Lynam Laura M, Lyons Mark K, Drazkowski Joseph F, Sirven Joseph I, Noe Katherine H, Zimmerman Richard S, Wilkens James A
Department of Neurology, Mayo Clinic Arizona, Phoenix, AZ, United States.
Clin Neurol Neurosurg. 2007 Sep;109(7):634-8. doi: 10.1016/j.clineuro.2007.05.017. Epub 2007 Jun 29.
Brain tumors may lead to symptomatic epilepsy. A retrospective analysis was undertaken to evaluate the frequency of seizure as the presenting symptom leading to brain tumor diagnosis in adults. One hundred and forty-seven consecutive patients with newly diagnosed brain tumors were analyzed regarding the frequency of seizures as the initial presenting symptoms and those subsequently developing seizures. One hundred twelve patients had primary central nervous system tumors (CNS) and 35 had metastatic lesions. Statistical evaluation was carried out using the Chi-square test with p values of <0.05 considered to be statistically significant. Astrocytomas and meningiomas were the most common primary CNS tumors in this study. Of these, oligodendrogliomas and grade 2 astrocytomas were significantly more likely to present with seizures (p<0.001). Seizures were a frequent presenting symptom, occurring in over 38% of those with primary brain neoplasms and 20% of those with cerebral metastases. Primary location of tumor also correlated amongst primary CNS tumors and was associated with a trend in seizure risk: parietal (80%); temporal (74%); frontal (62%); and occipital (0%) (p<0.5). The findings highlight the importance of obtaining appropriate evaluation for underlying malignancy in adults with new-onset seizures as well as provide more information to the patient for prognosis and counseling.
脑肿瘤可能导致症状性癫痫。进行了一项回顾性分析,以评估在成人中作为导致脑肿瘤诊断的首发症状的癫痫发作频率。对147例新诊断的脑肿瘤患者进行了分析,内容包括癫痫发作作为初始首发症状的频率以及随后发生癫痫发作的情况。112例患者患有原发性中枢神经系统(CNS)肿瘤,35例患有转移性病变。采用卡方检验进行统计学评估,p值<0.05被认为具有统计学意义。星形细胞瘤和脑膜瘤是本研究中最常见的原发性CNS肿瘤。其中,少突胶质细胞瘤和2级星形细胞瘤更有可能出现癫痫发作(p<0.001)。癫痫发作是一种常见的首发症状,在原发性脑肿瘤患者中超过38%出现,在脑转移患者中20%出现。肿瘤的原发部位在原发性CNS肿瘤中也存在相关性,并且与癫痫发作风险趋势相关:顶叶(80%);颞叶(74%);额叶(62%);枕叶(0%)(p<0.5)。这些发现强调了对新发癫痫发作的成人进行潜在恶性肿瘤适当评估的重要性,同时也为患者提供了更多关于预后和咨询的信息。