Neuropathological Findings In Children With Temporal Lobe Intractable Epilepsy And The Expression Of STAT3 In Temporal Cortex With Focal Cortical Dysplasia Type â…¢a

Epilepsy is a common pediatric neurological syndrome, which causes abnormal discharge of neurons in the brain by a variety of causes, causing brain dysfunction.According to statistics, China’s annual new-onset epilepsy in children was 0.33‰~0.82‰.Most patients get a good prognosis after a regular antiepileptic drug treatment. However, 20% ~ 30% of children can not control the seizures, eventually become refractory epilepsy, which seriously impact on children’s growth, and create enormous pressure on the family or the community. Temporal lobe epilepsy is a common type, accounting for 60% ~70% in surgical treatment for epilepsy children. The temporal lobe epilepsy has a variety of pathological types, such as focal cortical dysplasia(FCD), tumors, hippocampal sclerosis and so on. Make the pathological features of children with temporal lobe epilepsy clearly, can provide the basis for the treatment of children with refractory epilepsy.FCD is a type of malformations of cortical development, is an important cause of intractable epilepsy. After surgical treatment of epilepsy more than 75% of children and about 20% of adults with epilepsy exist FCD, about 50% of the whole population of patients with epilepsy is caused by FCD. Since its discovery FCD has been widely applied on various fields among neuroanatomy, pathology and imaging science. FCD is a series of pathology, clinical manifestations vary.Researchers have been trying to classify, so there appeared a variety of different classification methods depending on the application and evaluation methods. Palmini classified the FCD into typeⅠand typeⅡ, widespread used in clinical pathology. In 2011, International League Against Epilepsy(ILAE) revised a new classification-conjugated FCD, based on Palmini classified, hippocampal sclerosis, epilepsy-related tumors, vascular malformations adjacent FCD named associated FCD. FCD divided into isolated FCD and associated FCD.The isolated FCD included simplex typeⅠand typeⅡ, associated FCD typeⅢ. Currently this new type has become a hot research, but its pathogenesis is not clear.Signal transducer and activator of transcription 3(STAT3) is a DNA-binding protein,which has transcriptional activity.It involves in cell proliferation,differentiation, apoptosis and other biological phenomena in vivo biological signal through different pathways. A growing number of studies have found, STAT3 related to epilepsy closely. FCD is a common reason for refractory epilepsy, but its pathogenesis and epileptogenic mechanism are not clear, especially the new type of pathology-FCDⅢ. FCD Ⅲa is a common histological type of conjugated FCD. This study aims to detect the expression of STAT3 in temporal cortex of children which suffered from FCD Ⅲa, to explore the pathogenesis of FCD Ⅲa, and to provide the basis for researching the pathogenesis and treatment of children with intractable epilepsy. Part 1 Neuropathological findings in 38 children with temporal lobe intractable epilepsyObjectives:To explore the neuropathological characteristics of children with temporal intractable epilepsy.Methods:A retrospective analysis of the pathological characteristics is done in 38 children who underwent epilepsy surgery in our hospital from December 2011 to December 2013. HE staining was performed in all the cases. To analize the pathological characteristics in children who suffered from temporal lobe intractable epilepsy.Results:Histopathological study has found:3 cases with mild forms of cortical malformations, 21 cases with focal cortical dysplasia(FCD), 7cases of neoplasms,3 cases of pure hippocampal sclerosis, 2 cases of encephalitis,and 2 cases of cystosclerosis. Among those FCD cases, there are 3 cases of FCDⅠ, 5 cases of FCDⅡ and 13 cases of FCD Ⅲ(FCD Ⅲa 5, FCDⅢb1, FCD Ⅲc 1 and 6 cases of FCD Ⅲd).Conclusions:FCD is the most common form that causes temporal lobe intractable epilepsy in children, tumor ranks second. Part 2 The expression of STAT3 in temporal cortex of children with focal cortical dysplasia type ⅢaObjectives:To detect the expression of STAT3 in children with FCD type Ⅲa.Methods:The expression of STAT3 and P-STAT3(Ser727) were determined in temporal lobe specimens from 26 children with FCD type Ⅲa and from 5 normal children by immunohistochemistry, immunofluorescence and western blot.Results:The expression of P-STAT3(Ser727) was obviously higher in FCD type Ⅲa than control group, the difference was statistically significant(P<0.01).The expression of STAT3 in two groups had no significant difference(P>0.05). The immunofluorescence of GFAP showed that, P-STAT3 positive cells and GFAP-positive cells were similar in the location and shape.Conclusions:Activated STAT3 might be involved in the pathogenesis of FCDⅢa. P-STAT3 positive cells were astrocytes.Activated STAT3 might contribute to the patholgenesis of FCD type Ⅲa by mediating proliferation of astrocytes.