胚胎发育不良性神经上皮肿瘤的致痫灶处理

目的 探讨胚胎发育不良性神经上皮肿瘤(DNT)伴药物难治性癫痫患者的外科手术治疗方法.方法 回顾性分析了第三军医大学新桥医院神经外科采用外科手术治疗14例此类患者的经验.术前和术中均进行致痫灶定位,术中在切除肿瘤的同时一并处理肿瘤外致痫灶.结果 14例患者肿瘤均得到全切,未行放疗和化疗,无肿瘤复发及恶性转化.11例患者癫痫发作得到完全控制(Engel Ⅰ级),2例患者稀少发作(Engel Ⅱ级),1例患者术后仍有频繁癫痫发作,再次手术切除肿瘤周围致痫灶后癫痫得到完全控制.结论 DNT应当按照皮质发育障碍来处理,除切除肿瘤外,积极处理肿瘤外致痫灶可获得较佳的癫痫控制结果.

Management of epileptic foci in patients with dysembryoplastic neuroepithelial tumor

Objective To investigate the management of drug-resistant epilepsy in patients with dysembryoplastic neuroepithelial tumor (DNT). Methods Surgical experiences of 14 patients with DNT in our hospital were retrospectively reviewed. According to the EeoG during the operation and preoperative evaluation, the epileptic foci were managed when the tumor resection was performed. Results The tumors were cut off completely in all the patients; no radiotherapy or chemotherapy was performed after the operation; no recurrence or metastasis of the tumor was found. Engel Ⅰ outcome (seizure-free) was noted in 11 patients and Engel Ⅱ outcome (rare seizure) was noted in 2; frequent seizure was found in 1 after the first operation and seizure-free was achieved after the resection of epileptic foci around the tumor. Conclusion The DNT should be treated as having malformation in the cortical dysplasia and management of epileptic foci around the tumor shows favorable results in the controlling of epilepsy.