癫痫患者切除病灶病理学分析

Analysis of Pathology of Cerebral Epileptiogenic Foci acquired by Surgery in Patients with Epilepsy

目的分析癫痫患者切除的致痫灶标本的病理形态学特点。方法将切除的新鲜脑内致痫灶组织标本进行常规处理,HE染色、特殊染色及免疫组化染色,显微镜下观察其病理学改变。结果133例患者中,原发性癫痫58例(43.6%),包括皮质微发育不良15例,局灶性皮层发育不良(FCD)ⅠA14例,FCDⅠB8例,FCDⅡA11例,FCDⅡB6例,皮层发育不良2例,皮层发育畸形2例;继发性癫痫75例(56.4%),包括肿瘤60例,其中胶质瘤41例,其他原发和转移恶性肿瘤9例,良性肿瘤10例;非肿瘤者15例。结论癫痫是多种病因、多种病变引起的一组疾病,其病理形态学最常见的是脑肿瘤,其次是脑原发性结构异常。

Objective To analyse histological characteristics and pathological type of cerebral epileptogenic foci acquired by surgery. Methods The histological sections of 133 specimens of cerebral epileptogenic foci, which were acquired by surgery, were made by the routine method and stained respectively by hematoxylin and eosin, some special staining techniques and immunohistochemical techniques. Their pathological changes were observed under a light microscope. According to the pathological features of the epileptogenic foci, epilepsies were divided into primary epilepsy produced by primary cerebral structure abnormalities and secondary epilepsy produced by tumorous foci and nontumoreus foci. Results Of 133 cases of epilepsy, 58 were primary epilepsy （43.6%） and 75 secondary epilepsy. In 58 patients with primary epilepsy, cortical microdysplasia was found in 15 patients, focal cortical dysplasia （FCD） Ⅰ A in 14, FCD Ⅰ B in 8, FCD Ⅱ A in 11, FCD ⅡB in 6, cortical dysplasia in 2, and cortical development malformation in 2： In 75 patients with secondary epilepsy （56.4%）, neuroglioeytomas were found in 41, the other primary malignant tumors or metastasis of malignant tumors in 9, benign tumors in 10 and nontumoreus foci in 15. Conclusions Epilepsy may be caused by many intracranial etiological factors and pathological changes. The cerebral tumor is a most common cause producing epilepsy and the second cause of epilepsy is primary cerebral structure abnormalities according to the presented data. The etiological factor and pathogenesy of epilepsy are very complicated. The pathological change in the brain of the patients with epilepsy should he further studied.