50例颞叶癫痫的病理临床研究

以光镜和电镜观察了50例颞叶癫痫之手术切除病灶.结果发现:(1)颞叶癫痫的基本病变为神经细胞的变性和噬节,胶质细胞增生和脱髓鞘,以及出血、血铁素沉积、炎细胞浸润、继发囊肿和胶质、胶原瘢痕形成等.电镜下主要为神经细胞内脂褐素显著增加,粗面内质网扩张、线粒体肿胀等退行性变;(2)22例患者有明确的国产期损害、产伤、外伤及脑部感染或高热病史.这些病例的病灶病变也与病史吻合.另从病理上明确为血管畸形和肿瘤者12例.作者认为,加强围产期保健,减少产伤,避免外伤.预防和积极治疗感染是减少颞叶癫痫发病的重要一环.

The clinical and pathological studies on temporal lobe epilepsy

The resected foci from 50 cases of temporal lobe epilepsy (TLE) were studied by light and electron microscopy.The results showed that the basic lesions in TLE included degeneration of neurons,neuronoph- agia,glial proliferation and demyelination.Hemorrhage,hemosiderosis, inflammatory infiltration,secondary cyst and glia or collagen scar could be detected.Electron microscopically,the non-speclfic degenerative changes such as increased infracytoplasmic lipofuscin in neurons,dilated rough endo- plasmic reticula and swelling mitochondria were found.By inquiry there existed difinite history of perinatal damage,trauma,brain infection or high fever in nearly half of the cases (22 eases).In addition,12 cases were con- firmed histopathologically as vascular malformation or neoplasms.It is sug- gested that by detailed inquiry and pathologic examination the cause of epi- lepsy in most of cases can be clarified and perinatal damage,trauma,brain infection during infant and child and high fever may be main causes lead- ing to TLE.