Epilepsy & Developmental Neuropathology
Epilepsy & Developmental Neuropathology
What You'll Learn
- Hippocampal sclerosis — the pathology of mesial temporal lobe epilepsy
- Focal cortical dysplasia and the malformations of cortical development (migration/organization defects)
- Neurocutaneous epilepsy substrates (tuberous sclerosis, Sturge-Weber) and Rasmussen encephalitis
- Major neural-tube and posterior-fossa malformations
The neuropathology view of epilepsy substrates & malformations. Clinical epilepsy management lives in the Epilepsy notes; the embryology behind these malformations is in Embryology & Developmental Malformations.
What You'll Learn
| ILAE type | Neuron loss | Note |
|---|---|---|
| Type 1 (classic) | CA1 and CA4 predominant, with gliosis; CA2 relatively spared | Most common; best surgical outcome |
| Type 2 | CA1-predominant | Atypical |
| Type 3 | CA4-predominant | Atypical |
What You'll Learn
| FCD (ILAE) | Pathology | Association |
|---|---|---|
| Type I | Abnormal radial/tangential lamination only; no abnormal cells | Often MRI-subtle |
| Type IIa | Dyslamination + dysmorphic neurons (enlarged, maloriented) | mTOR pathway |
| Type IIb | Dysmorphic neurons + balloon cells (large, glassy eosinophilic cytoplasm) | “Transmantle sign”; like a forme fruste of TS |
| Type III | Dyslamination adjacent to another lesion (hippocampal sclerosis, tumor, vascular) | Dual pathology |
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