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Response of the authors to "Relations between absence seizures and the thalamus"/"Absans nobetleri ve talamus arasindaki Iliskiler" e yazarlarin yaniti.

Dear Editors,

We appreciate the authors of the letter "Relations between Absence Seizures and the Thalamus" for their interest to our article (1).

It is well-known that the WAG/Rij rat is a well-established animal model for human absence epilepsy characterized by the presence of spike-wave discharges (SWDs), but it should be kept in mind that this is still a "model" and may not reflect the real situation in humans. As stated by the authors, van de Bovenkamp-Janssen et al. have shown that organization of the rostral reticular thalamic nucleus (rRTN) of the non-epileptic rats appears to be very similar to that of the epileptic WAG/Rij rat, thus, SWD maintenance of WAG/Rij rats does not depend on a different synaptic organization of the rRTN (2). However, this finding does not mean that there is no difference in thalamic volume related to functional status in humans.

Even though there are some studies that showed decreased thalamic volume in patients with childhood absence epilepsy (CAE) (3), this could be related to the differences in the study groups. We included mostly adults with persisting absence seizures with generalized SWDs having also other idiopathic generalized epilepsy syndromes. It should be noted that in our study only 2 of the 31 patients were diagnosed with CAE (1). Juvenile myoclonic epilepsy was the most common diagnosis in our patients (n=17) and 5 of the main group had at least one episode of absence status epilepticus. The presence of absence status epilepticus is an indicator of poor prognosis for absence seizures (4). Thus, it is clear that our patients were highly selected patients with absence seizures persisting into adulthood and clearly more drug-resistant than the patients with CAE. In addition, the mean age of our patients and the age at onset of the absence seizures were higher than that of the Chan et al.'s patient group (3).

As a result of these prominent clinical differences, the increase in the thalamus volume in our patients with absence seizures may reflect the older age and resistant absence seizures. Our data may have some implications for functional dynamic changes in thalamus volume.

Regards

DOI: 10.4274/Npa.y6646

References

(1.) Aydin-Ozemir Z, Terzibasioglu E, Sencer S, Yapici Z, Baykan B. Volumetry of the thalamus in idiopathic generalized epilepsy. Archives of Neuropsychiatry-Noropsikiyatri Arsivi 2011; 48:243-248.

(2.) van de Bovenkamp-Janssen MC, Akhmadeev A, Kalimullina L, Nagaeva DV, van Luijtelaar EL, Roubos EW. Synaptology of the rostral reticular thalamic nucleus of absence epileptic WAG/Rij rats. Neurosci Res 2004; 48:21-31.

(3.) Chan CH, Briellmann RS, Pell GS, Scheffer IE, Abbott DF, Jackson GD. Thalamic atrophy in childhood absence epilepsy. Epilepsia 2006; 47:399-405.

(4.) Aydin-Ozemir Z, Baykan B, Gurses C, Bebek N, Gokyigit A. Kirk Yasin Ustundeki Idyopatik Jeneralize Epilepsi Olgularinda Klinik Ozellikler ve Prognoz. Journal of Neurological Sciences [Turkish] 2012; 29:32-41.

Correspondence Address/Yazisma Adresi: Zeynep Aydin Ozemir MD, Memorial Atasehir Hospital, Department of Neurology Istanbul, Turkey

GSM: +90 505 803 21 26 E-mail: drzeynepaydin@yahoo.com Received/Gelis tarihi: 05.05.2012 Accepted/Kabul tarihi: 14.05.2012

Zeynep AYDIN OZEMIR [1], Betul BAYKAN [2]

[1] Memorial Atasehir Hospital, Department of Neurology, Istanbul, Turkey

[2] Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
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Author:Aydin Ozemir, Zeynep; Baykan, Betul
Publication:Archives of Neuropsychiatry
Article Type:Letter to the editor
Date:Sep 1, 2012
Words:542
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