岛叶胶质瘤与顽固性癫痫

目的探讨岛叶胶质瘤致顽固性癫痫的发病机制及外科治疗方法。方法回顾性分析笔者医院自2007年8月～2010年8月收治的以癫痫为首发症状的48例岛叶胶质瘤。结果48例患者均以癫痫起病，其中全身阵挛性发作16例，复杂部分性发作17例，单纯部分性发作15例。本组病例均采用翼点入路切除肿瘤，其中全切36例，近全切12例。术后病理证实，45例为低级别胶质瘤。所有患者随访6～42个月，复查CT或MRI显示，肿瘤无复发，临床观察患者癫痫控制满意。结论岛叶胶质瘤以低级别胶质瘤多见，癫痫是首发和主要表现。肿瘤全切不但可以减少复发，还能极好地控制癫痫发作，是首选的外科治疗方法。

Study on Intractable Seizure Induced by Insular Lobe Glioma.

Objective To discuss the possible pathogenesis and microsurgical treatments for intractable seizures induced by gliomas located in insular region. Methods Forty - eight patients who suffered from gliomas in insular region and accepted surgical operations in our hospital from August 2007 to August 2010 were analyzed retrospectively. Results The clinical manifestations included generalized tonoelonie seizure in 16 cases, complex partial seizure in 17 cases, partial seizure in 15 cases. The lateral cleft approach was adopted for the patients. Among them, 36 cases were removed totally and the others were removed subtotally. Most of the tumors were low - grade as- trocytomas and oligodendromas. All the patients had a postoperative follow - up ranging from 6 to 42 months, which indicated that the seizure had been under control and the tumors had not recurred. Conclusion Low - grade gliomas are the major pathological findings in the insula area. Seizures are usually primary manifestations of insula region gliomas. Microsurgical total excision is the first choice to treat insular region glioma and surgical treatment that includes complete resections of these tumors can not only reduce the recurrence of the tumors but also achieve excellent seizure control.