胚胎发育不良性神经上皮瘤继发癫癎的外科治疗  

Surgical treatment of epilepsy secondary to dysembroplasticy neuroepithelial tumor

作　　者：郭韬[1] 李文玲[1] 康进生[1] 赵文清[1] 武江[1] 杜亚丽[1] 董长征[1] 岳向勇[1] 

机构地区：[1]河北省人民医院功能神经外科,石家庄050051

出　　处：《中国微侵袭神经外科杂志》2011年第3期116-118,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的总结胚胎发育不良性神经上皮瘤(DNT)继发癫癎的外科治疗经验。方法回顾性分析4例DNT的临床资料,根据脑磁图大体确定功能区范围,在唤醒麻醉下应用术中皮质电刺激刺激相应区域皮质,明确功能区、致癎灶和DNT边界。显微镜下切除DNT及致癎灶。结果 DNT全切除3例,大部分切除1例;致癎灶全切除1例,大部分切除3例。术后随访16～21个月,未出现癫癎发作3例,偶尔出现单纯部分性发作1例;视频脑电图复查均未见棘波放电。结论联合应用脑磁图与术中唤醒技术显微手术切除DNT、致癎灶是治疗继发癫癎的DNT安全、有效方法。Object To summarize the experience with the surgical treatment of epilepsy secondary to dysembroplasticy neuroepithelial tumor（DNT）.Methods Clinical data of 4 patients with DNT were analyzed retrospectively.The functional area was roughly determined by magnetoencephalogram.The functional area,epileptogenic focus and DNT boundary were ascertained by cortex electric stimulation during the surgery under awaking anesthesia.DNT and epileptogenic focus were resected under microscope.Results Total removal of DNT was achieved in 3 cases and subtotal resection in 1,while total removal of epileptogenic focus was achieved in 1 cases and subtotal resection in 3.During a followed-up period of 16 to 21 months,there was no epileptic seizure in 3 cases and simple partial seizures in 1.No spike-wave discharge was found by video-electroencephalogram reexamination.Conclusions Combination of magnetoencephalogram and awaking technique in microsurgery is a safe and effective method for the resection of DNT and epileptogenic focus.

关 键 词：癫癎 神经外胚瘤 原始 脑磁图描记术 经皮神经电刺激 

分 类 号：R742.1[医药卫生—神经病学与精神病学]