Neuropathological changes in cerebellar biopsies of epileptic patients

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.