Blanc, F; (2008) Post-mortem investigation of widespread cortical changes in patients with epilepsy and hippocampal sclerosis. Doctoral thesis , UCL (University College London).

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Abstract

Hippocampal sclerosis is a common pathological feature in temporal lobe epilepsy patients and may actually be an indicator of more widespread neocortical changes, which may be asymmetrical. There is some suggestion from neuroimaging research that these widespread changes may involve hippocampal projection sites such as the cingulate gyrus and entorhinal cortex. The aim of this study was to investigate, using quantitative post-mortem techniques, whether or not patients with epilepsy and hippocampal sclerosis have more widespread neocortical changes. Six hippocampal sclerosis cases were compared with four neurologically normal controls, using field fraction analysis for quantitative assessment, in order to measure the intensity of GFAP staining present in selected cortical and white matter cerebral regions. No overall differences in gliosis were found between the patients and the controls, however hippocampal projection regions were shown to be more gliotic than the same regions in the controls, as well as more gliotic in the hemisphere ipsilateral to the sclerosis. These preliminary findings suggest that there is more widespread damage occurring in both the grey and white matter of patients with hippocampal sclerosis and this is important when considering possible reasons as to why some patients who undergo resective surgery may continue to experience seizures post-operatively.

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