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Table 1 Pathology groups and clinical data

From: Evidence for mTOR pathway activation in a spectrum of epilepsy-associated pathologies

  Pathology group Case Age of onset of seizure (years) Age at resection (years)/Gender Outcome Resection site/Procedure Main pathology features in section
N = number of cases (Seizure type)
Epilepsy-lesional pathology HS N = 4 1 4 (PS, GS) 34 M SF Right ATL HS ILAE type I: neuronal loss in CA1, CA4, gliosis, granule cell dispersion; mossy fibre sprouting confirmed in 3 cases.
2 6 (PS, GS) 43 F NSF Right ATL
3~ 1 (PS) 55 F NSF Left ATL
4 31 (PS, GS) 46 M NSF Left ATL
HS With dysmorphic neurones n = 5 5 UK 30 F NSF Left ATL Hippocampal sclerosis (ILAE type I) with dysmorphic neurones in CA4 and balloon cell glia in DG: mossy fibre sprouting confirmed in 3 cases.
6 12 42 F NSF Right ATL
7 7 (PS, GS) 31 F SF ATL
8 25 (GS) 42 F SF Right ATL
9 14 (PS, GS) 54 F NSF Right ATL
FCDIIA N = 1 10~ 7 (PS, GS) 18 F NSF Right parietal resection Dysmorphic neurones; no balloon cells.
FCDIIB N = 5 11~ UK (PS, GS) 26 M SF Right temporal lobectomy Dysmorphic neurones, cortical dyslamination and balloon cells
12 11 months (PS) 24 F SF Left parietal resection
13~ 7 (GS) 34 F SF Right frontal resection
14 15 months (PS) 33 F NSF Right parietal resection
15 5 (PS, GS) 18 M NFS Right parietal resection
FCD IIIA N = 5 16 12 (PS) 54 F SF Right ATL Neuronal loss in outer cortical layers with gliosis and reorganisation of layer II neurones
17 2 (PS) 34 M SF Right ATL
18 18 (PS, GS, SE) 44 M SF Left ATL
19 8 (PS, GS) 40 M SF Left ATL
20 3 (PS, GS) 19 F SF Left ATL
FCD IIIB N = 3 21 10 months (PS, GS) 27 F SF Left temporal lobectomy Cortex adjacent to a long-term epilepsy associated tumour (LEAT/DNT)
22 6 (PS, GS) 23 M SF Right ATL
23 7 (PS) 31 F SF Temporal lobectomy
FCD IIID N = 3 24 3 (PS, GS) 18 F NSF Right hemispherectomy Cortical disorganisation adjacent to an early infarct
25 4 (PS) 23 M NSF Left ATL
26 11 (PS, GS) 18 F NSF ATL
Rasmussen’s Encephalitis N = 5 27 11 18/F NSF Right sided brain biopsy Active encephalitis* + gliotic atrophic cortex
28 3 (FS, GS) 30 M SF Right hemispherectomy Active encephalitis* + neuronal hypertrophy
29 14 (FS, GS, EPC) 18 M SF Temporal lobe resection and hemispherectomy Active encephalitis* + normal cortex and atrophic cortex and frequent dysmorphic neurones
30 UK 9 F NSF Left temporal lobe resection Burnt out encephalitis, atrophic cortex
31 UK UK NSF Cortical resection Burnt out encephalitis, atrophic cortex
Cortex adjacent to Cavernoma 32 27 (FS) 30 M SF Right temporal lobe resection Cavernoma with reactive gliosis including ‘balloon cell’ like glia
Control-non lesional Acute ICE injury N = 5 11~ 12 (S, GS) 26 M SF Right temporal lobectomy Organising electrode track cavity of 8 days
33 15 30 F SF Left ATL Organising electrode track cavity of 8 days
10~ 7 (FS, GS) 18 F NSF Right parietal resection Organising electrode track cavity of 8 days
12~ 11 months (FS) 24 F SF Left parietal resection Organising electrode track cavity of 10 days
13~ 7 (GS) 34 F SF Right frontal resection Organising electrode track cavity of 10 days
Epilepsy: Paired samples from different regions according to intracranial recordings. N = 4 34 6 (GS) 39M NSF Right frontal resection: No specific pathology- focal inflammation
Sample 1. Ictal onset zone
Sample 2. Peripheral samples in CUSA specimen
35 7 (PS, GS) 25 F SF Left frontal lobe resection No specific pathology
Sample 1. Seizure onset zone
Sample 2. Frontal pole; spreading of EEG activity
36 16 (PS) 33 M SF Right frontal lobe resection No specific pathology
Sample 1. Ictal onset zone
Sample 2. Inferior fronto-orbital; spreading of activity
37 8 (PS,GS) 37 M SF Right frontal lobe resection Focal inflammation only
Sample 1. Ictal onset zone
Sample 2. Spreading of EEG activity
Epilepsy: Pathology negative 38 12 (GS) 18 M NSF Frontal lobe cortex Pathology negative
39 18 (PS, GS) 31M NSF
40 6 (PS, GS, SE) 34 M SF Temporal lobe cortex No pathology in temporal lobe; HS in other sample
41 6 (PS, GS) 43 F SF
3~ 1 (PS) 55 F NSF
42 31 (PS, GS) 46 M NSF
43 UK 40M UK
44 6 (PS) 48 F NSF
45 7 (PS, GS) 48 M SF
Non-Epilepsy Cortex N = 3 46 NA 37M NA Left temporal lobectomy Metastatic carcinoma
47 NA 30M NA Left temporal lobectomy Low grade oligo-astrocytoma
48 NA 74M NA Right temporal lobectomy High grade astrocytoma
  1. ICE = Intracranial electrode, FCD = focal cortical dysplasia, HS = hippocampal sclerosis, DG = dentate gyrus, GS = generalised tonic clonic seizures, PS = partial of focal seizures (no distinction made between complex and simple type), SE = status epilepticus, EPC = Epilepsy partialis continua, SF = completely seizure free at follow up, NSF = not seizure free at follow up (includes nocturnal seizure and rare seizures/auras) [Follow up periods vary between 1 year to 15 years and status taken at last follow up], ATL = anterior temporal lobectomy including hippocampectomy, DNT = dysembryoplastic neuroepithelial tumour, ICE = intracranial electrode injury, CUSA = ultrasonic tissue aspirator, DG = dentate gyrus, UK = unknown. *Active encephalitis was determined by the presence of microglial nodules/neuronophagia and lymphocytic infiltrates on H&E as well as HLADR and CD163 labelling. ~These cases had more than one lesion in different regions of the surgical resection.