gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Different mossy fiber sprouting pattern in ILAE hippocampal sclerosis subtypes

Meeting Abstract

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  • Barbara Schmeiser - Neurochirurgische Universitätsklinik Freiburg, Freiburg, Deutschland
  • Ingmar Blümcke - Department of Neuropathology, University Hospital Erlangen, Erlangen, Deutschland
  • Roland Coras - University Medical Center, Department of Neuropathology, Erlangen, Deutschland
  • Josef Zentner - Universitätsklinikum Freiburg, Neurozentrum, Abteilung für Allgemeine Neurochirurgie, Freiburg, Deutschland
  • Armin Brandt - University Medical Center, Epilepsy Center, Freiburg, Deutschland
  • Marco Prinz - Universitätsklinikum Freiburg, Institut für Neuropathologie, Institut für Neuropathologie, Freiburg, Deutschland
  • Thomas Freiman - Goethe-Universität, Universitätsklinikum Frankfurt , Klinik und Poliklinik für Neurochirurgie, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.24.06

doi: 10.3205/17dgnc532, urn:nbn:de:0183-17dgnc5325

Published: June 9, 2017

© 2017 Schmeiser et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: In temporal lobe epilepsy, hippocampal sclerosis is the most prevalent pathology, characterized by selective neuronal cell loss, migration and axonal reorganization of granule cells. The new ILAE classification identifies four subtypes of hippocampal sclerosis. Whereas the selective neuronal cell death was well described for these subtypes, the role of granule cell dispersion and mossy fiber sprouting was not examined so far.

Methods: 319 patients who had were included in this retrospective analysis. Hippocampal specimens were stained for neuronal loss, granular cell dispersion (Neu-N, HE) and mossy fiber sprouting (synaptoporin-immunohistochemistry). For seizure outcome Engel score I-IV was applied.

Results: In ILAE 0 (no sclerosis) there was no cell loss, no granule cell dispersion and mossy fibers were present in their normal projection: CA3 and CA4. In ILAE 1, cell loss was massive in CA1, CA4 and moderate in CA2, CA3 as well as GCL being dispersed. Mossy fibers showed massive supragranular sprouting and a loss of mossy fibers in CA4 and CA3. In ILAE 2, cell loss was restricted to CA1. Granule cell dispersed and mossy fibers showed supragranlar sprouting, yet with fiber loss in CA4 and CA3 less than in ILAE 1. In ILAE 3, cell loss was abundant in CA3 and CA4 only. Granule cells were dispersed and mossy fibers showed sprouting as in ILAE 1 and 2. Fiber loss in CA4 and CA3 was lower than in ILAE 1 and 2, respectively.

Conclusion: Granule cell dispersion, mossy fiber sprouting and mossy fiber loss in CA4 and CA3 might develop independently of neuronal cell loss and affected region.