癫痫灶的超微结构观察及与癫痫发生机制的关系探讨

目的 观察癫痫患者痫灶的超微结构变化，以探讨癫痫的发生机制。方法 对12例顽固性癫痫患者进行皮质电图监测下手术切除痫灶，电镜下观察痫灶皮质。结果 痫灶有明显的病理变化，包括神经细胞数量减少、神经细胞水肿变性、核浓缩、异染色质边集，线粒体水肿、崩解、嵴排列紊乱，神经突触水肿，小血管或毛细血管扭曲、堵塞或内皮细胞水肿，基底膜增厚或分层，星形胶质细胞突起水肿。结论癫痫的发生均有一定的病理形态学基础，除了神经细胞、突触、星形胶质细胞的变化外，血脑屏障的改变与癫痫的发生及预后天系密切。

Ultrastructural observation on human epileptic foci and studying on the mechanism of epilepsy

Objective To observe the ultrastructural changes of human epileptic foci to study the mechanism of epilepsy. Methods EcoG spike foci on the surface of cerebral cortices in 12 cases of intractable epilepsy were removed surgically and studied under electron microscope. Results The ultrastructural changes of the foci were obvious, including the neurons decreasing in number and swelling and degeneration, nuclear pyknosis, marginal collection of heterochromatin; mitochondria swell or disintegrate with mitochondrial cristale vessels or capillaries appear twisted and obstructed, or endothelia cells swell; basement membrane increases in thickness or delamination; astroeytes swell. Conclusion The epileptic loci had obvious pathological changes in all cases, in addition to neurons, synapses, astrocyts, the changes of blood-brain barrier may play an important role in the mechanism of epileptic seizure and the development of epilepsy.