Cahan L D, Geddes J W, Choi B H, Cotman C
Division of Neurosurgery, University of California, Irvine.
Stereotact Funct Neurosurg. 1990;54-55:21-4. doi: 10.1159/000100185.
It has long been recognized that mesial temporal sclerosis is the most common pathologic finding in temporal lobes removed for the treatment of medically refractory complex partial epilepsy. The regions of the hippocampus most vulnerable contain the highest densities of excitatory amino acid receptors in the brain. We used receptor autoradiography to determine the density of N-methyl-D-aspartate (NMDA) and kainic acid (KA) receptors from 5 patients undergoing such surgery and compared the findings with 6 specimens obtained at postmortem. A 2-fold increase in the density of NMDA receptors and an increased density of KA receptors was found in entorhinal cortex in epileptic specimens. Loss of NMDA and KA receptor density was apparent in the sclerotic regions CA3 and CA1, but not in other areas of the hippocampus or dentate gyrus. These findings suggest that damage in the hippocampus may result, at least in part, from the presence of aberrant excitatory circuits in the entorhinal cortex.
长期以来，人们一直认识到，内侧颞叶硬化是因治疗药物难治性复杂部分性癫痫而切除的颞叶中最常见的病理发现。海马体中最易受损的区域含有大脑中兴奋性氨基酸受体密度最高的部分。我们使用受体放射自显影术测定了5例接受此类手术患者的N-甲基-D-天冬氨酸（NMDA）和海藻酸（KA）受体密度，并将结果与6例死后获得的标本进行了比较。在癫痫标本的内嗅皮质中发现NMDA受体密度增加了2倍，KA受体密度也增加了。在硬化区域CA3和CA1中，NMDA和KA受体密度明显降低，但在海马体或齿状回的其他区域则没有。这些发现表明，海马体损伤可能至少部分是由内嗅皮质中异常兴奋性回路的存在所致。
