J Korean Epilepsy Soc.  1999 Jun;3(1):16-21.

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

• Kim JS
• Kim JS
• Kim SY
• Seo JS

Abstract

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.

Keyword

TLE; Extent of hippocampal sclerosis; Seizure characteristics; Neuronal loss; Dynorphin

MeSH Terms

Dynorphins
Epilepsy
Epilepsy, Temporal Lobe*
Hippocampus
Humans
Magnetic Resonance Imaging
Neurons*
Sclerosis*
Seizures
Temporal Lobe*
Dynorphins