Chung M H, Horoupian D S
Division of Neuropathology, Stanford University Medical Center, California 94305-5324, USA.
J Neuropathol Exp Neurol. 1996 Apr;55(4):403-8.
Mesial temporal sclerosis (MTS) is the most frequently encountered abnormality in temporal lobectomies performed for medically intractable seizure disorders. The pathologic diagnosis of MTS relies on the identification of neuronal loss affecting various regions of the hippocampus. However, neuronal loss is often difficult to assess, particularly in lobectomies that are not performed en bloc. Because of this difficulty the presence of hippocampal pathology is often indeterminate. In this report we describe our experience with 73 temporal lobectomies performed for seizure disorders. In 58%, increased numbers of corpora amylacea (CoA) were found in association with MTS. The relationship between CoA and the pathogenetic mechanisms underlying MTS remains speculative. However, the association between MTS and corpora amylacea is important to recognize since the identification of abundant numbers of CoA provides a marker for MTS that can be useful in cases in which neuronal loss and gliosis are difficult to assess. For this purpose, it is strongly recommended that tissues resected from the hippocampus and amygdala for temporal lobe epilepsy be stained with LFB-PAS to highlight CoA.
内侧颞叶硬化（MTS）是因药物难治性癫痫疾病而进行颞叶切除术时最常遇到的异常情况。MTS的病理诊断依赖于识别影响海马体各个区域的神经元丢失。然而，神经元丢失往往难以评估，尤其是在未整块切除的叶切除术中。由于这一困难，海马体病理状况的存在常常难以确定。在本报告中，我们描述了我们对73例因癫痫疾病而进行的颞叶切除术的经验。在58%的病例中，发现淀粉样体（CoA）数量增加与MTS相关。CoA与MTS潜在发病机制之间的关系仍具有推测性。然而，MTS与淀粉样体之间的关联很重要，因为识别大量的CoA为MTS提供了一个标志物，在难以评估神经元丢失和胶质增生的病例中可能有用。为此，强烈建议对因颞叶癫痫而从海马体和杏仁核切除的组织进行LFB-PAS染色，以突出显示CoA。
