Histopathological Findings in Brain Tissue Obtained during Epilepsy Surgery

被引：714

作者：

Blumcke, I. ^{[1
]}

Spreafico, R. ^{[25
]}

Haaker, G. ^{[1
,10
]}

Coras, R. ^{[1
]}

Kobow, K. ^{[1
]}

Bien, C. G. ^{[4
]}

Pfaefflin, M. ^{[4
]}

Elger, C. ^{[5
]}

Widman, G. ^{[5
]}

Schramm, J. ^{[7
]}

Becker, A. ^{[6
]}

Braun, K. P. ^{[29
]}

Leijten, F. ^{[29
]}

Baayen, J. C. ^{[31
]}

Aronica, E. ^{[30
,32
,33
,34
]}

Chassoux, F. ^{[36
,37
]}

Hamer, H. ^{[3
]}

Stefan, H. ^{[3
]}

Roessler, K. ^{[2
]}

Thom, M. ^{[41
]}

Walker, M. C. ^{[42
]}

Sisodiya, S. M. ^{[42
]}

Duncan, J. S. ^{[42
]}

McEvoy, A. W. ^{[42
]}

Pieper, T. ^{[8
]}

Holthausen, H. ^{[8
]}

Kudernatsch, M. ^{[8
]}

Meencke, H. J. ^{[9
]}

Kahane, P. ^{[38
]}

Schulze-Bonhage, A. ^{[10
]}

Zentner, J. ^{[11
]}

Heiland, D. H. ^{[11
]}

Urbach, H. ^{[12
,13
]}

Steinhoff, B. J. ^{[14
]}

Bast, T. ^{[14
]}

Tassi, L. ^{[27
]}

Lo Russo, G. ^{[27
]}

Ozkara, C. ^{[47
]}

Oz, B. ^{[48
]}

Krsek, P. ^{[49
,50
]}

Vogelgesang, S. ^{[15
]}

Runge, U. ^{[16
]}

Lerche, H. ^{[17
,18
]}

Weber, Y. ^{[17
,18
]}

Honavar, M. ^{[51
]}

Pimentel, J. ^{[52
]}

Arzimanoglou, A. ^{[39
,40
,53
]}

Ulate-Campos, A. ^{[39
,40
,53
]}

Noachtar, S. ^{[19
]}

Hartl, E. ^{[19
]}

机构：

[1] Univ Hosp Erlangen, Dept Neuropathol, Erlangen, Germany

[2] Univ Hosp Erlangen, Dept Neurosurg, Erlangen, Germany

[3] Univ Hosp Erlangen, Epilepsy Ctr, Erlangen, Germany

[4] Krankenhaus Mara, Epilepsy Ctr Bethel, Bielefeld, Germany

[5] Univ Bonn, Med Ctr, Dept Epileptol, Bonn, Germany

[6] Univ Bonn, Med Ctr, Dept Neuropathol, Bonn, Germany

[7] Univ Bonn, Med Fac, Bonn, Germany

[8] Schon Klin Vogtareuth, Epilepsy Ctr Children & Adolescents, Neuropediat Clin, Vogtareuth, Germany

[9] Epilepsy Ctr Berlin Brandenburg, Berlin, Germany

[10] Univ Hosp, Epilepsy Ctr, Freiburg, Germany

[11] Univ Hosp, Dept Neurosurg, Freiburg, Germany

[12] Univ Freiburg, Med Ctr, Dept Neuroradiol, Freiburg, Germany

[13] Univ Freiburg, Fac Med, Freiburg, Germany

[14] Kork Epilepsy Ctr, Kehl Kork, Kehl, Germany

[15] Univ Hosp Greifswald, Dept Neuropathol, Greifswald, Germany

[16] Univ Hosp Greifswald, Dept Neurol, Greifswald, Germany

[17] Univ Tubingen, Hertie Inst Clin Brain Res, Dept Neurol & Epileptol, Tubingen, Germany

[18] Univ Ulm, Dept Neurol, Ulm, Germany

[19] Ludwig Maximilians Univ Hosp, Dept Neurol, Epilepsy Ctr, Munich, Germany

[20] Sachs Epilepsiezentrum Radeberg, Radeberg, Germany

[21] Goethe Univ, Epilepsy Ctr Frankfurt Rhine Main, Frankfurt, Germany

[22] Goethe Univ, Dept Neurol, Frankfurt, Germany

[23] Philipps Univ Marburg, Epilepsy Ctr Hessen Marburg, Marburg, Germany

[24] Heidelberg Univ, Dept Social Med Occupat & Environm Dermatol, Heidelberg, Germany

