International recommendation for a comprehensive neuropathologic workup of epilepsy surgery brain tissue: A consensus Task Force report from the ILAE Commission on Diagnostic Methods
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
26839983
DOI
10.1111/epi.13319
Knihovny.cz E-resources
- Keywords
- Brain, Encephalitis, Epilepsy, Glia, Malformation, Neuron, Neuropathology, Seizure, Tumor,
- MeSH
- Epilepsy diagnosis epidemiology surgery MeSH
- Hemispherectomy methods standards MeSH
- Hippocampus pathology MeSH
- Internationality * MeSH
- Consensus * MeSH
- Humans MeSH
- Malformations of Cortical Development diagnosis epidemiology surgery MeSH
- Brain pathology surgery MeSH
- Advisory Committees standards MeSH
- Psychosurgery methods standards MeSH
- Practice Guidelines as Topic standards MeSH
- Temporal Lobe pathology MeSH
- Stereotaxic Techniques standards MeSH
- Research Report standards MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Epilepsy surgery is an effective treatment in many patients with drug-resistant focal epilepsies. An early decision for surgical therapy is facilitated by a magnetic resonance imaging (MRI)-visible brain lesion congruent with the electrophysiologically abnormal brain region. Recent advances in the pathologic diagnosis and classification of epileptogenic brain lesions are helpful for clinical correlation, outcome stratification, and patient management. However, application of international consensus classification systems to common epileptic pathologies (e.g., focal cortical dysplasia [FCD] and hippocampal sclerosis [HS]) necessitates standardized protocols for neuropathologic workup of epilepsy surgery specimens. To this end, the Task Force of Neuropathology from the International League Against Epilepsy (ILAE) Commission on Diagnostic Methods developed a consensus standard operational procedure for tissue inspection, distribution, and processing. The aims are to provide a systematic framework for histopathologic workup, meeting minimal standards and maximizing current and future opportunities for morphofunctional correlations and molecular studies for both clinical care and research. Whenever feasible, anatomically intact surgical specimens are desirable to enable systematic analysis in selective hippocampectomies, temporal lobe resections, and lesional or nonlesional neocortical samples. Correct orientation of sample and the sample's relation to neurophysiologically aberrant sites requires good communication between pathology and neurosurgical teams. Systematic tissue sampling of 5-mm slabs along a defined anatomic axis and application of a limited immunohistochemical panel will ensure a reliable differential diagnosis of main pathologies encountered in epilepsy surgery.
2nd Faculty of Medicine Motol University Hospital Charles University Prague Prague Czech Republic
Department of Neuropathology Institute of Neurology University College London London United Kingdom
Department of Neuropathology Research Institute for Brain and Blood Vessels Akita Akita Japan
Department of Neuropathology University Hospital Erlangen Erlangen Germany
Department of Neurosurgery Sahlgrenska University Hospital Gothenburg Sweden
Department of Neurosurgery University Hospital Erlangen Erlangen Germany
Epilepsy Center Cleveland Clinic Foundation Cleveland Ohio U S A
SEIN Epilepsy Institute in the Netherlands Heemstede The Netherlands
References provided by Crossref.org
Genetic Testing for Malformations of Cortical Development: A Clinical Diagnostic Study
