Show Summary Details
Page of

Developmental Neurobiology, Neuroanatomy, and Neuropathology of Epilepsy 

Developmental Neurobiology, Neuroanatomy, and Neuropathology of Epilepsy
Chapter:
Developmental Neurobiology, Neuroanatomy, and Neuropathology of Epilepsy
Author(s):

Ingmar Blümcke

DOI:
10.1093/med/9780199659043.003.0004
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2016. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 17 January 2020

A broad spectrum of brain lesions associates with drug-resistant, chronic seizures, and can be increasingly recognized using high-resolution imaging techniques. Epilepsy surgery has become a successful treatment option in many of these patients. Based on our neuropathologic review of 4512 surgical epilepsy brain tissue samples collected at the European Epilepsy Brain Bank, hippocampal sclerosis, glio-neuronal tumors and malformations of cortical development (Focal Cortical Dysplasias, FCD) are most prevalent. These lesions may directly establish abnormal neuronal networks thereby provoking seizures. On the other hand, early seizure onset may compromise developmental programming and maturation of adjacent brain structures, which can also result in highly epileptogenic lesion patterns. However, international classification systems and grading scales for any distinct lesion pattern need to be established. They will be mandatory to advance the diagnostic work-up, allow comparison between treatment strategies as well as addressing underlying etiologies. In this respect, the International League against Epilepsy has published a first consensus classification for FCD, which will be discussed here. A similar approach may help to negotiate common grading scales for hippocampal sclerosis. Addressing more precisely defined clinico-pathological entities will also help to clarify pathomechanisms and, thereby, develop novel pharmacological targets. Indeed, recent evidence supports the notion that developmentally compromised signalling pathways are involved in many lesions’ etiology. Translating neurodevelopmental knowledge into clinical perspectives has been, therefore, very much promoted in last years and this chapter will also review neurobiological concepts of brain development to better understand the diverse morphological spectrum of epilepsy-associated brain lesions.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.