皮质发育不良性癫痫的超微形态学观察

Ultrastructure observation of refractory epilepsy with cortical dysplasia

目的探讨伴皮质发育不良的难治性癫痫脑组织的超微形态学改变与癫痫发病机制的关系。方法回顾性分析7例患者的临床资料，对其手术切除的标本进行电镜观察。结果伴皮质发育不良的难治性癫痫主要发生在巨脑回畸形、灰质异位、皮层发育不良及结构紊乱，电镜下表现为神经组织变性，神经元减少或增多，星形细胞肿胀，突触数量改变，突触前终末兴奋性递质小泡增多。结论伴皮质发育不良的难治性癫痫患者脑组织发生了大脑皮质神经元形态异常，固缩变性，皮质结构紊乱，神经毡内突触数量及结构的改变。

[ Abstract ] Objective To study the relationship between the ultrastructure changes and pathogenesis of refractory epilepsy with cortical dysplasia. Method To analyze the clinical data of 7 cases of refractory epilepsy retrospectively. The electron microscope was used to observe specimens of brain tissue got from surgical excision. Results Macrogyria, gray matter heterotopia, cortex underdevelopment and cortex derangement were observed in the brain tissue of refractory epileptic patients with cortical dysplasia. The electron microscopic examination showed nerve tissue degeneration, decreased or increased number of neurons, swelling astrocytes, synaptic number changes, increased presynaptic terminal round clear excitatory transmitters. Conclisions Ultrastructural pathological changes including less neurons, pyknosis and degeneration, cortex architecture disorders, changes of synaptic numbers and structures could be found in dysplasia cortex of refractory epilepsy patients.