颅内肿瘤继发癫痫的手术治疗

目的：研究颅内肿瘤继发癫痫患者手术治疗的方法及效果。方法：收集自1985—2002年我院经手术治疗的376例颅内肿瘤继发癫痫病人资料并进行分析，总结手术治疗颅内肿瘤继发癫痫的方法及效果。结果：近期癫痫症状消除或服药可完全控制发作者337例，占89．63％；服药可减少发作50％者20例，占5．32％；服药可减少发作10％以上者3例，占0．79％；无改善者2例，占0．53％；手术死亡者14例，占3．72％。术后半年至16年随访到155名患者，其中发作停止不需服抗癫痫药物者108例，占69．68％；服抗癫痫药物可以完全控制发作者12例，占7．74％；服药可以减少发作50％以上者4例，占2．58％；服药可以减少发作10％以上者9例，占5.8％；无改善者1例，占0．65％；死亡者21名，占13．55％。结论：颅内肿瘤继发癫痫的手术治疗宜采用微侵袭的手术方法，只要颅内肿瘤切除彻底，绝大多数病人可以取得显著疗效。手术是治疗颅内肿瘤继发癫痫首选和最有效的方法。

SURGICAL MANAGEMENT OF SECONDARY EPILEPSY CAUSED BY INTRACRANIAL TUMOR

Objective:To study the methods and effectiveness of surgical management of secondary epilepsy caused by intracranial tumor. Methods:All 376 cases with secondary epilepsy caused by intracranial tumor hospitalized from 1985 to 2002 who underwent surgical management were analyzed.Results:Soon after surgical management, in 337 cases, accounting for 89 63%,epilepsy disappeared or were totally controlled reduced more than 10% with 3 cases, in 0 79%.No changes than before were 2 cases, in 0 53%.Death after surgical management was 14 cases,in 3 72%,Postoperative half to 16 years,we followed up 155 cases.Among them 108 cases,cured without drugs,in 69 68%.Total controlled with drugs were 12 cases,in 7 74%.Epilepsy reduced more than 50% with drugs was 4 cases,in 2 58%.Epilepsy reduced more than 10% with drugs was 9 cases,in 5 8%.No change was 1 case,in 0 65%.Death was 21 cases,in 13 55%.Conclusion:Secondary epilepsy caused by intracranial tumor treated by surgical management should use modern surgical methods,and with the total removal of lesion caused epilepsy,most of the patients with secondary epilepsy can get remarkable effective result.Surgical management is the most effective method and should be the first choice .