Abstract
Purpose: Despite the availability of detailed electroclinical and imaging data, only a few neuropathological studies of nodular heterotopia have been published. The aim of this study was to describe the neuropathological features of various types of nodular heterotopia obtained from patients undergoing surgery for intractable epilepsy. Methods: Specimens of heterotopic nodules taken from 24 patients were neuropathologically investigated using routine and immunocytochemical procedures, and the data were compared with magnetic resonance imaging (MRI), electroclinical findings, and surgical outcomes. Results: The neuropathological data distinguished two groups. Group 1 (14 patients, 78% in Engel class 1) had similar characteristics regardless of the size, number, or location of the nodules, with both projecting and local circuit neurons in the nodules intermingled with glial cells. Thirteen patients had focal cortical dysplasia. The nodules were identified by MRI in all cases. In group 2 (10 patients, 90% in Engel class 1), all of the nodules were within the temporal lobe and associated with hippocampal sclerosis or gangliogliomas. They were very small (undetected by MRI) and mainly formed by projecting neurons with no evidence of glial cells. All of the patients had cortical dysplasia. Discussion: The distinctive neuropathological features of the nodules in the two groups suggest different etiopathogenetic mechanisms. In group 2, the presence of nodular formations in association with cortical dysplasia and either hippocampal sclerosis or ganglioglioma raises a question concerning so-called dual pathology in the temporal lobe.
| Original language | English |
|---|---|
| Pages (from-to) | 116-124 |
| Number of pages | 9 |
| Journal | Epilepsia |
| Volume | 50 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2009 |
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Keywords
- Dual pathology
- Neuropathology of epilepsy
- Nodular heterotopia
ASJC Scopus subject areas
- Clinical Neurology
- Neurology
Cite this
Nodular heterotopia : A neuropathological study of 24 patients undergoing surgery for drug-resistant epilepsy. / Meroni, Alessandra; Galli, Carlo; Bramerio, Manuela; Tassi, Laura; Colombo, Nadia; Cossu, Massimo; Lo Russo, Giorgio; Garbelli, Rita; Spreafico, Roberto.
In: Epilepsia, Vol. 50, No. 1, 01.2009, p. 116-124.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Nodular heterotopia
T2 - A neuropathological study of 24 patients undergoing surgery for drug-resistant epilepsy
AU - Meroni, Alessandra
AU - Galli, Carlo
AU - Bramerio, Manuela
AU - Tassi, Laura
AU - Colombo, Nadia
AU - Cossu, Massimo
AU - Lo Russo, Giorgio
AU - Garbelli, Rita
AU - Spreafico, Roberto
PY - 2009/1
Y1 - 2009/1
N2 - Purpose: Despite the availability of detailed electroclinical and imaging data, only a few neuropathological studies of nodular heterotopia have been published. The aim of this study was to describe the neuropathological features of various types of nodular heterotopia obtained from patients undergoing surgery for intractable epilepsy. Methods: Specimens of heterotopic nodules taken from 24 patients were neuropathologically investigated using routine and immunocytochemical procedures, and the data were compared with magnetic resonance imaging (MRI), electroclinical findings, and surgical outcomes. Results: The neuropathological data distinguished two groups. Group 1 (14 patients, 78% in Engel class 1) had similar characteristics regardless of the size, number, or location of the nodules, with both projecting and local circuit neurons in the nodules intermingled with glial cells. Thirteen patients had focal cortical dysplasia. The nodules were identified by MRI in all cases. In group 2 (10 patients, 90% in Engel class 1), all of the nodules were within the temporal lobe and associated with hippocampal sclerosis or gangliogliomas. They were very small (undetected by MRI) and mainly formed by projecting neurons with no evidence of glial cells. All of the patients had cortical dysplasia. Discussion: The distinctive neuropathological features of the nodules in the two groups suggest different etiopathogenetic mechanisms. In group 2, the presence of nodular formations in association with cortical dysplasia and either hippocampal sclerosis or ganglioglioma raises a question concerning so-called dual pathology in the temporal lobe.
AB - Purpose: Despite the availability of detailed electroclinical and imaging data, only a few neuropathological studies of nodular heterotopia have been published. The aim of this study was to describe the neuropathological features of various types of nodular heterotopia obtained from patients undergoing surgery for intractable epilepsy. Methods: Specimens of heterotopic nodules taken from 24 patients were neuropathologically investigated using routine and immunocytochemical procedures, and the data were compared with magnetic resonance imaging (MRI), electroclinical findings, and surgical outcomes. Results: The neuropathological data distinguished two groups. Group 1 (14 patients, 78% in Engel class 1) had similar characteristics regardless of the size, number, or location of the nodules, with both projecting and local circuit neurons in the nodules intermingled with glial cells. Thirteen patients had focal cortical dysplasia. The nodules were identified by MRI in all cases. In group 2 (10 patients, 90% in Engel class 1), all of the nodules were within the temporal lobe and associated with hippocampal sclerosis or gangliogliomas. They were very small (undetected by MRI) and mainly formed by projecting neurons with no evidence of glial cells. All of the patients had cortical dysplasia. Discussion: The distinctive neuropathological features of the nodules in the two groups suggest different etiopathogenetic mechanisms. In group 2, the presence of nodular formations in association with cortical dysplasia and either hippocampal sclerosis or ganglioglioma raises a question concerning so-called dual pathology in the temporal lobe.
KW - Dual pathology
KW - Neuropathology of epilepsy
KW - Nodular heterotopia
UR - http://www.scopus.com/inward/record.url?scp=58149248037&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58149248037&partnerID=8YFLogxK
U2 - 10.1111/j.1528-1167.2008.01717.x
DO - 10.1111/j.1528-1167.2008.01717.x
M3 - Article
C2 - 18637832
AN - SCOPUS:58149248037
VL - 50
SP - 116
EP - 124
JO - Epilepsia
JF - Epilepsia
SN - 0013-9580
IS - 1
ER -