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目的观察颞叶癫痫病人海马齿状同和CA3区苔藓纤维出芽情况。方法癫痫组样本来自12例颢叶癫痫病例的手术切除标本包含海马齿状回和CA3区的脑组织,对照组脑组织样本来自4例非癫痫病的尸检脑组织。应用Timm组织化学染色方法在光镜和电镜水平进行海马结构苔藓纤维发芽的研究。结果光镜下癫痫组可见苔藓纤维穿越海马齿状同颗粒细胞层到达内分子层,CA3区也可见明显的苔藓纤维发芽。癫痫组CA3区和齿状同内分子层苔藓纤维发芽评分高于对照组,统计学上差异有显著性意义。电子显微镜下观察显示癫痫组患者齿状回内分子层可见到银标记的突触末端,主要和树突形成突触连接,所形成的突触为非对称性突触。结论颞叶癫痫可致海马齿状同和CA3区苔藓纤维发芽增加,这可能是难治性癫痫形成的重要机制。
Objective To observe the sprouting of mossy fibers in dentate gyrus and CA3 area of hippocampus in patients with temporal lobe epilepsy. Methods The specimens from the epilepsy group from 12 cases of epilepsy were collected from the hippocampal dentate gyrus and the CA3 area. The control samples were obtained from 4 non-epileptic brain tissues. Timm histochemical staining was used to study the germination of mossy fibers in the hippocampal formation at light and electron microscopy. Results In the epilepsy group, visible moss fibers penetrated the dentate granule cell layer of the hippocampus to reach the inner molecular layer. The obvious mossy fiber sprouting was also observed in CA3 area. Epilepsy group CA3 and dentate inner layer moss fiber sprouting score higher than the control group, statistically significant difference was significant. Electron microscopy showed that in the epilepsy group, the silver-labeled synaptic terminals were visible in the dentate gyrus of patients with epilepsy. The synapses were mainly synaptic connections with the dendrites, and the synapses formed were asymmetric synapses. Conclusion Temporal lobe epilepsy can induce germination of mossy fiber in dentate and hippocampal CA3 region, which may be an important mechanism of refractory epilepsy.