难治性颞叶癫痫患者棘波灶及海马突触损伤的电镜观察

Ultrastructure of Spike Focus of Temporal Lobe Cortexes and Hippocampus in Patients with Protopathic Intractable Temporal Lobe Epilepsy

目的研究颞叶癫痫皮层棘波灶及海马突触的病理变化。方法原发性难治性颞叶癫痫行手术治疗患者9例,手术中在皮层脑电监测下取棘波灶的颞叶大脑皮质和海马组织,电镜下观察。结果颞叶皮质和海马突触数量及突触结构改变。结论颞叶皮层和海马超微结构的改变,特别是突触重组,可能是癫痫反复自发性发作的形态学基础,该病理变化与痫样活动的产生及神经系统的兴奋抑制平衡失调有关。

Objective To observe the pathology in temporal lobe cortexes and hippocampus in protopathic intractable temporal lobe epileptics. Methods The cortexes of spike foci in temporal lobe and hippocampus were obtained from 9 cases with protopathie intractable temporal lobe epilepsy who accepted operation. The samples were observed under the transmission electron microscope. Resuits The ultrastructure changes in spike focus of temporal lobe cortexes are similar to those in hippocampus. It is common that neurons were pycnotic and decreased. Astrocytes were hydropic and degenerative. Gliosis were found in some cases. The number of synapses increased or decreased in different cases and positions. Blood-brain barriers were destroyed because foot processes of astrocytes around capillaries were edematous. Conclusion Neuronal loss, gliosis and synaptic reorganization which occur in epileptic hippocampus and maybe also in epileptic temporal lobe cortexes destroy the balance between excitatory and inhibitory neurotransmission. The abnormalities probably associate with protopathic intractable temporal lobe epileptic seizures.