颞叶肿瘤所致症状性癫痫的外科治疗  

Surgical treatment of symptomatic epilepsy due to temporal lobe tumors

作　　者：董长征[1] 刘倩薇[1] 康进生[1] 梁传栋[1] 张波[1] 马万东 武江[1] 张爱军 赵文清[1] Dong Chang-zheng;Liu Qianwei;Kang J insheng(NO.2 Department of Neurosurgery,Hebei General Hospital,Shijiazhang,050051,China.)

机构地区：[1]河北省人民医院神经外二科,石家庄050051

出　　处：《立体定向和功能性神经外科杂志》2018年第3期129-132,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨颞叶肿瘤所致症状性癫痫的临床特征及手术治疗效果。方法回顾性分析我科2013.1～2015.1手术治疗的颞叶癫痫病例,分析其中32例病理证实存在颞叶肿瘤的病例资料,观察颞叶肿瘤所致症状性癫痫的临床特征及手术疗效。结果术后病理包括神经节细胞瘤13例,胚胎发育不良性神经上皮瘤(DNET)10例,星形细胞瘤4例,间变性星形细胞瘤1例,多形性胶质母细胞瘤1例,少突胶质细胞瘤2例,血管中心性胶质瘤1例。术后随访2～4年,Engel's I级10例,Ⅱ级15例,Ⅲ级5例,Ⅳ级2例。结论手术在首选全切颞叶肿瘤病变的同时,还要积极处理前颞叶及内侧结构,才能获得术后更好的癫痫控制。Objective To investigate the clinical features and surgical treatment of symptomatic epilepsy due to temporal lobe tumors.Methods A retrospective analysis of surgical cases with temporal lobe epilepsy from January 2013 to January 2015 and 32 cases of temporal lobe tumor which confirmed by pathology was conducted;The clinical features and surgical treatment of symptomatic epilepsy due to temporal lobe tumors were analyzed.Results Postoperative pathology included 13 cases of gangliocytoma,dysembryoplastic neuroepithelial tumor（DNET）of10 cases,astrocytoma of 4 cases,anaplastic astrocytoma of 1 cases,pleomorphic glioblastoma of 1 cases,oligodendroglima of 2 cases,and angiocentric glioma of 1 cases.Postoperative follow-up was 2-4 years;the overcomes include that 10 cases in Engel＇s I grade,15 cases in Engel＇s Ⅱgrade,5 cases in Engel＇sⅢ grade,and 2 cases in Engel＇sⅣ Grade.Conclusion Better epilepsy control can be obtained by total resection of temporal lobe tumors and epileptogenic zone including the anterior temporal lobe and medial structure.

关 键 词：症状性癫痫 颞叶 肿瘤 手术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]