Peculiar eosinophilic inclusions within astrocytes in a patient with malformed brain

Child Neurology: Pediatric seizures with hyaline astrocytic inclusions

“…5,7 Brain malformations are present in some [4][5][6]8 but not all cases of pediatric epilepsy with hyaline astrocytic inclusions. 3,5,7 Malformations present include cortical dysplasia, 6 polymicrogyria, 4,5,8 periventricular heterotopias, [4][5][6]8 periventricular white matter changes, 6 pachygyria, 8 cerebellar vermis hypoplasia, 8 or agenesis of corpus callosum. 6,8 Non-CNS congenital abnormalities are sometimes reported, and include cardiac septal defect, bowel malrotation, and upper extremity deformity.…”

“…3,5,7 Malformations present include cortical dysplasia, 6 polymicrogyria, 4,5,8 periventricular heterotopias, [4][5][6]8 periventricular white matter changes, 6 pachygyria, 8 cerebellar vermis hypoplasia, 8 or agenesis of corpus callosum. 6,8 Non-CNS congenital abnormalities are sometimes reported, and include cardiac septal defect, bowel malrotation, and upper extremity deformity. 6 In pediatric seizures with hyaline inclusions, these inclusions are found throughout the cerebral cortex and are absent from white matter, cerebellum, brainstem, or subcortical gray matter, but are not restricted to regions of brain malformations.…”

“…[2][3][4][5][6][7][8] The diagnosis is made by neuropathologic analysis that demonstrates brightly eosinophilic, hyaline, refractile astrocytic inclusions seen under light microscopy with hematoxylin & eosin stain. [2][3][4][5][6][7][8] We review the clinicopathologic entity of pediatric epilepsy with hyaline astrocytic inclusions and report an illustrative case.…”

“…[2][3][4][5][6][7][8] Key clinical characteristics of pediatric epilepsy with hyaline astrocytic inclusions are developmental delay and seizures. Developmental delay does not seem to have a predilection for specific domains and is usually severe.…”

“…[2][3][4][5][6][7][8] Seizures are often intractable despite treatment with antiepileptic drugs. [2][3][4][5][6][7][8] Of 12 patients who underwent surgical resection of epileptic foci, 2,3,5-7 3 patients had recurrent seizures with reduced frequency, 2,6 and 4 remained seizure-free for various periods of time by time of publication. 2,3,6 One patient died shortly after surgical resection complicated by a vascular event.…”