Ruban Dmitry, Byrne Richard W, Kanner Andres, Smith Michael, Cochran Elizabeth J, Roh David, Whisler Walter W
Department of Neurosurgery, University Medical Center, Chicago, Illinois, USA.
Neurosurg Focus. 2009 Aug;27(2):E6. doi: 10.3171/2009.5.FOCUS0998.
The authors undertook a study to review the clinical features and outcome in patients who underwent surgery for intractable chronic epilepsy caused by temporal lobe tumors.
The Rush Surgical Epilepsy Database was queried to identify patients with chronic intractable epilepsy who underwent resection of temporal lobe tumors between 1981 and 2005 at Rush University Medical Center. Medical records were reviewed for age of the patient at seizure onset, delay to referral for surgery, seizure frequency and characteristics, preoperative MR imaging results, extent of resection, pathological diagnosis, complications, duration of follow-up period, and seizure improvement.
Thirty-eight patients were identified, all with low-grade tumors. Gangliogliomas were the most common (36.8%), followed in descending order by dysembryoplastic neuroepithelial tumors (26.3%) and low-grade diffuse astrocytoma (10.5%). The mean duration between seizure onset and surgery was 15.4 years. Complex partial seizures were the most common presenting symptom. Detailed operative data were available for 28 patients; of these, 89.3% underwent complete resection of the amygdala, and 82.1% underwent partial or complete resection of hippocampus, in addition to lesionectomy. The mean follow-up duration was 7.7 years (range 1.0-23.1 years), with 78.9% of patients having seizure status that improved to Engel Class I, 15.8% to Engel Class II, and 5.3% to Engel Class III. Permanent complications were noted in 2.6% of patients.
The authors' examination of the long-term follow-up data in patients with temporal lobe tumors causing chronic intractable epilepsy demonstrated excellent results in seizure improvement after surgery.
作者开展一项研究，以回顾因颞叶肿瘤导致的顽固性慢性癫痫患者接受手术治疗后的临床特征及预后。
查询拉什外科癫痫数据库，以确定1981年至2005年间在拉什大学医学中心接受颞叶肿瘤切除术的慢性顽固性癫痫患者。回顾病历，记录患者癫痫发作起始年龄、手术转诊延迟时间、癫痫发作频率及特征、术前磁共振成像结果、切除范围、病理诊断、并发症、随访时间及癫痫改善情况。
共确定38例患者，均为低级别肿瘤。神经节细胞胶质瘤最为常见（36.8%），其次依次为胚胎发育不良性神经上皮肿瘤（26.3%）和低级别弥漫性星形细胞瘤（10.5%）。癫痫发作起始至手术的平均时间为15.4年。复杂部分性发作是最常见的首发症状。28例患者有详细的手术数据；其中，89.3%的患者杏仁核完全切除，82.1%的患者除病变切除外还接受了海马部分或完全切除。平均随访时间为7.7年（范围1.0 - 23.1年），78.9%的患者癫痫状态改善至恩格尔I级，15.8%改善至恩格尔II级，5.3%改善至恩格尔III级。2.6%的患者出现永久性并发症。
作者对因颞叶肿瘤导致慢性顽固性癫痫患者的长期随访数据检查表明，术后癫痫改善效果良好。
