鼻咽癌放射治疗后继发性癫痫的研究  

Epilepsy related to radiotherapy in patients with nasopharyngeal carcinoma

作　　者：李艺[1] 唐亚梅[1] 罗东华[2] 容小明[1] 叶剑虹[1] 彭英[1] 

机构地区：[1]中山大学孙逸仙纪念医院神经内科,广州510120 [2]中山大学附属肿瘤医院鼻咽科,广州510060

出　　处：《中华神经医学杂志》2012年第10期986-988,共3页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金（81272576、81200922）;广东省自然科学基金（S2011010004708、S2011010004615）

摘　　要：目的 探讨鼻咽癌放射治疗后放射性脑病患者继发癫痫发作的临床特点及影像学表现。方法 收集中山大学孙逸仙纪念医院自2005年2月至2010年12月收治的112例鼻咽癌放疗后放射性脑病患者资料，按照有无出现癫痫发作分为癫痫组与非癫痫组。总结癫痫组患者临床特点及头颅MR／、EEG表现。结果 112例放射性脑病患者中，出现癫痫发作的患者有17例（15．2％），其中继发全面性强直阵挛发作（S6TC）是最常见的发作形式（9例），其次为单纯部分性发作（5例）。与非癫痫组的放射性脑病患者相比，颞叶囊性变更常见于有癫痫发作的放射性脑病患者中。2例癫痫患者常规脑电图记录到散在的尖波、尖慢波。9例癫痫患者在治疗原发病后癫痫发作得到控制，无需加用抗癫痫药物。结论 鼻咽癌放射性脑病患者出现继发性癫痫者中，以SGTC和单纯部分性发作较常见，使用抗癫痫药物可以较好控制癫痫症状。Objective To investigate the clinical and imaging characteristics of epilepsy in radiation encephalopathy （RE） patients after nasopharyngeal carcinoma （NPC） radiotherapy. Methods One hundred and twelve RE patients after NPC radiotherapy, admitted to our hospital from February 2005 to December 2010, were chosen in our study; these patients were divided into epilepsy group and non-epilepsy group according to the appearance of epilepsy; their clinical and cranial MR imaging and EEG data were collected and compared. Results Epilepsy was a common symptom in RE patients after NPC radiotherapy, with an incidence of 15.2% （17/112）; secondary generalized tonic-clonic （SGTC） seizure was the most common type （9/17）, followed by simple partial seizure （5/17）. Cystic lesions in the temporal lobe under MRI in RE patients with epilepsy were more common as compared with those in RE patients without epilepsy. EEG recorded scattered sharp waves and sharp slow waves in RE patients with/without epilepsy. Nine RE patients with epilepsy achieved seizure-control without using the antiepileptic drugs after treatment of the primary disease. Conclusion SGTC seizure and simple partial seizure are common types in RE patients after NPC radiotherapy, and antiepileptic drugs can control the seizure.

关 键 词：鼻咽癌 癫痫 放射治疗 放射性脑病 

分 类 号：R742.1[医药卫生—神经病学与精神病学]