低级别胶质瘤占位效应与术后癫痫缓解率的相关性研究  

Relationship between the occuping effect of low-grade glioma and the control of postsurgical of epilepsy

作　　者：王引言[1] 毛庆[2] 王江飞[3] 吴陈兴[4] 李守巍[4] 李少武[1] 江涛[1,3] 

机构地区：[1]首都医科大学北京市神经外科研究所,100050 [2] 四川大学华西医院神经外科 [3] 首都医科大学附属北京天坛医院神经外科 [4]北京三博脑科医院、首都医科大学第十一临床医学院

出　　处：《中华神经外科杂志》2014年第10期1031-1034,共4页Chinese Journal of Neurosurgery

基　　金：基金项目：国家高技术研究发展计划（No.2012AA02A508）;国家973重点基础研究发展计划资助（2011CB707804）

摘　　要：目的 研究低级别胶质瘤累及部位与手术切除后癫痫控制效果的相关性。方法 回顾性分析351例低级别胶质瘤患者术前癫痫病史、肿瘤部位和术后6个月内癫痫发作情况。分析累及不同脑叶的低级别胶质瘤术前癫痫发病率以及手术全切除后患者术后癫痫的控制率。结果 本研究纳入患者总的术前癫痫发生率为66.4％.累及运动区的低级别胶质瘤最易引起癫痫（87.9％）.肿瘤全切除术使71.8％累及运动区低级别胶质瘤患者的癫痫症状得到有效控制.结论 通过比较手术前后患者癫痫情况,得出手术全切除可以明显缓解低级别胶质瘤占位引起的癫痫症状,并且对于累及运动区的低级别胶质瘤患者癫痫缓解效果明显。Objective The mechanism of tumor-related epilepsy was still far from clear.The objective of this study was to investigate the relationship between the tumor location and postoperative control of epilepsy in patients with pathologically diagnosed WHO grade Ⅱ low-grade gliomas.Methods We retrospectively collected 351 patients who were pathologically diagnosed as low-grade gliomas and underwent primary surgical treatment.The preoperative incidences of tumor-related epilepsy and postoperative incidences of tumor-related epilepsy at six months of follow-up were analyzed and were compared between patients harboring tumors in various brain regions.The rate of seizure control was calculated in patients underwent gross-total tumor resection.Results 66.4% of patients included in this study had a history of preoperative seizures.The low-grade gliomas located in the motor areas,including primary motor area,supplementary motor area and premotor area,caused relatively higher incidence of epilepsy （87.9%） compared with tumors located in other brain regions.Following surgical resection,up to 71.8% of patients with tumors that located in the motor areas achieved a satisfied control of tumor-related epilepsy at sixth month after the tumor resection.This percentage was higher than that in cases with low-grade gliomas locating at other brain regions.Conclusion The gross-total resection was an effective treatment in reducing the incidence of epilepsy induced by low-grade gliomas.Patients with tumors that located in the motor areas acquired the greatest benefit of seizure control from the surgical resection.

关 键 词：神经胶质瘤 低级别 癫痫 显微外科手术 

分 类 号：R739.41[医药卫生—肿瘤]