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Corpora amylacea: a marker for mesial temporal sclerosis
1Division of Neuropathology, Stanford University Medical Center, California 94305-5324, USA.
Abstract:
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.
Insights
Corpora amylacea (CoA) are frequently found with mesial temporal sclerosis (MTS), a common cause of intractable epilepsy. Abundant CoA can serve as a diagnostic marker for MTS when neuronal loss is unclear.
Area of Science:
- Neuropathology
- Epilepsy Research
- Histopathology
Background:
- Mesial temporal sclerosis (MTS) is the primary pathology in temporal lobectomies for intractable seizures.
- Diagnosing MTS relies on identifying hippocampal neuronal loss, which can be challenging in non-en bloc resections.
- Indeterminate hippocampal pathology is a common issue in epilepsy surgery evaluations.
Purpose of the Study:
- To investigate the association between corpora amylacea (CoA) and mesial temporal sclerosis (MTS).
- To evaluate the utility of CoA as a diagnostic marker for MTS in epilepsy surgery specimens.
- To recommend optimal staining techniques for identifying CoA in resected temporal lobe tissues.
Main Methods:
- Retrospective analysis of 73 temporal lobectomies performed for seizure disorders.
- Histopathological examination of hippocampal and amygdala tissues.
- Staining with LFB-PAS to highlight corpora amylacea (CoA).
Main Results:
- Increased numbers of corpora amylacea (CoA) were observed in 58% of cases with mesial temporal sclerosis (MTS).
- Corpora amylacea (CoA) presence was associated with MTS, offering a potential diagnostic marker.
- The identification of abundant CoA can aid diagnosis when neuronal loss is difficult to assess.
Conclusions:
- Corpora amylacea (CoA) are frequently associated with mesial temporal sclerosis (MTS).
- Abundant CoA serves as a valuable histological marker for MTS, especially when neuronal loss is equivocal.
- LFB-PAS staining of hippocampal and amygdala tissues is recommended for highlighting CoA in temporal lobe epilepsy evaluations.
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