TEMPORAL LOBE EPILEPSY and NEUROPATHOLOGY Histological Findings in Resected Temporal Lobes Correlated to Surgical Results and Clinical Aspects

Abstract

Neuropathological findings were studied in 74 patients with drug-resistant temporal lobe epilepsy who underwent unilateral temporal lobe resection. In 60% of the patients a well-defined neuropathological abnormality was revealed (13 cases of focal lesions, including 4 small tumors, 21 cases of gliosis, and 10 cases of perivascular infiltration), in 23% the findings were either questionably abnormal or without structural abnormality, while in the last 18% sequelae of a previous operation dominated the histology. The general trend was for the postoperative clinical outcome to be better, the more specific and circumscribed the histological abnormality. There was no correlation between the neuropathological findings and the preoperative types of seizures. Postoperative recurrence of seizures was more often observed in patients with gliosis than in those with other histological diagnoses. A positive correlation existed between a history of cerebral infection and the presence of perivascular lymphocytic and histiocytic infiltration, and gliosis was a frequent finding in patients with epilepsy of unknown etiology. No other significant correlation was found between the neuropathological abnormalities and the clinical, hereditary, etiological and social aspects.