Miller Douglas C, Scheitler Kristen M, Holloway Jeffery, Stacy C Christopher
Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, MO, United States.
J Neuropathol Exp Neurol. 2025 Feb 1;84(2):126-131. doi: 10.1093/jnen/nlae121.
Hippocampal dentate gyral dysplasia is well-described in temporal lobe epilepsy and may be a risk factor for sudden, unexpected death in several populations: infants (sudden infant death syndrome [SIDS], sudden unexpected infant death [SUID]), toddlers (sudden unexpected death of a child [SUDC]), and epileptics (sudden unexpected death in epilepsy [SUDEP]). We examined reports and histopathological slides from autopsies performed at our institution from 2008 through 2016 to determine whether the presence or absence of any of the described forms of such dysplasias (duplications, hyperconvolutions, and granule cell dispersion, including bilamination), correlated with the causes of death. From well over 4000 autopsies, we identified 949 autopsies with a neuropathology examination by a neuropathologist. Of these, 205 cases (21.6%) had 1 or more of the described abnormalities of 1 or both dentate gyri; 87 (42.4%) of the individuals in this group of 205 autopsies had died suddenly and unexpectedly, including 29/90 (32.2%) cases of SUDEP, 17/31 (54.8%) cases of SUDC, and 51/104 (49.0%) cases of infants with SIDS or SUID. We conclude that these changes are readily recognizable by experienced neuropathologists and that because they are overrepresented in an autopsy population that died suddenly and unexpectedly, they may represent a risk factor for such outcomes.
海马齿状回发育异常在颞叶癫痫中已有充分描述，并且在几类人群中可能是突然意外死亡的危险因素：婴儿（婴儿猝死综合征 [SIDS]、婴儿突然意外死亡 [SUID]）、幼儿（儿童突然意外死亡 [SUDC]）以及癫痫患者（癫痫猝死 [SUDEP]）。我们检查了2008年至2016年在我们机构进行的尸检报告和组织病理学切片，以确定上述任何一种发育异常形式（重复、过度卷曲以及颗粒细胞分散，包括双板层）的有无是否与死亡原因相关。在超过4000例尸检中，我们确定有949例尸检经过了神经病理学家的神经病理学检查。其中，205例（21.6%）出现了1个或2个齿状回中1种或多种上述异常；在这205例尸检的人群中，87例（42.4%）突然意外死亡，包括90例中的29例（32.2%）SUDEP、31例中的17例（54.8%）SUDC以及104例中的51例（49.0%）SIDS或SUID婴儿。我们得出结论，这些变化能够被经验丰富的神经病理学家轻易识别，并且由于它们在突然意外死亡的尸检人群中占比过高，它们可能代表了此类结局的一个危险因素。
