Kroh H, Taraszewska A, Ruzikowski E, Bidziński J, Mossakowski M J
Department of Neuropathology, Polish Academy of Sciences, Warsaw.
Neuropatol Pol. 1992;30(2):133-45.
The study was performed on cerebral tissue resected during temporal lobectomy in 16 patients whose long-standing cryptogenic epilepsy did not submit to anticonvulsive drugs. Cases presenting definite etiological factors such as CNS trauma, infection or neoplasm were excluded. Neuropathological investigations disclosed microangiomas and focal vascular malformations in the meninges and tissue in 7 patients. Neuronal heterotopias in the white matter and of the white matter in the cortex were observed in 3 cases. Main cortical changes were: neuronal loss, chronic neuronal degeneration, perineuronal satellitosis, and GFAP-positive submeningeal gliosis, especially at the bottom of sulci, perivascular gliosis and laminar or diffuse gliosis. The changes in the hippocampus were most enhanced in the end-plate and in the sector H3 of the pyramidal layer. Astrocytic gliosis in the white matter presented distinct GFAP and S-100 immunostaining; the latter involved in some cases a wider area than the GFAP reaction. The above named changes are analysed with regard to the presumed epileptogenic factors and to the postepileptic damage.
该研究对16例长期隐源性癫痫且抗惊厥药物治疗无效的患者在颞叶切除术中切除的脑组织进行。排除存在明确病因如中枢神经系统创伤、感染或肿瘤的病例。神经病理学检查发现7例患者的脑膜和脑组织中有微血管瘤和局灶性血管畸形。3例患者观察到白质和皮质白质中的神经元异位。主要皮质变化包括：神经元丢失、慢性神经元变性、神经元卫星现象以及GFAP阳性的软脑膜下胶质增生，尤其是在脑沟底部、血管周围胶质增生以及层状或弥漫性胶质增生。海马的变化在终板和锥体细胞层H3区最为明显。白质中的星形胶质细胞增生呈现明显的GFAP和S - 100免疫染色；在某些情况下，S - 100免疫染色涉及的区域比GFAP反应更广泛。针对推测的致痫因素和癫痫发作后的损伤对上述变化进行了分析。
