Clinicopathologic study of intractable epilepsy-related encephalitis
10.3760/cma.j.issn.0529-5807.2016.05.007
- VernacularTitle:难治性癫痫相关脑炎的临床病理学观察
- Author:
Cuicui LIU
1
;
Shiyun CHEN
;
Yueshan PIAO
;
Dehong LU
Author Information
1. 首都医科大学宣武医院病理科
- Keywords:
Epilepsy;
Encephalitis,viral;
Cytomegalovirus infections;
Immunohistochemistry
- From:
Chinese Journal of Pathology
2016;45(5):318-323
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinicopathologic features of intractable epilepsy related encephalitis.Methods The clinical and pathologic findings of 15 cases of intractable epilepsy after functional neurosurgical treatment were reviewed and analyzed retrospectively.Results All patients,including four male and 11 female,had medically intractable epilepsy.The mean age of onset for seizure was 5.3 years (1-15 years) and the disease duration was 4.7 years (0.5-15 years).A definite past history was identified in 11 patients,including viral encephalitis in nine patients,anoxia in utero and head trauma in one patient respectively.The extent and sites of involvement were different,including single cerebral hemisphere diffusely in five cases,multiple lobes in seven cases,and single lobe in three cases.Temporal lobe was involved in 13 cases,frontal lobe in eight,parietal lobe in eight,occipital lobe in seven,and insular lobe in four.Microscopically,all cases were characterized by perivascular inflammatory cells infiltration in the subarachnoid space.The focal cerebral cortex showed obvious atrophy with various degrees of the neuronal loss and glial proliferation,eventually leading to glial scar formation.In addition,microglia nodules,lymphatic cuff and neuronophagia were also observed.Seven cases of focal cortical dysplasia were identified among the 11 cases with adequate perilesional cerebral cortex.Hippocampus sclerosis was found in two cases.Intranuclear inclusions were seen in six cases,and these were immunopositive of cytomegaloviruslate antigen,and three cases also showed muhinucleated giant cells and calcifications.Conclusion Encephalitis is one of the common causes of refractory epilepsy,and may result in refractory epilepsy as a sequel.
