Salcman M, Defendini R, Correll J, Gilman S
Ann Neurol. 1978 Jan;3(1):10-9. doi: 10.1002/ana.410030104.
In 5 patients with pharmacologically intractable epilepsy, biopsy of the cerebellar cortex at the time of surface electrode implantation for therapeutic stimulation demonstrated marked degeneration of the Purkinje cell layer in every case. Two of the patients had never experienced a generalized convulsion. Comparison of these biopsy findings with the autopsy findings in two other groups of patients with a seizure disorder of different duration and severity and with the findings in other reported series suggests that permanent neuronal damage in epilepsy is related to the cumulative effects of the frequency and chronicity of the disorder. The pathogenesis remains unclear. The histopathological changes are identical to those seen in generalized cerebral hypoxia, but the observations in our series support the view that in epilepsy the pathogenesis may not be hypoxic.
在5例药物治疗难治性癫痫患者中，为进行治疗性刺激而植入表面电极时对小脑皮质进行活检，结果显示每例患者的浦肯野细胞层均有明显退化。其中2例患者从未经历过全身性惊厥。将这些活检结果与另外两组不同病程和严重程度的癫痫发作患者的尸检结果以及其他报道系列中的结果进行比较，提示癫痫中的永久性神经元损伤与该疾病的发作频率和慢性累积效应有关。发病机制仍不清楚。组织病理学变化与全身性脑缺氧所见相同，但我们系列中的观察结果支持以下观点：在癫痫中，发病机制可能并非缺氧。
