Histopathological Findings in Brain Tissue Obtained during Epilepsy Surgery

Blümcke I, Spreafico R, Haaker G, Coras R, Kobow K, Bien CG, Pfaefflin M, Elger C, Widman G, Schramm J, Becker A, Braun KP, Leijten F, Baayen JC, Aronica E, Chassoux F, Hamer H, Stefan H, Roessler K, Thom M, Walker MC, Sisodiya SM, Duncan JS, Mcevoy AW, Pieper T, Holthausen H, Kudernatsch M, Meencke HJ, Kahane P, Schulze-Bonhage A, Zentner J, Heiland DH, Urbach H, Steinhoff BJ, Bast T, Tassi L, Lo Russo G, Ozkara C, Oz B, Krsek P, Vogelgesang S, Runge U, Lerche H, Weber Y, Honavar M, Pimentel J, Arzimanoglou A, Ulate-Campos A, Noachtar S, Hartl E, Schijns O, Guerrini R, Barba C, Jacques TS, Cross JH, Feucht M, Muehlebner A, Grunwald T, Trinka E, Winkler PA, Gil-Nagel A, Delgado RT, Mayer T, Lutz M, Zountsas B, Garganis K, Rosenow F, Hermsen A, Von Oertzen TJ, Diepgen TL, Avanzini G (2017)


Publication Type: Journal article

Publication year: 2017

Journal

Book Volume: 377

Pages Range: 1648-1656

Journal Issue: 17

DOI: 10.1056/NEJMoa1703784

Abstract

Detailed neuropathological information on the structural brain lesions underlying seizures is valuable for understanding drug-resistant focal epilepsy.We report the diagnoses made on the basis of resected brain specimens from 9523 patients who underwent epilepsy surgery for drug-resistant seizures in 36 centers from 12 European countries over 25 years. Histopathological diagnoses were determined through examination of the specimens in local hospitals (41%) or at the German Neuropathology Reference Center for Epilepsy Surgery (59%).The onset of seizures occurred before 18 years of age in 75.9% of patients overall, and 72.5% of the patients underwent surgery as adults. The mean duration of epilepsy before surgical resection was 20.1 years among adults and 5.3 years among children. The temporal lobe was involved in 71.9% of operations. There were 36 histopathological diagnoses in seven major disease categories. The most common categories were hippocampal sclerosis, found in 36.4% of the patients (88.7% of cases were in adults), tumors (mainly ganglioglioma) in 23.6%, and malformations of cortical development in 19.8% (focal cortical dysplasia was the most common type, 52.7% of cases of which were in children). No histopathological diagnosis could be established for 7.7% of the patients.In patients with drug-resistant focal epilepsy requiring surgery, hippocampal sclerosis was the most common histopathological diagnosis among adults, and focal cortical dysplasia was the most common diagnosis among children. Tumors were the second most common lesion in both groups. (Funded by the European Union and others.).

Authors with CRIS profile

Involved external institutions

University of Amsterdam NL Netherlands (NL) Medizinische Universität Wien AT Austria (AT) Great Ormond Street Hospital (GOSH) GB United Kingdom (GB) Università degli Studi di Firenze / University of Florence IT Italy (IT) Maastricht University NL Netherlands (NL) Ludwig-Maximilians-Universität (LMU) DE Germany (DE) Hospices Civils de Lyon (CHU) FR France (FR) Centro Hospitalar Universitário Lisboa Norte (CHULN) PT Portugal (PT) Unidade Local de Saúde de Matosinhos PT Portugal (PT) Eberhard Karls Universität Tübingen DE Germany (DE) Universitätsmedizin Greifswald / Universitätsklinikum Greifswald DE Germany (DE) Univerzita Karlova v Praze / Charles University in Prague CZ Czech Republic (CZ) Istanbul University / İstanbul Üniversitesi TR Turkey (TR) Ospedale Niguarda Ca' Granda / ASST Grande Ospedale Metropolitano Niguarda IT Italy (IT) Epilepsiezentrum Kork DE Germany (DE) Albert-Ludwigs-Universität Freiburg DE Germany (DE) Universitätsklinikum Freiburg DE Germany (DE) University of Grenoble Alpes (UGA) / Université de Grenoble FR France (FR) Epilepsie-Zentrum Berlin-Brandenburg / Institut für Diagnostik der Epilepsien gGmbH (IDE) DE Germany (DE) Schön Kliniken DE Germany (DE) University College London (UCL) GB United Kingdom (GB) Centre hospitalier Sainte-Anne FR France (FR) University Medical Centre Utrecht (UMC Utrecht) NL Netherlands (NL) Vrije Universiteit Amsterdam (VU) / University Amsterdam NL Netherlands (NL) Rheinische Friedrich-Wilhelms-Universität Bonn DE Germany (DE) Krankenhaus Mara DE Germany (DE) Universitätsspital Zürich (USZ) CH Switzerland (CH) Foundation of the Carlo Besta Neurological Institute (IRCCS) IT Italy (IT) Ruprecht-Karls-Universität Heidelberg DE Germany (DE) Kepler Universitätsklinikum (KUK) AT Austria (AT) Goethe-Universität Frankfurt am Main DE Germany (DE) St. Luke's Hospital / Κλινική Άγιος Λουκάς GR Greece (GR) Kleinwachau - Sächsisches Epilepsiezentrum Radeberg gGmbH DE Germany (DE) Ruber International Hospital ES Spain (ES) Paracelsus Medizinische Privatuniversität AT Austria (AT)

How to cite

APA:

Blümcke, I., Spreafico, R., Haaker, G., Coras, R., Kobow, K., Bien, C.G.,... Avanzini, G. (2017). Histopathological Findings in Brain Tissue Obtained during Epilepsy Surgery. New England Journal of Medicine, 377(17), 1648-1656. https://dx.doi.org/10.1056/NEJMoa1703784

MLA:

Blümcke, Ingmar, et al. "Histopathological Findings in Brain Tissue Obtained during Epilepsy Surgery." New England Journal of Medicine 377.17 (2017): 1648-1656.

BibTeX: Download