边缘系统低级别胶质瘤与顽固性癫痫

目的 探讨边缘系统低级别胶质瘤致顽固性癫痫的临床特征、手术方法及疗效。方法 对自1993年3月一2000年12月本科因顽固性癫痫进行手术切除的11例边缘系统低级别胶质瘤作一回顾性分析。结果 11例患者中10例以癫痫起病，平均病程26个月，发作类型为复杂性部分性发作和继发性全身发作。11例患者均经扩大翼点入路行胶质瘤全切加上标准前额叶切除。术后病理为少枝突胶质瘤3例，星形细胞瘤Ⅰ级5例，星形细胞瘤Ⅰ—Ⅱ级3例。11例患者随访10个月一3年，复查CT或MRI检查，无肿瘤复发迹象，癫痫控制满意。结论 边缘系统低级别胶质瘤致顽固性癫痫，病程长，久治不愈，年龄偏轻，通过完全的肿瘤切除加上标准前额叶切除，可大大降低肿瘤的复发率，极好地控制癫痫。

Limbic and paralimbic low-grade gliomas associated with intractable seizures

Objective The low-grade gliomas which originate from limbic system are not uncommon. The purpose of the paper is to discuss that limbic gliomas associated with intractable seizure treated by surgery.Methods Eleven patients with low-grade gliomas in limbic system operated on in our hospital from Match 1993 to December 2000 were analyzed retrospectively.Results All of the tumors found in patients with intractable partial complex seizures involved anatomic structures of parts of the limbic system or closely associated with it. Their biological behavior was strikingly indolent, as suggested by a stable clinical history during many years of chronic seizures(mean,26 month). The total resection was performed in all of the patients in addition to a standard temporal lobectomy. Most were low-grade astrocytomas and oligodendromas. The patients had a postoperative follow-up ranging from 10 monthes to three years. The patients were seizure-free and tumor did not reoccour. Conclusion Surgical treatment that includes complete resections of these tumors and standard temporal lobectomy can achieve excellent seizure control.