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Sitovskaya D.A.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery Branch of the V.A. Almazov National Medical Research Center of the Ministry of Health of Russia;
Saint Petersburg State Pediatric Medical University

Zabrodskaya Yu.M.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery — Branch V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Sokolova T.V.

Medical Institute of Continuing Education of the Federal State Budgetary Institution of Higher Education «Moscow State University of Food Production»

Kuralbaev A.K.

V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Nezdorovina V.G.

Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute

Dobrogorskaya L.N.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery Branch of the V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Structural heterogeneity of epileptic foci in local drug-resistant epilepsy

Authors:

Sitovskaya D.A., Zabrodskaya Yu.M., Sokolova T.V., Kuralbaev A.K., Nezdorovina V.G., Dobrogorskaya L.N.

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Journal: Russian Journal of Archive of Pathology. 2020;82(6): 5‑15

DOI: 10.17116/patol2020820615

Read: 5470 times

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Table of contents

STRUCTURAL HETEROGENEITY OF EPILEPTIC FOCI IN LOCAL DRUG-RESISTANT EPILEPSY
STRUCTURAL HETEROGENEITY OF EPILEPTIC FOCI IN LOCAL DRUG-RESISTANT EPILEPSY

To cite this article:

Sitovskaya DA, Zabrodskaya YuM, Sokolova TV, Kuralbaev AK, Nezdorovina VG, Dobrogorskaya LN. Structural heterogeneity of epileptic foci in local drug-resistant epilepsy. Russian Journal of Archive of Pathology. 2020;82(6):5‑15. (In Russ.)
https://doi.org/10.17116/patol2020820615

Подписка 2026 Архив патологии (Russian Journal of Archive of Pathology)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

BACKGROUND

To study etiopathogenesis is one of the most important tasks of modern neurology. Various types of structural changes occur in drug-resistant epilepsy (DRE); however, they are described as distinct phenomena.

OBJECTIVE

To provide a comprehensive characterization of structural changes in the cortex and adjacent white matter in the electrophysiological activity zone (in the epileptic focus) in patients undergoing surgery for DRE.

MATERIAL AND METHODS

Biopsy material of fragments of the temporal lobe and hippocampus from 16 patients aged 21 to 54 years (mean age, 25 years) with DRE were intraoperatively obtained at the Prof. A.L. Polenov Russian Research Institute of Neurosurgery. The investigators studied histological sections stained with H&E, toluidine blue according to the Nissl method and the Spielmeyer method, as well as the results of immunohistochemical reactions with glial fibrillary acidic protein (GFAP), vimentin, and neurofilaments (NF) (Dako antibodies, Denmark).

RESULTS

Histological examination revealed a set of heterogeneous changes, reflecting the complex pathogenetic interactions that developed during the formation of an epileptic focus. Structural brain damage involved both gray and white matter. Focal cortical dysplasia was diagnosed in 14 (87.5%) cases; white matter neuronal heterotopia in 100%; neuronal reactive and destructive changes in 100%; epileptic leukoencephalopathy (vascular demyelination, microcysts, sclerosis and dystonia, gliosis) in 100%, cortical atrophy in 12.5%, and hippocampal sclerosis in 20% (in 2 out of the 10 examinees).

CONCLUSION

The morphopathological heterogeneity in the structure of epileptic foci reflects the complexity of etiopathogenetic interactions, the polymorphism of epileptic manifestations, and the individual nature of formation of the epileptic system, which requires an integral approach to understanding the pathogenesis and morphogenesis of formation of the epileptic system and provides a direction for a personalized approach to epilepsy treatment.

Keywords:

epilepsy
MR-negative epilepsy
drug-resistant epilepsy
epileptic focus
structural heterogeneity
focal cortical dysplasia
hippocampal sclerosis
demyelination
gliosis
leukoencephalopathy
pathomorphology

Authors:

Sitovskaya D.A.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery Branch of the V.A. Almazov National Medical Research Center of the Ministry of Health of Russia;
Saint Petersburg State Pediatric Medical University

Zabrodskaya Yu.M.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery — Branch V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Sokolova T.V.

Medical Institute of Continuing Education of the Federal State Budgetary Institution of Higher Education «Moscow State University of Food Production»

Kuralbaev A.K.

V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Nezdorovina V.G.

Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute

Dobrogorskaya L.N.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery Branch of the V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Received:

25.05.2020

Accepted:

16.09.2020

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