Brain Inflammation in an Infant With Hemimegalencephaly, Escalating Seizures, and Epileptic Encephalopathy

Area of Science:

• Neurology
• Neuroscience
• Pediatric Neurology

Background:

• Hemimegalencephaly is a congenital brain malformation characterized by unilateral hemisphere enlargement.
• It is frequently associated with intractable epilepsy, developmental delay, and neurological deficits.
• The underlying mechanisms contributing to epilepsy in hemimegalencephaly are not fully understood.

Purpose of the Study:

• To investigate the presence and extent of neuroinflammation in a pediatric patient with hemimegalencephaly and intractable epilepsy.
• To explore the potential role of neuroinflammation in seizure exacerbation and epileptic encephalopathy.

Main Methods:

• Case report of a 12-month-old girl with hemimegalencephaly.
• Surgical intervention: hemispherectomy due to escalating seizures, developmental arrest, and encephalopathy.
• Histopathological examination of resected brain tissue using immunohistochemistry.

Main Results:

• Immunohistochemical analysis revealed abundant activated CD68-positive microglia (indicating microgliosis).
• Evidence of reactive astrogliosis was also detected.
• These findings indicate active inflammatory changes within the affected brain hemisphere.

Conclusions:

• The presence of significant neuroinflammation in hemimegalencephaly associated with intractable epilepsy is demonstrated.
• Ongoing brain inflammation may contribute to seizure exacerbation and the development of epileptic encephalopathy.
• This suggests that anti-inflammatory strategies could be a potential therapeutic avenue for such cases.