1.Association Analysis Of A Polymorphism Of MDR1 Gene And Refractory Temporal Lobe Epilepsy In A Chinese Population 2.Analysis Of Risk Factors Of Intractable Temporal Lobe Epilepsy

Background and ObjectivesThere are at least 7-8 million epileptics in China, of which 20-30% are medically refractory/pharmacoresistant. Although pharmacoresistance is almost certainly due to several factors , the family of multidrug transporter proteins are likely to play a prominent role in this phenomenon given the often observed broad resistance to all antiepileptic drugs despite their different modes of action. The best studied member of this family, P-glycoprotein(P-gp) has been implicated in the causation of pharmacoresistant epilepsy. The expression and efflux efficency of P-gp is influnced by a polymorphism(C3435T) in the encoding gene(MDRl), evidence suggests that the homozygous C-variant, which is associated with higher expression and increased activity of P-gp, is more common in patients with pharmocoresistent epilepsy. In addition, recent studys showed high-degree linkage disequilibrium among C1236T-G2677T-C3435T, homozygous carriers of the CGC haplotype in exons 12, 21 and 26 were found to exhibit higher pharmacoresistance in patients with epilepsy. We have investigated the prevalence of those polymorphisms in a population of china, and the association with pharmacoresistance in temporal lobe epilepsy(TLE).Materials and MethodsThe study consisted of 154 outpatients diagnosed with either mesial TLE with hippocampal sclerosis(HS) or cryptogenic, nonlesional TLE who visited the Hakuai Epilepsy Center in Peking Union Medical College Hospital from December 2000 to Jan 2006. Diagnosis of TLE was based on comprehensive clinical, neuropsychological, EEG, and MR evaluations, cerebral mass lesions were excluded. All patient had used several suitable AEDs(at least include one of the followings: Carbamazepine, Phenytoin or Oxcarbazepine) over 12 consecutive months. We stratified patients for whom average seizure frequencies could be reliably assessed into "drug-resistant group" (n = 80, the mean age at the time of the study was 32.6 ±8.7years, the mean age at seizure onset was 17.3...