gms | German Medical Science

57th Annual Meeting of the German Society for Neuropathology and Neuroanatomy (DGNN)

German Society for Neuropathology and Neuroanatomy

12. - 15.09.2012, Erlangen

57th Annual Meeting of the German Society for Neuropathology and Neuroanatomy (DGNN)

Mild microscopic abnormalities in the neocortical temporal lobe epilepsy.

Meeting Abstract

  • presenting/speaker Bárbara O. Estupiñán Díaz - International Center for Neurological Restoration, Havana City, Cuba, Pathology, Havana, Cuba
  • Lilia María Morales - International Center for Neurological Restoration, Havana City, Cuba, Pathology, Havana, Cuba
  • Margarita M. Báez Martín - International Center for Neurological Restoration, Havana City, Cuba, Pathology, Havana, Cuba
  • Lourdes Lorigados Pedre - International Center for Neurological Restoration, Havana City, Cuba, Pathology, Havana, Cuba
  • Iván García Maeso - International Center for Neurological Restoration, Havana City, Cuba, Pathology, Havana, Cuba
  • Otto Trápaga Quincoses - International Center for Neurological Restoration, Havana City, Cuba, Pathology, Havana, Cuba
  • Juan E. Bender del Busto - International Center for Neurological Restoration, Havana City, Cuba, Pathology, Havana, Cuba
  • María E. García Navarro - International Center for Neurological Restoration, Havana City, Cuba, Pathology, Havana, Cuba
  • Leney Hidalgo Portal - International Center for Neurological Restoration, Havana City, Cuba, Pathology, Havana, Cuba

Deutsche Gesellschaft für Neuropathologie und Neuroanatomie. 57th Annual Meeting of the German Society for Neuropathology and Neuroanatomy (DGNN). Erlangen, 12.-15.09.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgnnPP6.4

DOI: 10.3205/12dgnn115, URN: urn:nbn:de:0183-12dgnn1150

Published: September 11, 2012

© 2012 Estupiñán Díaz et al.
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Outline

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Background and Purpose: The lateral neocortex of patients with temporal lobe epilepsy (TLE) shows microscopic alterations that have not been detected in the magnetic resonance images (MRI) of high resolution. The aim of our work was to demonstrate the microscopic alterations in the neocortex of pharmacoresistant TLE patients. We also evaluate a postsurgical clinical evolution.

Patients and Methods: Nineteen patients (14 males) with hippocampal sclerosis and normal lateral neocortex in MRI were analyzed. A tailored temporal lobectomy guided by electrocorticography (ECoG) was performed. The tissues were fixed in 10% buffered formalin, embedded in paraffin, cut at 6 mm thick and stained with hematoxilyn – eosin and Klüver-Barrera. In selected cases immunohistochemical reaction (GFAP, neurofilament, and synaptophysin) was performed. For the histopathological diagnosis of the focal cortical dysplasias (FCD) Palmini's classification was used, and in a second stage the classification propose by Blümcke et al. was considered.

Results: The resected neocortical tissue was in relation to ECoG findings. We found FCD type IA in 10 patients and IB in 9 cases, identifying dual pathology in 55.8% of the sample. However, FCD type IIIa was found in all patients according to Blümcke's classification. The 68.4% of the sample was seizure free after the last clinical evaluation.

Conclusions: This series demonstrates that pharmacoresistant TLE patients with normal cualitative MRI have significant histopathological alterations in the neocortex. Therefore, we suggest to record electrocortical activity during surgery and to confirm microscopic abnormalities in all patients with drug-resistant TLE to a better clinical evolution.