Ferrer I, Oliver B, Russi A, Casas R, Rivera R
Unidad de Neuropatología Hospital Príncipes de España, Universidad de Barcelona, Spain.
J Neurol Sci. 1994 May;123(1-2):18-25. doi: 10.1016/0022-510x(94)90198-8.
Serial sections of cortical resection of 30 patients suffering from drug-resistant epilepsy were processed for parvalbumin and calbindin-D28k immunocytochemistry to determine local circuit neuron populations. Our findings indicate that there is not a simple mechanism to explain neocortical epileptic foci. On the basis of the present results it can be suggested that: (1) reduced percentage of local circuit neurons in the vicinity of neoplasms may account for a decreased intracortical inhibition. (2) Abnormal morphology and distribution of local circuit neurons may result in abnormal cortical inhibition in patients with focal cortical dysplasia, and, probably, in other focal migrational disorders, including neuronal nests in the white matter. (3) Increased percentages of immunoreactive local circuit neurons and fibers in focal neocortical necrosis (cavernous angiomas), diffuse hypoxic encephalopathy, and hippocampus in patients with temporal lobe epilepsy due to mesial sclerosis, may play a role in epilepsy. These neurons can be activated by reduced excitatory inputs, or they may establish abnormal synaptic contacts with other inhibitory neurons. (4) Lack of consistent morphologic abnormalities in the neocortex of patients with temporal lobe epilepsy, and in patients with cryptogenetic frontal lobe epilepsy, suggests that electrically abnormal neocortical foci in these cases are probably epiphenomena.
对30例耐药性癫痫患者的皮质切除术连续切片进行小白蛋白和钙结合蛋白-D28k免疫细胞化学处理，以确定局部回路神经元群体。我们的研究结果表明，没有一个简单的机制可以解释新皮质癫痫病灶。根据目前的结果，可以提出以下几点：（1）肿瘤附近局部回路神经元百分比降低可能导致皮质内抑制作用减弱。（2）局部回路神经元的形态和分布异常可能导致局灶性皮质发育异常患者以及可能包括白质中神经元巢在内的其他局灶性迁移障碍患者出现异常的皮质抑制。（3）在局灶性新皮质坏死（海绵状血管瘤）、弥漫性缺氧性脑病以及因内侧颞叶硬化导致的颞叶癫痫患者的海马中，免疫反应性局部回路神经元和纤维的百分比增加，可能在癫痫中起作用。这些神经元可因兴奋性输入减少而被激活，或者它们可能与其他抑制性神经元建立异常的突触联系。（4）颞叶癫痫患者和隐源性额叶癫痫患者的新皮质缺乏一致的形态学异常，表明这些病例中电活动异常的新皮质病灶可能是附带现象。
