|
|
||||||||
From the Richmond Institute of Neurology and Neurosurgery, Beaumont Hospital, Dublin, Ireland.
Fifty patients underwent superficial temporal lobectomy for intractable temporal lobe epilepsy. Total cure rate was 52%, and significant improvement was achieved in 88%. Cytoarchitectural changes in gray and white tissue were analyzed under light microscopy. Neuronal dysgenesis was correlated with the duration of seizure disorder, age of onset, and other etiologic factors, and with clinical outcome. Temporal lobes from 33 neurologically normal autopsy brains which were age- and sex-matched with patients were examined as controls. Severe neuronal ectopia (> 8 neurons/2 mm2 white matter) was present in 42% of patients with epilepsy and in none of controls. There was neuronal clustering in 28% of those with epilepsy, and Chaslin's (subpial) gliosis in 38%. Controls did not have these changes. The presence of severe neuronal ectopia and clustering was predictive of a favorable clinical outcome following surgery (p < 0.05). No correlation was found between microdysgenesis and other factors. These findings suggest that the presence of neuronal dysgenesis may be of significance in the clinical outcome following surgery, and that the abnormal tissue may be important as a morphologic substrate for seizures in some patients.
Address correspondence to Dr. Hardiman, Harvard Longwood Area Neurological Training Program, c/o Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115. Address reprint requests to Dr. Farrell, Richmond Institute of Neurology and Neurosurgery, Beaumont Hospital, Dublin 9, Ireland.
Received March 16,1987. Accepted for publication in final form December 2,1987.
This article has been cited by other articles:
![]() |
A. Hammers, M.-C. Asselin, R. Hinz, I. Kitchen, D. J. Brooks, J. S. Duncan, and M. J. Koepp Upregulation of opioid receptor binding following spontaneous epileptic seizures Brain, April 1, 2007; 130(4): 1009 - 1016. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Thom, J. Zhou, L. Martinian, and S. Sisodiya Quantitative post-mortem study of the hippocampus in chronic epilepsy: seizures do not inevitably cause neuronal loss Brain, June 1, 2005; 128(6): 1344 - 1357. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Kakita, S. Kameyama, S. Hayashi, H. Masuda, and H. Takahashi Pathologic Features of Dysplasia and Accompanying Alterations Observed in Surgical Specimens From Patients With Intractable Epilepsy J Child Neurol, April 1, 2005; 20(4): 341 - 350. [Abstract] [PDF] |
||||
![]() |
H Clusmann, T Kral, E Fackeldey, I Blumcke, C Helmstaedter, J von Oertzen, H Urbach, and J Schramm Lesional mesial temporal lobe epilepsy and limited resections: prognostic factors and outcome J. Neurol. Neurosurg. Psychiatry, November 1, 2004; 75(11): 1589 - 1596. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Fauser, A. Schulze-Bonhage, J. Honegger, H. Carmona, H.-J. Huppertz, G. Pantazis, S. Rona, T. Bast, K. Strobl, B. J. Steinhoff, et al. Focal cortical dysplasias: surgical outcome in 67 patients in relation to histological subtypes and dual pathology Brain, November 1, 2004; 127(11): 2406 - 2418. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. P. Carne, T. J. O'Brien, C. J. Kilpatrick, L. R. MacGregor, R. J. Hicks, M. A. Murphy, S. C. Bowden, A. H. Kaye, and M. J. Cook MRI-negative PET-positive temporal lobe epilepsy: a distinct surgically remediable syndrome Brain, October 1, 2004; 127(10): 2276 - 2285. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Kakita, S. Kameyama, S. Hayashi, H. Masuda, and H. Takahashi Pathologic Features of Dysplasia and Accompanying Alterations Observed in Surgical Specimens from Patients with Intractable Epilepsy J Child Neurol, March 1, 2004; 19(3): 341 - 350. [Abstract] [PDF] |
