Leite J P, Terra-Bustamante V C, Fernandes R M, Santos A C, Chimelli L, Sakamoto A C, Assirati J A, Takayanagui O M
Department of Neurology, University of São Paulo School of Medicine at Ribeirão Preto, Brazil.
Neurology. 2000 Nov 28;55(10):1485-91. doi: 10.1212/wnl.55.10.1485.
Several studies suggest that neurocysticercosis is the main cause of symptomatic epilepsy in developing countries. In such areas, calcified cysticercotic lesions (CCL) are frequently found in patients with complex partial seizures associated with hippocampal sclerosis (HS). The authors studied whether there are clinical and pathologic differences between HS patients with and without CCL.
The authors determined the clinical and pathologic findings of 30 patients with HS and compared them with 32 patients with HS + CCL. Hippocampi from both groups were measured for fascia dentata Timm staining and cell density in hippocampal subfields.
In the HS + CCL group, single or multiple CCL were found in all lobes with no lobar predominance. An initial precipitating event occurred in 83.3% of HS and in 62.5% of HS + CCL. First complex partial seizure occurred at 10.1 years in HS and at 11.9 years in HS + CCL. No significant differences were found for fascia dentata Timm staining and hippocampal cell densities. Good postsurgery outcome (Engel I classification) did not differ between groups, with this result occurring in 76.6% of patients with HS and 81.2% of patients with HS + CCL.
The presence of CCL does not influence the clinical and pathologic profile of patients with hippocampal atrophy. Clinical histories and postsurgical outcomes were similar to those of patients with classic HS, suggesting that the CCL is probably, in this set of patients, a coincidental pathology and does not have a role in epileptogenesis.
多项研究表明，神经囊尾蚴病是发展中国家症状性癫痫的主要病因。在这些地区，钙化囊尾蚴病变（CCL）常见于伴有海马硬化（HS）的复杂部分性发作患者中。作者研究了有CCL和无CCL的HS患者在临床和病理方面是否存在差异。
作者确定了30例HS患者的临床和病理结果，并将其与32例HS + CCL患者进行比较。对两组患者的海马进行齿状回Timm染色和海马亚区细胞密度测量。
在HS + CCL组中，所有脑叶均发现单个或多个CCL，无明显脑叶优势。83.3%的HS患者和62.5%的HS + CCL患者发生过初始诱发事件。HS患者首次复杂部分性发作发生在10.1岁，HS + CCL患者发生在11.9岁。齿状回Timm染色和海马细胞密度无显著差异。两组患者术后良好结局（Engel I级分类）无差异，HS患者中76.6%、HS + CCL患者中81.2%达到该结果。
CCL的存在不影响海马萎缩患者的临床和病理特征。临床病史和术后结局与经典HS患者相似，表明在这组患者中，CCL可能是一种巧合的病理情况，在癫痫发生过程中不起作用。
