Widespread microdysgenesis in therapy-resistant epilepsy--a case report on post-mortem findings.
Microdysgenesis is a subtle malformation, which is often found in specimens from epilepsy surgery. It is, however, not clear whether the changes are focal or diffuse. A recent autopsy case offered an opportunity to investigate whether microdysgenesis found after temporal lobe surgery was focal or widespread in the brain. The entire brain of a 20-year-old patient who died suddenly and unexpectedly was examined histologically. Microdysgenesis had previously been diagnosed after a left temporal lobectomy performed because of therapy-resistant seizures. A light microscopic examination was performed on specimens stained with Luxol-fast blue-cresyl violet and polyclonal antibodies to glial fibrillary acidic protein. Widespread microdysgenesis with irregular nerve cell distribution in the cortex and an increased number of nerve cells in cortical layer I and in the white matter was found in the right temporal and parietal lobes and bilaterally in the frontal and occipital lobes. The post-mortem examination confirmed the previous diagnosis of microdysgenesis and showed that the changes were widespread in a patient who was operated on because of focal epilepsy.
Eriksson
S H
SH
Department of Neurology, Institute of Clinical Neuroscience, Göteborg, Sweden.
Rydenhag
B
B
Uvebrant
P
P
Malmgren
K
K
Nordborg
C
C
D000328:Adult; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000601:surgery; D004828:Epilepsies, Partial / Q000473:pathology* / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009474:Neurons / Q000473:pathology; D017211:Treatment Failure