||||
![]() |
G. Battaglia, S. Pagliardini, L. Saglietti, F. Cattabeni, M. Di Luca, S. Bassanini, and V. Setola Neurogenesis in Cerebral Heterotopia Induced in Rats by Prenatal Methylazoxymethanol Treatment Cereb Cortex, July 1, 2003; 13(7): 736 - 748. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Hammers, M. J. Koepp, M. P. Richardson, R. Hurlemann, D. J. Brooks, and J. S. Duncan Grey and white matter flumazenil binding in neocortical epilepsy with normal MRI. A PET study of 44 patients Brain, June 1, 2003; 126(6): 1300 - 1318. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Colombo, L. Tassi, C. Galli, A. Citterio, G. Lo Russo, G. Scialfa, and R. Spreafico Focal Cortical Dysplasias: MR Imaging, Histopathologic, and Clinical Correlations in Surgically Treated Patients with Epilepsy AJNR Am. J. Neuroradiol., April 1, 2003; 24(4): 724 - 733. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Bernasconi, A. Bernasconi, Z. Caramanos, S. B. Antel, F. Andermann, and D. L. Arnold Mesial temporal damage in temporal lobe epilepsy: a volumetric MRI study of the hippocampus, amygdala and parahippocampal region Brain, February 1, 2003; 126(2): 462 - 469. [Abstract] [Full Text] [PDF] |
||||
![]() |
L Jutila, A Immonen, E Mervaala, J Partanen, K Partanen, M Puranen, R Kalviainen, I Alafuzoff, H Hurskainen, M Vapalahti, et al. Long term outcome of temporal lobe epilepsy surgery: analyses of 140 consecutive patients J. Neurol. Neurosurg. Psychiatry, November 1, 2002; 73(5): 486 - 494. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Hammers, M. J. Koepp, R. Hurlemann, M. Thom, M. P. Richardson, D. J. Brooks, and J. S. Duncan Abnormalities of grey and white matter [11C]flumazenil binding in temporal lobe epilepsy with normal MRI Brain, October 1, 2002; 125(10): 2257 - 2271. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Tassi, N. Colombo, R. Garbelli, S. Francione, G. Lo Russo, R. Mai, F. Cardinale, M. Cossu, A. Ferrario, C. Galli, et al. Focal cortical dysplasia: neuropathological subtypes, EEG, neuroimaging and surgical outcome Brain, August 1, 2002; 125(8): 1719 - 1732. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. A. Gabel and J. J. LoTurco Layer I Ectopias and Increased Excitability in Murine Neocortex J Neurophysiol, May 1, 2002; 87(5): 2471 - 2479. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Thom, S. Sisodiya, W. Harkness, and F. Scaravilli Microdysgenesis in temporal lobe epilepsy: A quantitative and immunohistochemical study of white matter neurones Brain, November 1, 2001; 124(11): 2299 - 2309. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Bothwell, G. E. Meredith, J. Phillips, H. Staunton, C. Doherty, E. Grigorenko, S. Glazier, S. A. Deadwyler, C. A. O'Donovan, and M. Farrell Neuronal Hypertrophy in the Neocortex of Patients with Temporal Lobe Epilepsy J. Neurosci., July 1, 2001; 21(13): 4789 - 4800. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Mohamed, E. Wyllie, P. Ruggieri, P. Kotagal, T. Babb, A. Hilbig, C. Wylie, Z. Ying, S. Staugaitis, I. Najm, et al. Temporal lobe epilepsy due to hippocampal sclerosis in pediatric candidates for epilepsy surgery Neurology, June 26, 2001; 56(12): 1643 - 1649. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. P. Doherty, A. J. Cole, F. Cendes, F. Andermann, and F. Dubeau The Requirement for Ictal EEG Recordings Prior to Temporal Lobe Epilepsy Surgery Arch Neurol, April 1, 2001; 58(4): 678 - 680. [Full Text] [PDF] |
