伴顽固性癫痫的脑肿瘤的病理分析

目的 分析伴顽固性癫痫患者的脑肿瘤病理特点,探讨最适合的手术方式.方法 在符合顽固性癫痫并进行手术治疗的病例中,回顾分析45例病理证实存在脑肿瘤的病例资料.结果 癫痫灶位于额叶8例,颞叶34例,顶枕叶3例;病理证实神经元和混合性神经元-胶质肿瘤35例(78%).WHO Ⅰ级36例,WHO Ⅰ～Ⅱ4例,WHO Ⅱ级5例.术后随访1年以上的42例,全部生存.癫痫发作控制结果 显示Engel Ⅰ级32例(76%),Ⅱ级5例,Ⅲ级4例,Ⅳ级1例.结论 与顽固性癫痫相关的脑肿瘤是一类特殊的病理组群,手术切除包括肿瘤在内的癫痫灶,效果满意.

Clinicopathological characteristics and surgical treatment of tumors associated with medically intractable epilepsy

Objective To analyze the spectrum of neoplasms associated with refractory epilepsy and to evaluate the optimum surgical treatment of these patients. Method The clinical, electrophysiological, operative,and histopathological data of 45 patients who underwent surgery for medically intractable epilepsy were retrospectively evaluated. Results The majority of tumors were located in the temporal lobe(n = 34) and frontal lobe (n = 8). The most frequent tumors were neuronal and mixed neuronal-glial tumors (76%), including gangliocytoma or ganglioglioma(n = 15), dysembryoplastic neuroepithelial tumour(n = 7). All the tumors were low histopathological grade (WHO Ⅰ or Ⅱ). In all patients, complete resection of tumor and epileptogenic area was intended. Complications were encountered in 5 patients. Of the 45 patients who had postoperative follow-up more than one year, 78% were seizure-free and no patient died. Conclusions The neoplasms associated with medically intractable epilepsy constitute a distinct clinicopathological group of tumors. Complete surgical removal of the tumors and the epileptogenic area can achieve excellent seizure control