胚胎发育不良性神经上皮肿瘤致癫痫的手术治疗  

Surgical strategy of epileptogenic dysembryoplastie neuroepithelial tumor

作　　者：徐建堃[1] 单永治[1] 朴月善[2] 樊晓彤[1] 安阳[1] 赵永瑞[1] 赵国光[1] 

机构地区：[1]首都医科大学宣武医院神经外科,北京100053 [2]首都医科大学宣武医院病理科,北京100053

出　　处：《中华神经外科杂志》2014年第9期904-907,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨胚胎发育不良性神经上皮肿瘤（DNT）致癫痫患者的手术策略.方法 回顾性分析自2008年1月至2013年8月首都医科大学宣武医院神经外科手术治疗14例DNT患者的经验,术前常规通过MRI及视频脑电图（VEEG）等检查对肿瘤及致痫灶进行评估,术中行皮层脑电监测（EcoG）对致痫灶定位,手术方式：肿瘤病灶加致痫灶切除.结果 14例患者肿瘤均得到全切,手术后病理证实为DNT,未行放疗和化疗,无肿瘤复发及恶性转化.10例患者术后癫痫发作得到完全控制（Engel Ⅰ级）,4例患者术后稀少发作（EngelⅡ级）.结论 DNT是低级别神经元～胶质细胞肿瘤,常见于青少年,多伴药物难治性癫痫,除切除肿瘤外,积极处理肿瘤外致痫灶可以很好地控制癫痫.Objective To investigate the surgery strategy of patients with epileptogenic dysembryoplastic neuroepithelial tumors （DNTs）.Methods The retrospective analysis of surgical experiences of 14 patients with DNTs in our hospital was performed.The tumors and epileptic foci were evaluated preoperatively by MRI and VEEG as routine.Using EcoG monitoring during the operation,we performed the resection of tumors and epileptic foci together.Results The tumors were cut off completely in all the patients.The histological examination confirmed that all lesions were DNTs.Radiotherapy or chemotherapy was not performed after the operation.There was no recurrence of tumors.Engel Ⅰ outcome （seizure-free） was noted in 10 patients and Engel Ⅱ outcome（rare seizure） in 4.Conclusions The DNT is low grade neurons to glial cell tumor.It is common in teenagers and always compares with intractable epilepsy.Management of epileptic foci around the tumor showed favorable results in the controlling of epilepsy.

关 键 词：胚胎发育不良性神经上皮肿瘤 癫痫 手术 术中皮层脑电监测 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R739.4[医药卫生—临床医学]