Prospective clinical study neuroplasticity NEUROPLASTICY motor carrier of epilepsy in children refractory under treatment neurosurgical HEMISFERIC

Abstract

AbstractThe medically refractory epilepsy is a neurological disorder that promotes an increased risk of developing psychosocial wear, restrictions and impaired quality of life of children and their caregivers, which may result from the effects of seizures and antiepileptic drugs and delayed psychomotor development. Resective techniques are associated with motor impairments, for example, residual hemiparesis on the side contralateral to the lesion and demonstrating sensory deficits in activities of daily living (ADL's). In this sense the rehabilitation aims to put that individual in conditions of activity in daily life with the best efficiency efficiency. Centers involved involved with surgery internationally present results that demonstrate significant improvements after rehabilitation, but do not describe rehabilitation programs, this so it becomes necessary to the description of the same, facilitating the understanding of the protocols and adapting it to our community. This study aims to evaluate the changes of the lower motor, including gait of children with intractable epilepsy unwieldy underwent hemispherectomy and intensive rehabilitation. Would an assessment gait kinematics using a system of cameras Qualisys Oqus 300 ®, in addition to the motor evaluation function to be held through the scales FULG-MEYER, BERG, TINETTI, PEDI before surgical intervention, and consequently in a month, three, six months and one year after rehabilitation. Qualitative data will be grouped into categories and expressed in percentage. Quantitative data are presented as means, standard error of the mean and standard deviation. To test for normality is used the Kolmogorov-Smirnov test. For analysis of parametric data between two groups will be held the Student t test and for three or more groups will be conducted analysis of variance (ANOVA) followed by Tukey post-test, when indicated. For nonparametric data will be used the Mann-Whitney U test (two samples) or Kruskal-Wallis (two or more samples), with post-test Dunn. Statistical differences will be considered when P <0.05. will be usedstatistical software for Windows environment BioEstat, version 5.0, developedby the Institute for Sustainable Development Mamirauá, supported by the Ministry Science and Technology.Key Words: Epilepsy surgery, neuroplasticity, rehabilitation, gait. (AU)