癫痫病人脑棘波灶轴突、突触和树突的病理学研究  

An immunohistochemical study on axons, synapses and dendrites in spike foci of human epileptic brains

作　　者：李桂林[1] 孙淑清[1] 李敬军[1] 

机构地区：[1]北京市神经外科研究所神经病理室,100050

出　　处：《中华神经外科杂志》2004年第4期295-298,共4页Chinese Journal of Neurosurgery

基　　金：<北京市科技新星培养计划>基金资助(编号854872200);获北京市科技进步二等奖

摘　　要：目的研究癫痫病人脑棘波灶内轴突、突触和树突的病理学变化。方法癫痫患者29例,手术治疗时在皮层电图监测下取棘波灶大脑皮质,用βAPP、突触素和MAP2免疫组化方法,分别对轴突、突触和树突的病理变化进行研究,并对突触做了电镜观察。结果棘波灶内轴突病变不明显;突触分布不均,或密集成片,或稀疏淡染,电镜下轴棘非对称性突触前轴突末梢水肿,突触小泡减少或消失;树突屈曲变形,病变严重者树突变得粗细不均,或变成串珠状,多数树突失去分枝,血管周围树突排列紊乱。此外,在5例临床诊断为原发性癫痫的病例,观察到白质内神经细胞异位。结论癫痫棘波灶的病理变化主要发生在突触和树突,突触的增多、重组和丢失,以及白质神经细胞异位可能是癫痫异常放电的病理学基础。Objectives To investigate the immunohistochemical changes of axons, synapses and dendrites of the spike foci in human epileptic brain. Methods The cortexes of spike foci were surgically obtained from 29 cases with intractable epilepsy. βAPP, synaptophysin and MAP2 immunohistochemistry was used to investigate the changes of axons, synapses and dendrites in the spike foci, respectively. Results The synapses were densely clustered or sparsely scattered. The dendrites were distorted or beaded and lost their branches. The axons did not show visible alterations. In 5 of 10 cases diagnosed as primary epilepsy, neuronal heterotopia was seen in the white matter. Conclusions It was suggested that synaptogenesis, synaptic loss and reorganization may result in abnormal electric activities of epilepsy. The neuronal heterotopia may be one of causes for primary epilepsy.

关 键 词：癫痫 轴突 突触 树突 病理学 

分 类 号：R742.1[医药卫生—神经病学与精神病学]