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December 03-04, 2018 | Chicago, USA
American Pathology and Oncology Research
&
15
th
International Congress on
Microbial Genetics and Molecular Microbiology
International Conference on
Journal of Clinical & Experimental Pathology | ISSN: 2161-0681 | Volume 8
Histopathological findings in surgically resected treatment-resistant epilepsy cases
M Ozge Tepe
1
, Ozan Hasimoglu
2
, Candan Gurses
3
, Altay Sencer
1
and
Bilge Bilgic
1
Istanbul University, Turkey
2
Mazhar Osman Bakirkoy Psychiatry and Neurological Diseases Research and Training Hospital, Turkey
3
Koc University, Turkey
Statement of the Problem:
In treatment-resistant epilepsy, different etiologies, histomorphological and immunohistochemical
features, and diseases are included. Hippocampal sclerosis and focal cortical dysplasia are the most common histopathological
diagnosis while tumor, vascular malformation, encephalitis, and glial scar are featured in decreasing frequency. Hippocampal
sclerosis and focal cortical dysplasia are histopathologically classified according to the International League Against Epilepsy
(ILAE) classifications. Molecular genetic studies in recent years have been effective in determining targeted therapies in patients
who do not respond to antiepileptic drugs. mTOR pathway and immune system activation have been shown to play a role in
epileptogenesis. To determine the incidence of different etiologies in the treatment-resistant epilepsy patients and find out
histomorphological and immunohistochemical features and to demonstrate the relationship between the ILAE subtypes and
the clinical features and try to predict the prognosis of the patients were main purposes in the neuropathological examination
of our surgically resected treatment-resistant epilepsy cases.
Methodology & Theoretical Orientation:
In addition to immunohistochemistry (NeuN, Neurofilament-H, CD34, GFAP,
IDH-1, and Olig-2) was performed in the diagnostic process, pS6 was used to demonstrate mTOR pathway activation in FCD
cases and CD3, CD8, Iba-1 antibodies were applied to demonstrate neuroinflammation in HS cases.
Findings:
Statistical analysis of HS and FCD, were the most frequent histological findings, revealed a significant difference
in age of seizure onset, epileptic seizure duration, surgical age, gender status, and Engel classification. pS6 expression was
observed in dysmorphic neurons and balloon cells in the cases of FCD type II while lymphocyte infiltration was seen in all HS
cases.
Conclusion & Significance:
Significant pS6 expression in FCD type II indicates that mTOR pathway inhibitors may be involved
in the treatment of epilepsy. In HS cases, no statistical significant pathological feature to predict efficacy of immunomodulating
therapy in a special subgroup has been identified.
Biography
M Ozge Tepe graduated from Istanbul University, Istanbul Faculty of Medicine at the age of 24 years. She has trained in medical pathology during her residency
since 2014.
m.ozgetepe89@gmail.comM Ozge Tepe et al., J Clin Exp Pathol 2018, Volume 8
DOI: 10.4172/2161-0681-C5-058