Surgical pathology of epilepsy: a review

This review discusses the neuropathological issues pertaining to temporal lobectomies and neocortical resections for medically refractory seizures of childhood. Most cases in our pediatric series are "lesional" and have CT/MRI abnormalities that contribute to a higher incidence of "dual pathology" lesions rather than pure mesial temporal sclerosis. Almost up to two thirds of our cases are represented by neuronal migration disorders and low grade gliomas. We have also encountered lesions that have both neoplastic and malformative foci, some of which behave more like tumors, while others defy precise classification as tumor or malformation. Our preliminary data indicate a role for cytomegalovirus in some cases of Rasmussen's encephalitis.