Funções de memória em pacientes com epilepsia refratária do lobo temporal antes e após transplante autólogo de células-tronco da medula óssea

Abstract

Introduction: As a chronic disease which is highly prevalent, epilepsy has an important impact on the affected person's psychic/cognitive functioning and their family and social relationships. Among refractory epilepsies, epilepsy of the temporal lobe (ETL) is the most frequent in adults. Studies about lesions on the hippocampus and their effects found that patients with ETL presented verbal and visual memory deficits, depending on the affected hemisphere. Refractoriness to clinical treatment leads to the recommendation of surgery when it is seen that up to that point there have not been any other therapeutic alternatives available. In this context, there is a glimpse of a new treatment possibility for refractory epilepsies, using stem cells. These present a large capacity for proliferation and auto-renovation and the capacity to respond to external stimuli and give rise to different, more specialized cell lines. Objectives: To evaluate the effect of autologous stem cell transplants of bone marrow on the memory functions of patients with refractory epilepsy of the mesial temporal lobe. Patients and Methods: The selection of patients was done at the Outpatient Center for Clinical Epilepsy Research at PUCRS São Lucas Hospital [Ambulatório de Pesquisa Clínica em Epilepsia do Hospital São Lucas da PUCRS]. The 13 patients submitted themselves to therapy, and they were evaluated before and after the stem cell treatment (3 and 6 months after). The tests utilized for neuropsychological evaluation (pre and post-therapy) include the Wechsler Memory Scale revised (WMS-R), the Rey Auditory Verbal Learning Test (RAVLT) and the Taylor Complex Figure. Results and Conclusions: The results indicate a significant increase in the neuropsychological scores over time. In six out of seven utilized tests, the increase of average score obtained was significant. In only one test (visual reproduction I WMS R), the increase showed limitrofe statistical significance (between 5% and 10%). Given the favorable evolution of those patients analyzed, the stem cell transplant showed itself to be feasible, safe and with important perspectives for rehabilitation as well as psychosocial and professional reinsertion.