||||
![]() |
S. H. Eriksson, F. J. Rugg-Gunn, M. R. Symms, G. J. Barker, and J. S. Duncan Diffusion tensor imaging in patients with epilepsy and malformations of cortical development Brain, March 1, 2001; 124(3): 617 - 626. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. F. Moran, L. Lemieux, N. D. Kitchen, D. R. Fish, and S. D. Shorvon Extrahippocampal temporal lobe atrophy in temporal lobe epilepsy and mesial temporal sclerosis Brain, January 1, 2001; 124(1): 167 - 175. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. P. Leite, V. C. Terra-Bustamante, R. M. F. Fernandes, A. C. Santos, L. Chimelli, A. C. Sakamoto, J. A. Assirati, and O. M. Takayanagui Calcified neurocysticercotic lesions and postsurgery seizure control in temporal lobe epilepsy Neurology, November 28, 2000; 55(10): 1485 - 1491. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Duchowny, P. Jayakar, and B. Levin Aberrant neural circuits in malformations of cortical development and focal epilepsy Neurology, August 8, 2000; 55(3): 423 - 428. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Nordborg, S. Eriksson, B. Rydenhag, P. Uvebrant, and K. Malmgren Microdysgenesis in surgical specimens from patients with epilepsy: occurrence and clinical correlations J. Neurol. Neurosurg. Psychiatry, October 1, 1999; 67(4): 521 - 524. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. J. Won, K.-H. Chang, J.-E. Cheon, H. D. Kim, D. S. Lee, M. H. Han, I.-O. Kim, S. K. Lee, and C.-K. Chung Comparison of MR Imaging with PET and IctalSPECT in 118 Patients with Intractable Epilepsy AJNR Am. J. Neuroradiol., April 1, 1999; 20(4): 593 - 599. [Abstract] [Full Text] |
||||
![]() |
R. Kuzniecky, S. S. Ho, R. Martin, E. Faught, R. Morawetz, C. Palmer, and F. Gilliam Temporal lobe developmental malformations and hippocampal sclerosis: Epilepsy surgical outcome Neurology, February 1, 1999; 52(3): 479 - 479. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. A. Mitchell, G. D. Jackson, R. M. Kalnins, M. M. Saling, G. J. Fitt, R. D. Ashpole, and S. F. Berkovic Anterior temporal abnormality in temporal lobe epilepsy: A quantitative MRI and histopathologic study Neurology, January 1, 1999; 52(2): 327 - 327. [Abstract] [Full Text] |
||||
![]() |
K. S. Lee, J. L. Collins, M. J. Anzivino, E. A. Frankel, and F. Schottler Heterotopic Neurogenesis in a Rat with Cortical Heterotopia J. Neurosci., November 15, 1998; 18(22): 9365 - 9375. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Duncan Armstrong and E. M. Mizrahi Topical Review: Pathologic Basis of the Symptomatic Epilepsies in Childhood J Child Neurol, August 1, 1998; 13(8): 361 - 371. [Abstract] [PDF] |
||||
![]() |
C. M Verity Do seizures damage the brain? The epidemiological evidence Arch. Dis. Child., January 1, 1998; 78(1): 78 - 84. [Full Text] |
||||
![]() |
K. S. Lee, F. Schottler, J. L. Collins, G. Lanzino, D. Couture, A. Rao, K.-i. Hiramatsu, Y. Goto, S.-C. Hong, H. Caner, et al. A Genetic Animal Model of Human Neocortical Heterotopia Associated with Seizures J. Neurosci., August 15, 1997; 17(16): 6236 - 6242. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. A. Brumback and R. W. Leech Memories of a Sea Horse J Child Neurol, July 1, 1996; 11(4): 263 - 264. [PDF] |
||||
![]() |
G.L. Holmes and M.P. Frosch Case 7-1996- An eight-year-old boy with intractable seizures N. Engl. J. Med., February 29, 1996; 334(9): 586 - 593. [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |