Abstracts

Rationale: Some epileptic syndromes of childhood manifest in an age-specific manner and are defined by distinct electroclinical features They are all refractory to medical therapy and are invariably associated with psychomotor deficits, and in the most severe cases, either epileptic encephalopathy or progressive neurodegeneration. Several studies have demonstrated that surgery reduces seizure significantly in children with encephalopathy. This study is aimed to know the cellular alterations in FLEMethods: : We studied three cases of children with intractable epilepsy associated with severe behavioral problems. Preoperative evaluation was carried out according to a standarized Institutional protocol. The surgery was guided by ECoG monitoring and a lesionectomy plus corticectomy was performed to achieve seizure control. The tissue specimens were processed and studied under light microscopy with different immunohisto chemical markers (synaptophysin, nestin, vimentin, Neum, Actine, Glutamate, HLADR). Results: The three children have been followed up for at least one year and are seizure free. Microscopical examination showed cortical dysplasia with some neurons with stratification and dyslamination,the expression of nestine, vimentin and synaptophysin was encreased, many dismorphic nerve cells in the white matter, hypomielinization, astrocytosis, and early apoptosis associated with high phagocytic activity given by microglia. Conclusions: We propose that development of gangliomas induces sinaptogenesis and disruption of the cortical laminar architecture. Nestine, vimentine and synaptophysin expression as well as radial gliosis may be physiological consequences related to the development of epilepsy and behavioral problems. However, more studies are needed to explore this relationship.