[Pathological changes in the epileptogenic foci of children with intractable epilepsy]
Li-Mei Feng1, Gui-Zhi Xia, Rong-Na Ren
1Department of Pediatrics, Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, China.
Insights
Pathological changes in the brain, including synaptic remodeling, are key to understanding intractable epilepsy in children. These findings highlight the link between brain structure and seizure activity.
Area of Science:
- Neurology
- Pathology
- Pediatric Epilepsy
Objective:
To investigate pathological changes in the epileptogenic foci of children with intractable epilepsy and their clinical significance.
Methods:
Thirty children with intractable epilepsy were included in the study. The epileptogenic foci were surgically resected and pathological changes in the obtained specimens were observed under a light microscope (LM) and a transmission electron microscope (TEM).
Results:
Under the LM, cortical dysplasia was found in 14 cases (47%), hippocampal sclerosis in 11 cases (37%), dysembryoplastic neuroepithelial tumor in 1 case (3%), ganglioglioma in 1 case (3%), and encephalomalacia in 3 cases (10%). The TEM observation revealed pathological changes in the ultrastructure of the hippocampus and extra-hippocampal cortex, such as changes in the number of synapses and synaptic structure, decrease in neurons and karyopyknosis, swelling and degeneration of astrocytes, and changes in mitochondrial structures.
Conclusions:
Pathological changes in the hippocampus and extra-hippocampal cortex, especially synaptic remodeling, may be the morphological basis for spontaneous recurrent seizures in children with intractable epilepsy. The pathological changes and epileptiform activity are related to an imbalance between excitatory and inhibitory neurotransmission.
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