Standardized processing and pathological evaluation of surgical specimens from 490 cases of pediatric refractory epilepsy
10.3760/cma.j.cn101070-20241124-00785
- VernacularTitle:儿童难治性癫痫490例致痫病变手术标本处理及病理学评估
- Author:
Chang LIU
1
;
Shuang ZHANG
;
Xiaojuan ZHU
;
Xiaojun BA
;
Xin LI
;
Lixin CAI
;
Ye WU
;
Ting LI
Author Information
1. 北京大学第一医院儿童癫痫中心，北京 100034
- Publication Type:Journal Article
- Keywords:
Child;
Epilepsy;
Refractory epilepsy;
Focal cortical dysplasia;
Malformation of cortical development;
Mild malformation of cortical development with oligod
- From:
Chinese Journal of Applied Clinical Pediatrics
2025;40(8):613-618
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application and clinical significance of pathological diagnostic criteria for medically refractory epilepsy in children.Methods:Cross-sectional study.A retrospective analysis was conducted on 490 children(pathology involved) with medically refractory epilepsy treated continuously in the Pediatric Epilepsy Center of Peking University First Hospital from January 2019 to May 2022.The distribution of different pathological types was observed, and the differences in clinical characteristics among different pathological types were analyzed through Kruskal-Wallis or χ2 tests.The impact of clinical and pathological features on patient prognosis was evaluated through regression analysis. Results:Focal cortical dysplasia (FCD) was the predominant lesion (49.59%, 243/490).The electroencephalograms ( χ2=6.720, P=0.035) and clinical seizure characteristics ( χ2=26.370, P<0.001) in FCDⅡ were more focal than those in FCD Ⅰ and Ⅲ.Moreover, the proportions of focal resection in surgery ( χ2=24.286, P<0.001) and central involvement ( χ2=22.849, P<0.001) in FCDⅡ were higher than those in FCD Ⅰ and Ⅲ.Univariate and multivariate regression analyses revealed that FCD Ⅱ had a better prognosis than other dysplastic patients among the 375 cases of dysplasia ( P=0.049).Next-generation sequencing was performed on 35 cases of cortical malformations with such morphological characteristics as increased numbers of neurons in the white matter and Olig2-positive glial cell hyperplasia, and SLC35A2 mutations were detected in 2 cases (5.71%). Conclusions:Pathology of refractory epilepsy is specialized and continuously evolving.Standardized specimen processing and the accumulation of morphological, immunohistochemical, and molecular genetic data provide the foundation for clarifying the neuropathological nature of epilepsy, improving integrated classification, and advancing prognosis prediction and targeted therapy.
