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1、臨床神經(jīng)外科雜志2013年第1O卷第6期329dot:10.3969/j.issn.1672-7770.2013.06.004癲癇專題導(dǎo)致難治性癲癇的顳'file瘤特點分析遇濤,張國君,李勇杰,蔡立新,閏曉明,樸月善,杜薇,樸媛媛【摘要】目的分析導(dǎo)致難治性癲癇的顳葉腫瘤的臨床特征、病理類型及手術(shù)療效。方法回顧手術(shù)治療的難治性顳葉癲癇病例,分析其中73例病理證實存在顳葉腫瘤的病例的臨床病理特點及手術(shù)療效。結(jié)果術(shù)前MRI顯示有占位效應(yīng)的病例23例;占位效應(yīng)不明顯,僅出現(xiàn)局部信號異常的病例50例。病理檢查顯示最主要的腫瘤類型為混合性膠質(zhì)一神經(jīng)元腫瘤59例,其中WHOI級63例;行
2、前顳葉切除術(shù)的70例,局部病灶切除術(shù)的3例。術(shù)后1例死亡,余術(shù)后隨訪2~10年,因非腫瘤相關(guān)性原因死亡1例,Engel’SI級55例,Ⅱ級9例,Ⅲ級5例,Ⅳ級2例。結(jié)論與難治性顳葉癲癇相關(guān)的腦腫瘤是一類特殊的病理組群,表現(xiàn)相對良性的生物學(xué)特性,手術(shù)切除包括腫瘤在內(nèi)的癲癇灶效果滿意?!娟P(guān)鍵詞】藥物難治性癲癇;顳葉癲癇;腫瘤;手術(shù)【中圖分類號】R734.1【文獻(xiàn)標(biāo)識碼】A【文章編號】1672—7770(2013)06-0329-03Clinicopathologicalcharacteroftumorsassociatedwithrefractorytemporallobeep
3、ilepsyYUTao,ZHANGGuoqun,LIYong-jie,eta1.DepartmentofFunctionalNeurosurgery,XuanwuHospital,CapitalMedicalUniversity,Beqing100053,ChinaAbstract:ObjectiveToanalyzethespectrumofneoplasmsassociatedwithrefractorytemporallobeepilepsy(TLE)andtoevaluatetheoptimumsurgicaltreatmentforthesepatients.Me
4、thodsTheclinical,electrophysiological,operativeandhistopathologicaldataof73patientswhounderwentsurgeryformedicallyintractableepilepsywereanalyzedretrospectively.ResultsAllthetumorswerelocatedinthetemporallobe.MRIshowedmasseffectofthetumorin23patientsandfocalonlyabnormalsignalwithoutmasseff
5、ectin50.Themostfrequenttumorswereneuronalandmixedneuronal—glialtumoursin59patients,includinggangliocytomaorganglioglioma(n=31),dysembryoplasticneuroepithelialtumour(n=8).AUthetumorswerelowhistopathologicalgrade(WHO1orI1).Inallpatients,completeresectionoftumorsandepileptogenicareawereintend
6、ed.Complicationswereencounteredin4patientsincludingonedeathafteroperation.Anotherpatientdeadforotherreason.Alltherest71patientshadpostoperativefollow—upmorethanoneyear,Engel’SIin55(77.5%),Ⅱin9,111in5,Ⅳin2.ConclusionsTheneoplasmsassociatedwithmedicallyintractableTLEconstituteadistinctclinic
7、0pathologicalgroupoftumors.Completesurgicalremovalofthetumorsandtheepileptogenicareacanachieveexcellentseizurecontro1.Keywords:medicallyintractableepilepsy;temporallobeepilepsy;tumor;surgery顳葉腫瘤是引起顳葉癲癇的原因之一。其中有4月至2010年12月,在北京功能神經(jīng)外科研究所一些腫瘤并無顱內(nèi)占位征象,臨床僅表現(xiàn)為反復(fù)的接受癲癇