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经典的神经病理学观点认为,原发性全身性癫痫没有脑部病损的证据,这种癫痫的病理学特征是发作性损伤引起的选择性脑实质坏死。作者对8例确诊为原发性全身性癫痫患者的临床资料和病理学检查结果进行全面分析。非特异性改变:5例出现脑水肿,其中4例有急性非特异性缺氧性神经细胞损害。从病损分布和细胞形态学判断,这些损害是在临终前1/2～6小时内,由于呼吸循环衰竭引起的脑普遍性缺氧的结果。仅1例发现散在性、斑块状、选择性神经细胞坏死,并伴有新鲜的胶质修复。Scholz(1951)提出,选择性脑实质坏死是发作性损伤的结果,这一观点至今普遍流传。但该例的病损分布和性质均与 Scholz 报告不同。作者认为这种损害是昏迷引起的,而不是发作性损伤的结果。有2例发现系统性萎缩,其中
Classical neuropathology suggests that there is no evidence of brain damage in primary generalized epilepsy, a pathologic feature of seizures that is selective for parenchymal necrosis of the brain due to seizures. The authors conducted a comprehensive analysis of the clinical data and pathological findings of 8 patients with confirmed primary generalized epilepsy. Non-specific changes: 5 cases of cerebral edema, of which 4 cases of acute non-specific hypoxic neuronal damage. Judging from the distribution of the lesion and the morphology of the cells, these lesions are the result of general brain hypoxia caused by respiratory cycle failure within 1/2 to 6 hours before dying. Only one case found scattered, plaque, selective necrosis of the nerve cells, accompanied by fresh glial repair. Scholz (1951) suggested that selective brain parenchymal necrosis is the result of episodic damage, a belief that has prevailed so far. However, the distribution and nature of lesions in this case are different from the Scholz report. The author believes that this damage is caused by a coma, rather than the result of episodic damage. Two cases found systemic atrophy, among them