title: [Pathological changes in the epileptogenic foci of children with intractable epilepsy].
abstract: OBJECTIVE
  To investigate pathological changes in the epileptogenic foci of children with intractable epilepsy and their clinical significance.
  
  
  METHODS
  Thirty children with intractable epilepsy were included in the study. The epileptogenic foci were surgically resected and pathological changes in the obtained specimens were observed under a light microscope (LM) and a transmission electron microscope (TEM).
  
  
  RESULTS
  Under the LM, cortical dysplasia was found in 14 cases (47%), hippocampal sclerosis in 11 cases (37%), dysembryoplastic neuroepithelial tumor in 1 case (3%), ganglioglioma in 1 case (3%), and encephalomalacia in 3 cases (10%). The TEM observation revealed pathological changes in the ultrastructure of the hippocampus and extra-hippocampal cortex, such as changes in the number of synapses and synaptic structure, decrease in neurons and karyopyknosis, swelling and degeneration of astrocytes, and changes in mitochondrial structures.
  
  
  CONCLUSIONS
  Pathological changes in the hippocampus and extra-hippocampal cortex, especially synaptic remodeling, may be the morphological basis for spontaneous recurrent seizures in children with intractable epilepsy. The pathological changes and epileptiform activity are related to an imbalance between excitatory and inhibitory neurotransmission.
authors.affiliation: Department of Pediatrics, Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, China.
authors.forename: Li-Mei
authors.initials: LM
authors.lastname: Feng
authors.forename: Gui-Zhi
authors.initials: GZ
authors.lastname: Xia
authors.forename: Rong-Na
authors.initials: RN
authors.lastname: Ren
authors.forename: Peng-Fan
authors.initials: PF
authors.lastname: Yang
authors.forename: Lin-Ying
authors.initials: LY
authors.lastname: Zhou
authors.forename: Zhen
authors.initials: Z
authors.lastname: Mei
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology* / Q000648:ultrastructure; D002540:Cerebral Cortex / Q000473:pathology / Q000648:ultrastructure; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000473:pathology* / Q000601:surgery; D005260:Female; D006624:Hippocampus / Q000473:pathology / Q000648:ultrastructure; D006801:Humans; D007223:Infant; D007360:Intelligence; D008297:Male; D046529:Microscopy, Electron, Transmission