Difference between revisions of "Epilepsy"
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*Mesial temporal sclerosis = scarring of the medial temporal lobe. | *Mesial temporal sclerosis = scarring of the medial temporal lobe. | ||
**Involves: hippocampus, parahippocampal gyrus and amygdala. | **Involves: hippocampus, parahippocampal gyrus and amygdala. | ||
*Granule cell dispersion | |||
===Hippocampal sclerosis=== | ===Hippocampal sclerosis=== | ||
| Line 33: | Line 34: | ||
Notes: | Notes: | ||
*Gliosis withot neuronal loss is not considered hippocampal sclerosis. | *Gliosis withot neuronal loss is not considered hippocampal sclerosis. | ||
===Granule cell dispersion=== | |||
*Affects dentate gyrus. | |||
*Observed in up to 40% specimen with hippocampal sclerosis. | |||
*Clinico-pathological classification:<ref>{{Cite journal | last1 = Blümcke | first1 = I. | last2 = Kistner | first2 = I. | last3 = Clusmann | first3 = H. | last4 = Schramm | first4 = J. | last5 = Becker | first5 = AJ. | last6 = Elger | first6 = CE. | last7 = Bien | first7 = CG. | last8 = Merschhemke | first8 = M. | last9 = Meencke | first9 = HJ. | title = Towards a clinico-pathological classification of granule cell dispersion in human mesial temporal lobe epilepsies. | journal = Acta Neuropathol | volume = 117 | issue = 5 | pages = 535-44 | month = May | year = 2009 | doi = 10.1007/s00401-009-0512-5 | PMID = 19277686 }}</ref> | |||
**Granule cell pathology (GCP) Type 1: Substantial granule cell loss. | |||
**Granule cell pathology (GCP) Type 2: Cell dispersion, ectopic neurons or clusters of neurons in the molecular layer or bi-lamination. | |||
Clinic: | |||
*Association with longer epilepsy duration. | |||
DDx: | DDx: | ||
Revision as of 09:50, 21 April 2016
Epilepsy is a common chronic seizure disorder.
General
- Epilepsy = seizures that are "idiopathic", i.e. no brain tumour, no mass lesion, no brain injury.
- Most common form: temporal lobe epilepsy.[1]
Etiology
- Many.
Syndromic:
Tumour:
Types
Features:[4]
- Temporal lobe epilepsy
- Mesial temporal sclerosis = scarring of the medial temporal lobe.
- Involves: hippocampus, parahippocampal gyrus and amygdala.
- Granule cell dispersion
Hippocampal sclerosis
- Most frequent histopathology in temporal lobe epilepsy (33% of all epilepsy surgery specimen).
- ILAE classification for hippocampus specimen:[5]
- ILAE type 1: cell loss predominantly in CA1 and CA4 sectors.
- ILAE type 2: predominant CA1 neuron loss and gliosis.
- ILAE type 3: CA4 predominant neuronal cell loss and gliosis.
Clinic: ILAE type 1: benefit from epilepsy surgery.
Notes:
- Gliosis withot neuronal loss is not considered hippocampal sclerosis.
Granule cell dispersion
- Affects dentate gyrus.
- Observed in up to 40% specimen with hippocampal sclerosis.
- Clinico-pathological classification:[6]
- Granule cell pathology (GCP) Type 1: Substantial granule cell loss.
- Granule cell pathology (GCP) Type 2: Cell dispersion, ectopic neurons or clusters of neurons in the molecular layer or bi-lamination.
Clinic:
- Association with longer epilepsy duration.
DDx:
- Epilepsy.
- Dementia.
Sudden unexpected death in epilepsy
- Abbreviated SUDEP.
Diagnosis:
- Negative autopsy.
- History of epilepsy.
Epidemiology:[7]
- Typically poorly controlled epilepsy.
- Incidence: 0.09-9 per 1000 patient-years.
See also
References
- ↑ URL: http://emedicine.medscape.com/article/342150-overview. Accessed on: 20 November 2010.
- ↑ Cataltepe, O.; Turanli, G.; Yalnizoglu, D.; Topçu, M.; Akalan, N. (Apr 2005). "Surgical management of temporal lobe tumor-related epilepsy in children.". J Neurosurg 102 (3 Suppl): 280-7. doi:10.3171/ped.2005.102.3.0280. PMID 15881751.
- ↑ Im, SH.; Chung, CK.; Cho, BK.; Lee, SK. (Mar 2002). "Supratentorial ganglioglioma and epilepsy: postoperative seizure outcome.". J Neurooncol 57 (1): 59-66. PMID 12125968.
- ↑ MUN. 15 November 2010.
- ↑ Blümcke, I.; Thom, M.; Aronica, E.; Armstrong, DD.; Bartolomei, F.; Bernasconi, A.; Bernasconi, N.; Bien, CG. et al. (Jul 2013). "International consensus classification of hippocampal sclerosis in temporal lobe epilepsy: a Task Force report from the ILAE Commission on Diagnostic Methods.". Epilepsia 54 (7): 1315-29. doi:10.1111/epi.12220. PMID 23692496.
- ↑ Blümcke, I.; Kistner, I.; Clusmann, H.; Schramm, J.; Becker, AJ.; Elger, CE.; Bien, CG.; Merschhemke, M. et al. (May 2009). "Towards a clinico-pathological classification of granule cell dispersion in human mesial temporal lobe epilepsies.". Acta Neuropathol 117 (5): 535-44. doi:10.1007/s00401-009-0512-5. PMID 19277686.
- ↑ Tomson, T.; Nashef, L.; Ryvlin, P. (Nov 2008). "Sudden unexpected death in epilepsy: current knowledge and future directions.". Lancet Neurol 7 (11): 1021-31. doi:10.1016/S1474-4422(08)70202-3. PMID 18805738.