Document Detail

Bilateral reorganization of the dentate gyrus in hippocampal sclerosis: a postmortem study.
MedLine Citation:
PMID:  19710404     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hippocampal sclerosis (HS) is the most common surgical pathology associated with mesial temporal lobe epilepsy (MTLE). HS is typically characterized by mossy fiber sprouting (MFS) and reorganization of neuropeptide Y (NPY) fiber networks in the dentate gyrus. One potential cause of postoperative seizure recurrence following temporal lobe surgery may be the presence of seizure-associated bilateral hippocampal damage. We aimed to investigate patterns of hippocampal abnormalities in a postmortem series as identified by NPY and dynorphin immunohistochemistry.
METHODS: Analysis of dentate gyrus fiber reorganization, using dynorphin (to demonstrate MFS) and NPY immunohistochemistry, was carried out in a postmortem epilepsy series of 25 cases (age range 21-96 years). In 9 patients, previously refractory seizures had become well controlled for up to 34 years prior to death.
RESULTS: Bilateral MFS or abnormal NPY patterns were seen in 15 patients including those with bilateral symmetric, asymmetric, and unilateral HS by conventional histologic criteria. MFS and NPY reorganization was present in all classical HS cases, more variably in atypical HS, present in both MTLE and non-MTLE syndromes and with seizure histories of up to 92 years, despite seizure remission in some patients.
CONCLUSION: Synaptic reorganization in the dentate gyrus may be a bilateral, persistent process in epilepsy. It is unlikely to be sufficient to generate seizures and more likely to represent a seizure-induced phenomenon.
M Thom; L Martinian; C Catarino; M Yogarajah; M J Koepp; L Caboclo; S M Sisodiya
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-26
Journal Detail:
Title:  Neurology     Volume:  73     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-29     Completed Date:  2009-10-21     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1033-40     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Cell Count
Dentate Gyrus / pathology*,  physiology*
Dynorphins / metabolism
Epilepsy, Temporal Lobe / pathology*,  physiopathology*
Functional Laterality / physiology*
Middle Aged
Mossy Fibers, Hippocampal / metabolism
Neuropeptide Y / metabolism
Young Adult
Grant Support
G0600934//Medical Research Council; G79059//Medical Research Council
Reg. No./Substance:
0/Neuropeptide Y; 74913-18-1/Dynorphins
Comment In:
Neurology. 2009 Sep 29;73(13):1008-9   [PMID:  19710402 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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