皮层脑电图监测辅助显微手术治疗脑肿瘤继发癫痫预后评估

目的]评估皮层脑电图(ECoG)监测下显微手术切除肿瘤并处理致痫灶对伴癫痫症状脑肿瘤患者的预后.方法]65例伴有癫痫症状的脑肿瘤患者,术中通过ECoG确定癫痫灶,应用显微手术切除肿瘤组织后,再根据ECoG所确定的癫痫灶进行切除或热灼,术后观察患者癫痫发作情况并随访3～72个月.结果]65例患者切除肿瘤前均可通过ECoG描记到癫痫波,切除肿瘤后,癫痫波完全消失者59例.术后57例癫痫发作停止,8例发作程度减轻,3例胶质瘤复发失去随访.结论]针对脑肿瘤继发性癫痫患者,术中在ECoG监测下切除致痫灶或同时进行皮层热灼,是一种控制术后癫痫继续发作的有效治疗方法.

Evaluation of the Prognosis of Patients with Brain Tumor and Secondary Epilepsy UndergoingElectrocorticogram Monitoring Assisted Microsurgery

Objective] To evaluate the prognosis of brain tumor patients with epilepsy undergoing micro- surgery monitored by electrocorticogram（ECoG）. Methods] Epileptogenic loci in 65 cases of brain tumor with epilepsy were determined by ECoG. After the tumor tissue was excised by microsurgery, epileptogenic focus determined by ECoG was removed or treated with thermo-coagulation. Epileptic seizure was observed af- ter operation and followed up for 372 months. Results] Epileptiform waves in 65 patients were detected by ECoG before tumor resection. After tumor resection, epileptiform waves in 59 patients completely disap- peared. After operation, epileptic seizure of 57 patients ceased and seizure degree of 8 patients relieved. Three patients with glioma had recurrence and were not followed up. Conclusion] For brain tumor patients with sec ondary epilepsy, the removal and thermo-coagulation of epileptogenis foci monitored by ECoG is an effective method for controlling postoperative secondary epileptic seizure.