Tuberous sclerosis complex with refractory epilepsy: a clinicopathologic study of 14 cases.
- Author:
Le LIANG
1
;
Hui LENG
;
Wei XING
;
Yanke GUO
;
Jing FU
;
Kangping MA
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Astrocytes; chemistry; pathology; Child; Drug Resistant Epilepsy; surgery; Epilepsy; complications; metabolism; pathology; Epilepsy, Frontal Lobe; complications; metabolism; pathology; Female; Giant Cells; chemistry; pathology; Humans; Magnetic Resonance Imaging; Male; Nestin; analysis; Neurons; metabolism; pathology; Retrospective Studies; Tuberous Sclerosis; complications; metabolism; pathology; Vimentin; analysis
- From: Chinese Journal of Pathology 2016;45(2):102-106
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo study the clinicopathologic features of tuberous sclerosis complex (TSC).
METHODSThe clinicopathologic data of the patients diagnosed as TSC with refractory epilepsy and resection of epileptic focus were retrospectively analyzed.
RESULTSFourteen cases were included, the mean age was (15.8±12.9) years, with a male predominance (male to female ratio=10:4). Frontal lobe was the most common (13/14) site of involvement. MRI showed multiple patchy long T1 and long T2 signals. CT images showed multiple subependymal high density calcified nodules in nine cases. Histology showed mild to severe disruption of the cortical lamination, cortical and subcortical tubers with giant cells and/or dysmorphic neurons. The giant cells showed strong immunoreactivity for vimentin and nestin, while the dysmorphic neurons partially expressed MAP2 and NF. Vimentin also stained strongly the "reactive" astrocytes. Thirteen cases had follow-up information: Engel class I in six cases, Engel class II in six cases, and Engel class III in one case.
CONCLUSIONSDiagnosis of TSC relies on combined pathologic, clinical and neuroradiological features. Immunohistochemical staining can be helpful. Resection of epileptic focus is an effective method to treat refractory epilepsy in TSC.