[25] IRCCS Fdn, Neurol Inst C Besta, Clin Epileptol & Expt Neurophysiol Unit, Milan, Italy

[26] IRCCS Fdn, Neurol Inst C Besta, Epilepsy Ctr, Dept Neurophysiol, Milan, Italy

[27] Osped Niguarda Ca Granda, Claudio Munari Epilepsy Surg Ctr, Milan, Italy

[28] Univ Florence, Childrens Hosp A Meyer, Pediat Neurol Unit & Lab, Florence, Italy

[29] Univ Med Ctr Utrecht, Brain Ctr Rudolf Magnus, Dept Neurol & Neurosurg, Utrecht, Netherlands

[30] Univ Med Ctr Utrecht, Dept Neuropathol, Utrecht, Netherlands

[31] Vrije Univ Amsterdam Med Ctr, Dept Neurosurg, Amsterdam, Netherlands

[32] Univ Amsterdam, Dept Neuropathol, Acad Med Ctr, Amsterdam, Netherlands

[33] Vrije Univ Amsterdam Med Ctr, Dept Neuropathol, Amsterdam, Netherlands

[34] Stichting Epilepsie Instellingen Nederland, Heemstede, Netherlands

[35] Maastricht Univ, Med Ctr, Acad Ctr Epileptol, Dept Neurosurg, Maastricht, Netherlands

[36] St Anne Hosp, Dept Neurosurg, Paris, France

[37] Paris Descartes Univ, Paris, France

[38] Grenoble Alpes Univ, Michallon Hosp, Dept Neurol, GIN INSERM Unite 836, Grenoble, France

[39] Univ Hosp Lyon, Dept Clin Epileptol, Sleep Disorders & Funct Neurology Children, Lyon, France

[40] Lyon Neurosci Res Ctr, Brain Dynam & Cognit Team, Lyon, France

[41] UCL Inst Neurol, Dept Neuropathol, London, England

[42] UCL Inst Neurol, Clin & Expt Epilepsy, London, England

[43] UCL Great Ormond St Inst Child Hlth, Dev Biol & Canc Programme, London, England

[44] UCL Great Ormond St Inst Child Hlth, Dev Neurosci Program, London, England

[45] Great Ormond St Hosp Sick Children, Dept Histopathol, London, England

[46] Young Epilepsy, Lingfield, England

[47] Istanbul Univ, Cerrahpasa Med Fac, Dept Neurol, Istanbul, Turkey

[48] Istanbul Univ, Cerrahpasa Med Fac, Dept Pathol, Istanbul, Turkey

[49] Charles Univ Prague, Motol Epilepsy Ctr, Dept Pediat Neurol, Prague, Czech Republic

[50] Motol Univ Hosp, Fac Med 2, Prague, Czech Republic

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2017年 / 377卷 / 17期

关键词：

TEMPORAL-LOBE EPILEPSY; TASK-FORCE REPORT; ILAE COMMISSION; CONSENSUS CLASSIFICATION; TRENDS; EXPERIENCE; PROPOSAL;

D O I：

10.1056/NEJMoa1703784

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

BACKGROUND Detailed neuropathological information on the structural brain lesions underlying seizures is valuable for understanding drug-resistant focal epilepsy. METHODS We report the diagnoses made on the basis of resected brain specimens from 9523 patients who underwent epilepsy surgery for drug-resistant seizures in 36 centers from 12 European countries over 25 years. Histopathological diagnoses were determined through examination of the specimens in local hospitals (41%) or at the German Neuropathology Reference Center for Epilepsy Surgery (59%). RESULTS The onset of seizures occurred before 18 years of age in 75.9% of patients overall, and 72.5% of the patients underwent surgery as adults. The mean duration of epilepsy before surgical resection was 20.1 years among adults and 5.3 years among children. The temporal lobe was involved in 71.9% of operations. There were 36 histopathological diagnoses in seven major disease categories. The most common categories were hippocampal sclerosis, found in 36.4% of the patients (88.7% of cases were in adults), tumors (mainly ganglioglioma) in 23.6%, and malformations of cortical development in 19.8% (focal cortical dysplasia was the most common type, 52.7% of cases of which were in children). No histopathological diagnosis could be established for 7.7% of the patients. CONCLUSIONS In patients with drug-resistant focal epilepsy requiring surgery, hippocampal sclerosis was the most common histopathological diagnosis among adults, and focal cortical dysplasia was the most common diagnosis among children. Tumors were the second most common lesion in both groups.

引用

页码：1648 / 1656

页数：9

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