Neuropathologic findings in intractable epilepsy: a clinicopathologic analysis of 822 cases
10.3760/cma.j.issn.0529-5807.2017.10.003
- VernacularTitle: 822例手术治疗难治性癫痫相关的病理学特征回顾分析
- Author:
Zejun DUAN
1
;
Kun YAO
;
Jian ZHOU
;
Lin LI
;
Feng ZHAI
;
Changqing LIU
;
Zhong MA
;
Yu BIAN
;
Guoming LUAN
;
Xueling QI
Author Information
1. Department of Pathology, Beijing Key Lab of Epilepsy Research, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China
- Publication Type:Journal Article
- Keywords:
Epilepsy, complex partial;
Malformations of cortical development;
Disease attributes;
Diagnosis
- From:
Chinese Journal of Pathology
2017;46(10):673-678
- CountryChina
- Language:Chinese
-
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.
