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Significance of Purkinje cell density in seizure suppression by chronic cerebellar stimulation

From the Surgical Neurology Branch, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.

Cerebellar biopsy specimens were obtained at the time of cerebellar electrode installation in three epileptic patients. Cerebellar autopsy specimens also were examined from four epileptic patients and from five patients without epilepsy or neurologic disease. All specimens from seizure patients showed isomorphic gliosis of the cerebellar cortices. Significantly lower Purkinje cell densities were found in epileptic patients as compared with nonepileptic control patients. Our two epileptic patients showing marked Purkinje cell loss before cerebellar stimulation appeared to have better seizure control during stimulation than the patient who had only mild reduction in Purkinje cell density. These data suggest that augmentation of Purkinje cell inhibitory discharges is not the dominant mechanism for seizure suppression during cerebellar stimulation. Comparison of cerebellar specimens obtained during electrode installation with those obtained later during electrode revisions may have prognostic significance.

Requests for reprints should be sent to Dr. Van Buren at the Surgical Neurology Branch, NINCDS, Bethesda, MD 20014.

Dr. Wood's current address is the Division of Neurosurgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, Pennsylvania 19104.

This paper was presented in part at the annual meeting of the American Association of Neurological Surgeons, San Franciso, April 1976.

Received for publication September 22, 1975.