CX32 And CX43 Expression Level In The Cerebral Cortex And Clinical Characters In Intractable Epilepsy Patients

Overview:This paper aims to analyze and summarize the etiology, clinical manifestations, EEG and imaging materials of 24 cases intractable epilepsy patients and expounds the clinical characteristics of them; Explore the gap junctions expression, which is composed by CX32 and CX43 in the cerebral cortex of patients and provide new ideas of clinical research and treatments for intractable epilepsy patients.Materials and methods:Collecting the informations of 24 patients (as experimental group) with intractable epilepsy who were in hospital and undergo surgery from January 2010 to February 2011 and 6 cases of patients (as control group) who had emergency surgery for neurosurgery brain trauma during the same term. Gathering the exairesis brain tissue to observe the above CX32 and CX43 expression of the brain tissue through immunohistochemical and immune electron microscopy, then statistical analysis of the result row.Result:In our experimental group, the common causes of seizures were head trauma, encephalitis, cerebral cysticercus, asphyxia etc. Symptomatic cases were 11 cases(45.8%), major generalized tonic-clonic epilepsy as main clinical feature of intractable epilepsy patients were 17 cases (58.3%), complex partial seizure were 7cases (29.1%), multi-type seizures were 13 cases (54.2%),19 cases (79.2%) having abnormal imaging study,23 cases (95.8%) having inter-ictal EEG abnormalities.CX32 and CX43 are expressed in both experimental and control groups. In control group, the positive-cell number were 7.4±2.0 and 12.0±7.0 under light microscope (400×power). While in experimental group, the positive-cell number were 31.8±7.4 and 50.0±9.7. There were significant differences between the 2 groups(P<0.001).Under electron microscope(20000×power), the expression of CX43, CX32 on cerebral nerve cell membrane of experience group were relatively high, particle intensive, clustering or patching distribution, while in control group only small number of particles distributed on cerebral nerve cell membrane, which further confirmed that the expression of CX32, CX43 in experimental group is higher than the control group.Conclusion:1.11 cases (45.8%) of this experiment group of patients with intractable epilepsy have clear etiology, common pathogenies are brain injury, encephalitis, brain cysticercosis, etc. Multiple attacks coexistence are important clinical characteristics, iconography abnormalities, EEG abnormalities in attack interphase are common in patients with intractable epilepsy. So we highlight use routine antiepileptic medications, if failed we shift to use of selective therapy, including surgical resection after careful evaluation.2. Intractable epilepsy betrayed higher CX32 and CX43 expression in comparison to control group on LM and EM, but the high expression of CX32 and CX43 is unrelated with course of disease. So the gap junction formed by CX32 and CX43 may play an important role in the occurrence and development of epilepsy.3. Innovation points:Application of immune electron microscopy and immunohistochemical method to discuss the expression of epileptogenic brain tissue CX32, CX43 of intractable epilepsy has not been seen at home reports.