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KMID : 0877219990030010016
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Journal of Korean Epilepsy Society
1999 Volume.3 No. 1 p.16 ~ p.21
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Relationship of Longitudinal Extent of Hippocampal Sclerosis to Clinical Characteristics, Hippocampal Neuronal Cell Loss and Dynorphin-Immunoreactivity Patterns in Intractable Temporal Lobe Epilepsy with Hippocampal Sclerosis
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Kim Jang-Sung
Kim Jung-Sun
Kim Sun-Yong
Seo Joong-Seok
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Abstract
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Purpose: In mesial temporal lobe epilepsy (TLE). Hippocampl sclerosis (HS) is a pathologic substrate and characterized by significant neuronal loss and band-like synaptic reorganization in dentate inner molecular layer (DGIML) og sclerotic hippocampus with either Timm`s staining or Dynorphin (Dyn)-immunohistochemical staining methods. Hippocampus has neuronal synaptic circuitries of both intralamellar and translamellar patterns, from which we may hypothesize that longitudinal extent of HS represents variable pathophysiologic implications of neuronal injury, ictogenesis and epileptogenesis in mesial TLE. We tested the hypothesis.
Methods: Eleven mesial TLE patients with HS on MRI were recruited from epilepsy surgery registry. Resected hippocampal slices were stained with Dyn immunohistochemical method. We classified them into cases with partial HS and thoes with extensive HS according to longitudinal HS extent,. Between the two groups, clinical characteristics of seizures or epilepaies, Hippocampal neuronal density and neuronal loss. and Dynimmunoreactivity (IR) patterns were compared and analyzed. Dyn-IR pattern was classified as presence or absence of DGIML band and of CA3-IR.
Results: Nine cases showed extensive HS whereas two were classified as partial HS. There appeared no significant differences in clinical characteristics, neuronal density, neuronal loss and Dyn-IR patterns between those with extensive and partial HS.
Conclusion: In this study, we could not prove the hypothesis that difference in HS extend on MRI may represent distinctive variabliity in severity of hippocampal neuronal injury and in ictiogenetic or epileptogenetic pathophysiology.
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KEYWORD
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TLE , Extent of hippocampal sclerosis, Seizure characteristics, Neuronal loss, Dynorphin
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