Neurocysticercosis and microscopic hippocampal dysplasia in a patient with refractory mesial temporal lobe epilepsy.
Epidemiologic studies suggest that neurocysticercosis (NC) is the main cause of symptomatic epilepsy in developing countries. The association between NC and mesial temporal lobe epilepsy (MTLE) has been reported by several authors. Recent data have shown that the presence of NC does not influence the clinical and pathological profile in MTLE patients and suggest that not all cysticercotic lesions are inevitably epileptogenic. We describe a 50-years-old woman with partial seizures due to NC which evolve to MTLE. The patient was submitted to a corticoamygdalohippocampectomy to treat refractory epilepsy. An immunohistochemical study using neuronal markers was made on hippocampal formation. Besides the typical aspects of Ammon's horn sclerosis (AHS), the microscopic examination demonstrates cellular features of hippocampal malformation including dysmorphic neurons and focal bilamination of granular cell layer. We suggest that, in this case, a developmental disorder lowered the threshold for the NC-induced seizures and contributed to the establishment of refractory epilepsy.
da Silva
Alexandre Valotta
AV
Laboratório de Neurologia Experimental, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. valotta.nexp@epm.br
Martins
Heloise Helena
HH
Marques
Carolina Mattos
CM
Yacubian
Elza Marcia Targas
EM
Sakamoto
Américo Ceiki
AC
Carrete
Henrique
H
da Silva Centeno
Ricardo
R
Stavale
João Norberto
JN
Cavalheiro
Esper Abrão
EA
D004833:Epilepsy, Temporal Lobe / Q000469:parasitology* / Q000601:surgery; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020019:Neurocysticercosis / Q000150:complications*