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In children, cortical resections in epilepsy surgery tend to involve multiple lobes, compared to adults, partly due to underlying pathology. We reported two types of histopathological abnormalities in glial cells in children who underwent epilepsy surgery for drug-resistant epilepsy. Oligodendroglia-like cells (OLC) can recruit multiple-lobe epileptogenic zones in pediatric drug-resistant focal epilepsy. Increased OLC presented with non-focal epileptiform discharges on scalp EEG and epileptic spasms (ES), and required multiple-lobe resections. We found increased populations of subcortical OLC in the extensive epileptogenic zone. The presence of cerebral astrocytic inclusions, called filaminopathy, recently has been described in a subset of children with early-onset drug-resistant epilepsy, with or without structural brain malformations and varying degrees of developmental delay. They often provoked cluster of ES from the beginning of seizure history. Functional hemispherectomy may be required for seizure control in a subset of children with filaminopathy. |
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