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Epileptic Disorders

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Neurocysticercosis and pharmacoresistant epilepsy: possible role of calcified lesions in epileptogenesis Volume 22, issue 4, August 2020

Figure 1

Diagnostic assessment for seizure localization and neuropathology. (A) Representative slices of 3T brain MRI with T1, T2-weighted and susceptibility-weighted image (SWI) sequences showing calcification located in the right mid-frontal gyrus. (B) Scalp EEG with longitudinal bipolar montage. (C) Left panel: macroscopic examination showing a calcified cysticercus resected from the middle frontal gyrus; middle panel: microscopic examination of samples stained with haematoxylin-eosin showing a calcified cysticercus with inflammatory cells and astrocytic gliosis (1: cerebral cortex with astrocytic gliosis; 2: lymphocyte cells; 3: fibrosis wall); right panel: scolex fragments (arrow) surrounded by a non-specific chronic inflammatory process.

Figure 2

Neuropathological and immunohistochemical analysis. (A) Fragment of brain tissue containing the calcified granuloma. An amplified image shows cresyl-violet staining of the lesion. Insets, a and b, represent proximal (up to 200 μm from the NCC fibrous wall) and distal (more than 200 μm from the NCC fibrous wall) cortex regions, respectively, for which the IHC analysis was performed.(B) Evaluation of immunohistochemical markers in representative slices from different regions (left panel: x5 magnification; other panels: x10 magnification). (C) Immunofluorescence (magnification: x40); note the marked increase in microglial activation in the necrotic and proximal regions.