颞叶低度发育性肿瘤的癫痫特征及手术疗效分析  

Analysis of electro-clinical characteristics and surgical outcome of low-grade developmental tumors in temporal lobe

作　　者：丰倩[1] 张冰清[1] 王海祥[1] 柏建军[1] 林久銮[1] 孙朝晖[1] 史洁[1] 周文静[1] FENG Qian;ZHANG bingqing;WANG Haixiang;BAI Jianjun;LIN Jiuluan;SUN Zhaohui;SHI Jie;ZHOU Wenjing(Epilepsy center,Yuquan Hospital,Tsinghua University,Beijing 100049,China)

机构地区：[1]清华大学玉泉医院(清华大学中西医结合医院)癫痫中心,北京100049

出　　处：《癫痫杂志》2025年第1期30-34,共5页Journal of Epilepsy

基　　金：科技部“常见多发病防治研究”重点专项(2022YFC2503803)。

摘　　要：目的分析颞叶低度发育性肿瘤的癫痫发作特征、脑电图特征及手术疗效。方法回顾性分析2008年10月—2023年3月49例在清华大学玉泉医院诊断为颞叶低度发育性肿瘤患者的临床资料,包括癫痫起病年龄、癫痫发作病程,癫痫发作类型、脑电图特征及手术随访。结果根据癫痫发作类型分为两组:第一组为痉挛发作、第二组为局灶性发作。痉挛发作组共12例,平均起病年龄为(1.00±0.59)岁[范围(0.50~2.20)岁],该组患者发作间期脑电图为广泛性及多脑区性放电,以病变侧颞区及同侧后头部显著。局灶性发作组共37例,平均起病年龄为(8.90±8.84)岁[范围(0.20~27.0)岁],其中以自主神经性发作、强直发作、自动症发作为主要发作表现;该组患者发作间期脑电图以病变侧颞区放电著,可波及额区,后头部放电较少。两组起病年龄差异有统计学意义(P<0.01)。痉挛发作组平均随访(2.80±1.57)年,术后EngelⅠ级100.00%(12/12);局灶性发作组平均随访(6.50±4.78)年,术后EngelⅠ级91.80%(34/37);两组术后无发作率差异无统计学意义(P>0.05)。结论对于颞叶低度发育性肿瘤患者,癫痫发作类型主要包括痉挛发作和局灶性发作,痉挛发作组起病年龄较早,而局灶性发作的患者多在儿童期或更大年龄起病,婴幼儿期少见。外科手术治疗颞叶发育性肿瘤癫痫发作具有疗效良好。Objective To analyze the electro-clinical characteristics and surgical outcome of low-grade developmental tumors in temporal lobe.Methods The onset age,seizure duration,seizure types,electroencephalogram and surgical outcome of 49 patients with low-grade developmental tumor of temporal lobe were analyzed retrospectively.Results Two groups of the seizure types were divided.The first group was spasm,the other was focal onset.There were 12 cases in spasm group,with an average onset age of(1.00±0.59)years.The discharge was extensive and multi-brain-area locaded,especially in the temporal montages and the ipsilateral posterior montages.There were 37 cases in second group,with an average onset age of(8.90±8.84)years,mainly including autonomic seizure,tonic seizure and automotor seizure.In this group,the discharge was mainly recorded in the temporal montages,which could spread to the frontal montages and less locaded in posterior montages.The difference of onset age between the two groups was statistically significant(P<0.01).The average follow-up of spasm group was(2.80±1.57)years,and the surgical outcome of all patients in this group were all EngelⅠ(100.00%,12/12).The focal onset group was followed up for an average of(6.50±4.78)years,and the rate of EngelⅠwas 91.80%(34/37).There was no significant difference between the two groups(P>0.05).Conclusions For low-grade developmental tumors in temporal lobe,there are two seizure types,including spasm and focal onset.The onset age of spasm is earlier,while patients with focal onset mostly start at childhood or older,rare in infancy.Surgery has a good effect on the treatment of temporal lobe developmental tumor epilepsy.

关 键 词：低度发育性肿瘤 颞叶癫痫 神经节细胞胶质瘤 胚胎发育不良性神经上皮肿瘤 

分 类 号：R739.41[医药卫生—肿瘤]