Page 12 - scheppingen

one
and a low amount of carbohydrates which leads to the production of ketones that are thought to reduce seizure activity. Although this diet is quite effective, it leads to sei- zure freedom in 55% and reduces seizure frequency in more than 85% of patients with drug-resistant epilepsy within the first three months of treatment 21, its high fat content causes constipation, diarrhea and vomiting, and its rigid composition limits palatability
Figure 1. Histological characteristics of TSC. A-C TSC brain with a cortical tuber. A Brain secti- on showing disturbed grey-white matter border within the tuber (arrow). B T2-weighted spin- echo magnetic resonance imaging, arrow indicates a subcortical hyperintense tuber. C Luxol fast blue-periodic acid-Schiff (Luxol-PAS) staining, showing myelin in blue, indicating reduced myelina- tion at the location of the tuber (arrow). D GFAP staining indicating astrogliosis in cortical tubers. E-G Cortical tubers in the brains of fetal monozygotic twins at 23 weeks gestation. E Haematoxy- lin and eosin (HE) staining indicating giant cells in the tuber. F Low-magnification image of an HE staining. A subcortical eosinophilic tuber is visible in the white matter. G pS6 overexpression in giant cells in the tuber. Scale bar: E: 100 μm; G: 200 μm. The images in E-F were adapted from Prabowo et al., Brain Pathol, 2013;23(1) 28.
10