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[Neuropathologic findings in intractable epilepsy: a clinicopathologic analysis of 822 cases].
- Source :
-
Zhonghua bing li xue za zhi = Chinese journal of pathology [Zhonghua Bing Li Xue Za Zhi] 2017 Oct 08; Vol. 46 (10), pp. 673-678. - Publication Year :
- 2017
-
Abstract
- Objective: To investigate the clinicopathologic characteristics of intractable epilepsy. Methods: Based on the classification criteria proposed by the International League Against Epilepsy (ILAE), a retrospective analysis of the pathological characteristics was done in 822 patients who underwent epilepsy surgery in Sanbo Brain Hospital, Capital Medical University, from June 2008 to December 2012. Results: The mean age of epilepsy onset was 9.9 years, mean duration of epilepsy was 11.9 years. Complex partial seizures were the main presenting features. Histopathological study showed 33 cases (4.01%) with mild forms of cortical malformations, 690 cases (83.94%) with focal cortical dysplasia (FCD) and 99 cases with others (including 39 pure hippocampal sclerosis, 20 cystosclerosis, 19 Sturge-Weber syndrome, 8 tuberous sclerosis complex, 6 without significant pathological changes, 5 gyral malformations and 2 hamartoma). Among the 690 FCD cases, 106 were FCD typeⅠ, 91 were FCD typeⅡ and 493 were FCDⅢ(Ⅲa: 160, Ⅲb: 106, Ⅲc: 26 and Ⅲd: 201). Conclusions: FCDⅢd is the most common histopathological subtype causing intractable epilepsy, mainly due to focal hypoxia/ischemia in the perinatal period, which results in scarring of local brain tissue; this is followed by other isolated forms of FCD (FCDⅠand FCDⅡ), and then FCD Ⅲa and FCD Ⅲb. The reason to distinguish isolated forms of FCD (types Ⅰ and Ⅱ) from FCD Ⅲ and to subclassify FCD Ⅲ is to allow better definition of cortical dyslamination. Therefore, the pathogenic factors of intractable epilepsy can be grouped in greater details, and facilitate the diagnosis and potential curative treatment of intractable epilepsy.
- Subjects :
- Age of Onset
Brain abnormalities
Brain pathology
Child
Drug Resistant Epilepsy classification
Drug Resistant Epilepsy complications
Drug Resistant Epilepsy diagnosis
Humans
Hypoxia-Ischemia, Brain complications
Infant, Newborn
Retrospective Studies
Seizures etiology
Drug Resistant Epilepsy pathology
Malformations of Cortical Development pathology
Subjects
Details
- Language :
- Chinese
- ISSN :
- 0529-5807
- Volume :
- 46
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Zhonghua bing li xue za zhi = Chinese journal of pathology
- Publication Type :
- Academic Journal
- Accession number :
- 29050067
- Full Text :
- https://doi.org/10.3760/cma.j.issn.0529-5807.2017.10.003