A clinicopathologic analysis of specimens of hemispherectomy or multilobar resection from 46 cases of refractory epilepsy
10.3760/cma.j.issn.1006-7876.2011.01.008
- VernacularTitle:难治性癫痫46例患者大脑半球或多脑叶切除标本的临床病理学分析
- Author:
Yuefeng WANG
;
Yueshan PIAO
;
Dehong LU
;
Wei WANG
;
Li CHEN
;
Lifeng WEI
;
Hong YANG
- Publication Type:Journal Article
- Keywords:
Epilepsy;
Cerebrum;
Cicatrix;
Malformations of cortical development;
Encephalitis
- From:
Chinese Journal of Neurology
2011;44(1):24-29
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinicopathologic features of the brain tissue from multilobar resection or hemispherectomy for refractory epilepsy. Methods The clinical and pathologic findings of 46 cases seen at Xuanwu hospital from 2005 to 2009 were reviewed retrospectively. Results The mean age of seizure onset and disease duration were 3.9 years and 10.2 years, respectively. There were 33 cases of hemispherectomy and 13 cases of multilobar resection. Temporal lobe abnormality was seen in all cases. The pathologic subgroups were as follows: ulegyria (31/46), malformation of cortical development (MCD, 7/46 ) and infection (8/46). Microscopic examination of ulegyria showed cortical architectural disturbances, neuronal loss, reactive gliosis and appearance of corpora amylacea. We also noted deposition of hemosiderin (13 cases), calcification (9 cases) and island-like neurons (5 cases). All ulegyria cases were accompanied by varying degree of cortical dysplasia, and hippocampus sclerosis were identified in 7 cases. MCD comprised of 5 cases of focal cortical dysplasia ( FCD), including 3 cases of FCDⅠB, 1 case of FCDⅡA and 1 case of FCDⅠA, 1 case of polymicrogyria and 1 case of porencephaly. Among 8 infection eases, there were 5 cases of Rasmussen encephalitis ( RE), l case of cysticercosis, 1 case of tuberculous meningitis and l case of Cytomegalovirus encephalitis. Conclusions The most common pathological category of specimens from hemispherectomy or multilobar resection is ulegyria with obvious temporal lobe abnormality. This is followed by MCD ( with FCDⅠB as the main type) and central nervous system infection (RE as the most frequent abnormality).
