interictal extreme delta brush is more specific. It has important value. LGI1 receptor encephalitis is characterized by FBDS, it has important clinical significance.Anti-Hu antibody encephalitis lesions diffuse distribution, clinical manifestations are different. It may be associated with seizures, seizure types are not-specific.It may have slow waves or sharp and slow waves.
ObjectiveTo observe the expressions of p-mTOR, p-S6K1 and p-4EBP1 in the human brain with refractory epilepsy and to explore the role of mTOR signaling pathway in intractable epilepsy. MethodsCollecting the brain tissues of 24 patients with refractory epilepsy for surgical treatment from March 2010 to July 2011 as experimental group in hospitalized Epilepsy Center at the First Hospital of Jilin University, Changchun City. Collecting temporal lobe or frontal lobe brain tissue from 6 autopsy of patients who had emergency surgery for neurosurgery brain tranma during the same period. Using immunohistochemistry to observe the expression of p-mTOR, p-S6K1, p-4EBP1 in the two groups of brain tissues, and analyzed statistically. Results① p-mTOR, p-S6K1 and p-4EBP1 were expressed in both neurons and glial cells of experimental and control groups. P-mTOR, p-S6K1, p-4EBP1 positive cells of experimental group was significantly higher than the control group(P<0.01). The expression level of p-mTOR, p-S6K1, p-4EBP1 in the brain tissues of patients with different seizure frequency and with different duration:the expression level of p-mTOR, p-S6K1, p-4EBP1 in the brain tissues of patients in the group of epilepsy 10 years and more than 10 years were significantly higher than the group of epilepsy fewer than 10 years and the difference was statistically significant (P<0.05). ② The structural changes of brain tissues were observed under the optical microscope and electron microscope. Under the optical microscope:the distribution of nerve cells were uneven, the nucleus was vacuolated, the cytoplasm was less and gliosis. Under the transmission electron microscope:the number of neurons was reduced, nuclear condensation, the heterochromatin was increased, the nucleolus were dissymmetry and the nuclear membrane was breakage, also see neurons became psychotic, cell body became smaller, astrocyte cell membrane became edema, chromatin was dissymmetry, some mitochondrial were swelling and transparent, and others were vacuolated, the mitochondrial crista was in disorder. ③ p-mTOR, p-S6K1 and p-4EBP1 are expressed in the cerebral vascular of the brain in both experimental and control groups.In the experimental group, the expression is high concentration.In the control group, the expression is scattered in a small amount. Conclusionsp-mTOR, p-S6K1 and p-4EBP1 are widely expressed in neurons and glial cells with refractory epilepsy, which was significantly increased compared with control group. The expression of p-mTOR, p-S6K1and p-4EBP1 is related to frequency of epileptic seizures and course.