Pathology of childhood epilepsies

Abstract

This chapter deals with clinicopathologic tissues relevant to ‘infantile/pediatric epilepsy’, and describes neuropathologic findings of non-neoplastic lesions in the brains of infants and children who have intractable seizure disorders. Recent advances in the molecular biological aspects of tuberous sclerosis-associated cortical tubers will also be briefly described. Until recently, these abnormalities (including malformative and inflammatory lesions) were usually assessed at necropsy,1 by which time ‘secondary’ changes (brain structural abnormalities resulting from a protracted seizure disorder, rather than contributing to its cause) were likely to have complicated the neuropathologic findings. In recent years the surgical treatment of pediatric epilepsy has evolved into an acceptable alternative to the medical management of intractable seizures in children.2,3 The result has been that neuropathologists have had the opportunity to assess brain lesions (associated with seizures in infants and children) in a relatively pristine state, allowing for more reasonable clinicopathologic correlations than were possible in the past using only autopsy tissues.