Seo Dae Won, Hong Seung Bong
Department of Neurology, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2003 Aug;18(4):559-65. doi: 10.3346/jkms.2003.18.4.559.
To investigate the epileptogenic foci in dysembryoplastic neuroepithelial tumor (DNT) in the temporal lobe, we studied extraoperative electrocorticography (ECoG) with subdural electrode arrays from nine patients with intractable epilepsy due to temporal DNT. Ictal onset zones and irritative zones were decided by the ECoG. The locations of these zones were compared to the location of the tumor. The number of ictal onset zone and irritative zone was 2.1+/-0.93 and 2.9+/-1.45 in a patient with a DNT. They were detected more frequently in the adjacent tissues of the tumor (88.9%) rather than within the tumor or in mesial temporal area (66.7%). Mesial temporal involvement was found in 6 patients (66.7%) as an ictal onset zone, and in 5 (55.6%) as an irritative zone. The 7 patients (77.8%) had ictal onset zone in areas different from active irritative zone. The surgical outcome was better, when ictal onset zone was completely resected rather than partially removed. Temporal DNT can make multiple ictal onset zones and irritative zones in different regions including the mesial temporal area. Deliberate resection of epileptogenic foci, including all ictal onset zones and irritative zones, ensures excellent seizure control.
为研究颞叶胚胎发育不良性神经上皮肿瘤（DNT）中的致痫灶，我们对9例因颞叶DNT导致难治性癫痫的患者，使用硬膜下电极阵列进行了术中皮质脑电图（ECoG）研究。通过ECoG确定发作起始区和激惹区。将这些区域的位置与肿瘤位置进行比较。DNT患者中发作起始区和激惹区的数量分别为2.1±0.93个和2.9±1.45个。它们在肿瘤相邻组织中被检测到的频率更高（88.9%），而非在肿瘤内或颞叶内侧区域（66.7%）。6例患者（66.7%）的颞叶内侧作为发作起始区受累，5例患者（55.6%）的颞叶内侧作为激惹区受累。7例患者（77.8%）的发作起始区位于与活跃激惹区不同的区域。当发作起始区被完全切除而非部分切除时，手术效果更好。颞叶DNT可在包括颞叶内侧区域在内的不同区域形成多个发作起始区和激惹区。彻底切除致痫灶，包括所有发作起始区和激惹区，可确保良好的癫痫控制。
