成人癫癇患者术后病理特征分析  

Postoperative pathological characteristics of epilepsy patients in adult

作　　者：初霞[1] 赵伟[1] 白刚刚 郭效东[2] 赵坡[3] CHU Xia;ZHAO Wei;BAI Gang-gang;GUO Xiao-dong;ZHAO Po(Department of Pathology,the 988th Hospital of the Joint Logistics Support Force,PLA,Zhengzhou 450042,China;Department of Neurosurgery,the 988th Hospital of the Joint Logistics Support Force,PLA,Zhengzhou 450042,China;Department of Pathology,the First Medical Center,Chinese PLA General Hospital,Beijing100853,China)

机构地区：[1]中国人民解放军联勤保障部队第988医院病理科,郑州450042 [2]中国人民解放军联勤保障部队第988医院神经外科,郑州450042 [3]解放军总医院第一医学中心病理科,北京100853

出　　处：《诊断病理学杂志》2021年第7期523-526,531,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨与成人癫癇相关的临床病理特征和原因。方法对88例以癫癇为主要临床诊断,手术年龄>18岁的患者术后标本进行病理检查,比较不同病理类型患者的癫癇发作病史、影像特征和术后效果。结果成人癫癇患者术后病理最常见的是局灶皮层发育不良(FCD)(73.8%,65/88),其次是脑肿瘤(26.2%,23/88)。FCD以IIa型最多见(15.9%),男女性别比2.4∶1,平均年龄35.9岁,平均癫癇病史11.5年,易累及海马,临床症状以复杂部分性发作为主,影像学阳性率89.2%(58/65)。脑肿瘤主要是星形细胞瘤和脑膜瘤(各占9.1%),男女性别比1.6∶1,平均年龄45.7岁,癫癇病史1个月至1年,不累及海马,临床主要表现为突发的意识丧失伴四肢抽搐,影像学均有脑部占位。术后Engel分级,FCD各亚型间无统计学差异,低级别脑肿瘤术后效果优于高级别脑肿瘤。结论与成人癫癇相关的主要病理特征是FCD和脑肿瘤,二者在癫癇病史和术后癫癇控制程度上都不同。Objective To explore the clinicopathological features and causes of epilepsy in adult.Methods Epilepsy was the main clinical diagnosis and the age of operation was more than 18 years.There were 88 cases.The history,imaging features and postoperative outcomes of epileptic seizures in patients with different pathology were compared.Results Focal cortical dysplasia(FCD)was the most common type in postoperative pathology for adult patients with epilepsy(73.8%,65/88).Brain tumor was the next(26.2%,23/88).Type IIa was more than other types in FCD(15.9%).The male-female sex ratio was 2.4∶1.The average age was 35.9 years.Epilepsy duration time was 11.5 years on average.The hippocampus was susceptible.The seizure forms were complex partial onset.The positive rate of image was 89.2%(58/65).The most frequent brain tumors were astrocytoma and meningioma(9.1%each).The sex ratio was 1.6∶1 and the average age was 45.7 years.The history of epilepsy was from 1 month to 1 year.The hippocampus was not involved.Sudden loss of consciousness accompanied by limb convulsions were the main clinical symptoms.Imaging showed that there was cerebral space occupation.In the control degree of postoperative epilepsy there was no statistical difference among FCD types,but low grade brain tumors were superior to high grade brain tumors.Conclusion FCD and brain tumor are the main pathological characters related to epilepsy in adult.The history of epileptic seizure and the degree of postoperative epileptic control are different between them.

关 键 词：癫癇 病理 局灶性皮层发育不良 脑肿瘤 

分 类 号：R742.1[医药卫生—神经病学与精神病学]