| Objective To analyze and summarize the histopathological features of the brain tissue of epileptic foci in 62 patients with intractable epilepsy treated by surgical resection,and to identify the pathological type of them according to the latest criteria for the classification of epilepsy proposed by the International League Against Epilepsy(ILAE).To analyze the difference of the expression of NMDA receptor in brain between the patients with intractable epilepsy and people without epilepsy.And to study the correlation between NMDA receptor expression in brain and the duration of epilepsy.Method Collect the paraffin section of the brain tissue of 62 patients with intractable epilepsy who accepted surgical treatment in the general hospital of Jinan military region from January 2008 to June 2015 and observe the slice through 400-fold microscope after hematoxylin and eosin staining and immunohistochemical staining of NeuN,MAP-2,and NF-H.Confirm the classification of them according to the criteria formulated by ILAE in 2011.Observe the NR1 subunit expressed in the slice of brain tissue of 62 patients with intractable epilepsy and 17 patients with cerebral vascular malformation who had no epileptic seizure under 400× visual field of microscope,and draw the scores of the NR1 expression according to the positive rate and color intensity of them.Analyze the difference of NR1 expression scores between epilepsy group and control group by Mann-Whitney rank sum test,then analyze the difference of NR1 expression scores between the different pathological subtype of epilepsy by ANOVA on ranks.And analyze the relevance of the duration of epilepsy and NR1 expression scores by linear regression.Result 62 cases of drug refractory epilepsy patients,male 39 cases,female 23 cases,mean age 25.34±10.17 years old,average age of onset 13.52±10.91 years old,average course of disease 11.82±8.02 years.Focal cortical dysplasia were found in 43 cases,including 3 cases of FCD type Ia,1 cases of FCDIb,2 cases of FCD type Ic,10 cases of FCD type IIa,5 cases of FCD type IIb,2 cases of FCD Type IIIa,2 cases of FCD IIIb,4 cases of FCD IIIc,and 14 cases of FCD IIId.And there were 8 cases of mild cortical dysplasia,7 cases of central nervous system tumors(including 3 cases of astrocytoma,3 cases of gravel meningiomas,1 cases of malignant neural epithelial tumors of the embryonic development),3 cases of simple hippocampal sclerosis,1 cases of encephalitis.Minor onset in 43 cases,of which FCD 29 cases,FCD IIId 11 cases;Adult onset in 19 cases,of which FCD 14 cases,FCDIIId type 3 cases.Temporal lobe epilepsy in 27 cases,of which FCD 15 cases.Frontal lobe epilepsy in 15 cases,of which FCD 13 cases.Epilepsy foci involving multiple cortical patients in 20 cases,of which FCD 15 cases.The expression scores of NR1 in brain tissue of epilepsy group was obviously higher than that in control group(P<0.001).There was no significant difference in the expression scores of NR1 between different pathological types,and there was no significant correlation between the duration of epilepsy and the NR1 expression scores.Conclusion(1)FCD is the most common pathological type of refractory epilepsy,and to FCDIIId type most.In accordance with the new classification standard of FCD proposed by ILAE,the proportion of FCD in various pathological types of epilepsy significantly increased compared with previous reports,especially in the adult onset patients.(2)The expression level of NMDA receptor in brain tissue of patients with intractable epilepsy was higher than that in control group(P<0.001).There was no significant difference in the expression level of NMDA receptor between different pathological types,and there was no significant correlation between the duration of epilepsy and the expression of NMDA receptor. |
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