Takebayashi Seiji, Hashizume Kiyotaka, Uchida Kazuki, Tanaka Tatsuya
Department of Neurosurgery, Asahikawa Medical College, Japan.
No To Shinkei. 2006 Mar;58(3):245-9.
There have recently been a number of new pathological findings of specimens from epileptic foci that have become widespread of surgical treatment. We reported a case with seizures resulting from brain lesions which pathologically demonstrated a coexistence with a cavernous angioma and a focal cortical dysplasia. A 24-year-old man was admitted to our hospital because of generalized convulsion from 1 year ago. Brain MRI revealed an enhanced mass lesion, in diameter 1.5 cm, with hemosiderin rim in the left temporal tip. Ictal EEG showed the initiation of the spike from the lateral side of the left temporal lobe. Because the epileptogenic focus was thought to be the lateral side in the left temporal lobe, anterolateral temporal resection was performed and subsequently total removal of the tumor was performed. He had no seizure after surgery. A light microscopic examination was performed on specimens stained with hematoxilin and eosin. We verified to be pathologically coexistent with a cavernous angioma and a focal cortical dysplasia. We also found unusual neurons that were accompanied by perineuronal glial satellitosis in the subcortical white matter, those were occasionally observed in epileptic foci and were thought to be a form of neuronal migration disorders.
最近,癫痫病灶标本出现了一些新的病理学发现,这使得手术治疗得到广泛应用。我们报告了一例因脑病变导致癫痫发作的病例,病理检查显示该病变同时存在海绵状血管瘤和局灶性皮质发育不良。一名24岁男性因1年前出现全身抽搐而入住我院。脑部MRI显示左侧颞叶尖部有一个直径1.5 cm的强化肿块病变,周边有含铁血黄素环。发作期脑电图显示癫痫尖波起源于左侧颞叶外侧。由于认为癫痫病灶位于左侧颞叶外侧,遂行前外侧颞叶切除术,随后将肿瘤完全切除。术后他未再发作。对苏木精和伊红染色的标本进行了光镜检查。我们在病理上证实该病变同时存在海绵状血管瘤和局灶性皮质发育不良。我们还在皮质下白质中发现了异常神经元,伴有神经元周围胶质卫星现象,这种现象偶尔在癫痫病灶中观察到,被认为是神经元迁移障碍的一种形式。