Developmental and Congenital Anomalies Related to Epilepsy

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Developmental and Congenital Anomalies Related to Epilepsy

Last updated on Tuesday, September 9 2008 by jdmiles

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Pathology of Epilepsy
A video presentation by gliageek describing the pathological findings in certain epilepsy syndromes.

Related images:

Amygdala, high power H&E stain demonstrating innumerable corpora amylacea.
Corpora amylacea, comprising inside will breakdown products of astrocyte metabolism, may be increased in regions of the brain containing chronic reactive astrocytosis.

Amygdala, H&E stained section
Although felt to be nonspecific, corpora amylacea may be increased in regions of the brain containing chronic reactive astrocytosis.

Hippocampal endplate, H&E stained section
Endplate sclerosis may represent the only histopathologic abnormality seen in some patients with temporal lobe epilepsy. Patients manifesting isolated endplate sclerosis ( also referred to as endfolium sclerosis have a much poorer expected postoperative outcome...

Focal cortical dysplasia, Palmini 1a, H&E stain
Palmini 1a focal cortical dysplasia comprises architectural dyslamination with preservation of normal neuronal morphology

Focal cortical dysplasia, Palmini 1b, low-power overview.
Palmini 1b focal cortical dysplasia combines architectural dyslamination with either clusters of immature neurons or cytomegalic but and non-dystrophic neurons. A cluster of mixed immature and cytomegalic neurons can be seen in the upper right hand portion of the cerebral cortex

Focal cortical dysplasia, Palmini 1b, high power H&E stained section
At higher power, the admixture of immature, normal-appearing, and cytomegalic neurons can be appreciated more readily.

Focal cortical dysplasia, Palmini 2a, low power overview H&E stained section of cerebral cortex
At low power, diffuse increase in the density of large parental appearing neurons admixed with increased numbers of glial type nuclei can be appreciated.

Focal cortical dysplasia, Palmini 2a, high power view of cerebral cortex
In addition to enlargement of the neuronal perikarya, dysmorphic neurons are characterized by increased density is of cytoplasmic neurofilaments, which impart an irregular and hyperchromatic appearance to the neuronal cell bodies.

Focal cortical dysplasia, Palmini 2b, low-power overview of cerebral cortex
At low power, the cerebral cortex can be seen to demonstrate disorganization of the normally laminar pattern of neuronal nuclei, similar to that seen in Palmini type 2A cortical dysplasia

Focal cortical dysplasia, Palmini 2b, high power H&E stained section
At high power, ballooned cells similar to those seen in patients with tuberous sclerosis can be appreciated by their abundant homogeneous glassy pink cytoplasm and eccentric large nuclei, sometimes with visible nucleoli.

White Matter Neurons in temporal lobe epilepsy.
The presence of white matter neurons is considered by many to represent a mild malformation of cortical development. As White matter neurons may be found quite readily in patients without a history of epilepsy, consensus criteria indicate that greater than...

White Matter Neurons, neurofilament immunohistochemical stain
White matter neurons are more easily found within neurofilament immunostained sections. In order to obtain an acceptable level of signal to noise ratio, immunohistochemical staining must be done with antibodies directed against non-phosphorylated neurofilament epitopes.

Meningioangiomatosis, low power H&E stained section of cerebral cortex and leptomeninges
Meningioangiomatosis, particularly those examples not associated with neurofibromatosis type II, may be responsible for seizure activity.