LSUHSC - Cancer Center, Neurosurgery Department and Neuroscience Center of Excellence, 2020 Gravier St., New Orleans, LA 70112, USA.
Med Hypotheses. 2012 Nov;79(5):622-6. doi: 10.1016/j.mehy.2012.07.037. Epub 2012 Sep 5.
Glial neoplasms account for nearly 50% of all adult primary brain tumors. They originate from glial cells in the brain and/or spinal cord and include low-grade diffuse astrocytomas, anaplastic-astrocytomas, and glioblastomas. Of all brain tumors, glioblastoma multiforme (GBM) is the most aggressive and is characterized by rapid glial cell growth, resistance to radio- and chemo- therapies, and relentless infiltration and spreading throughout the central nervous system (CNS). In glioblastomas, primary tumor growth and CNS invasion are associated with the activation of complex structural molecular and metabolic changes within the tumor tissue, which profoundly affect the surrounding neuronal networks and may in part explain induction of epilepsy. In fact, epileptic seizures are very common among patients with glial tumors, reaching nearly 50% in glioblastoma patients and almost 90% in low-grade astrocytomas. The overall hypothesis presented here discusses the possibility that the aberrant tumor cell metabolism may act directly on neuronal network, and this leads to seizure susceptibility. Further invasion and growth of the malignant glial cells exacerbate this initial pathologic state which promotes recurrent seizures (epileptogenesis).
神经胶质瘤约占所有成人原发性脑肿瘤的 50%。它们起源于大脑和/或脊髓的神经胶质细胞，包括低级别弥漫性星形细胞瘤、间变性星形细胞瘤和胶质母细胞瘤。在所有脑肿瘤中，胶质母细胞瘤（GBM）最为侵袭性，其特征是神经胶质细胞的快速生长、对放疗和化疗的耐药性，以及在中枢神经系统（CNS）内的无情浸润和扩散。在胶质母细胞瘤中，原发肿瘤的生长和 CNS 侵袭与肿瘤组织内复杂的结构分子和代谢变化的激活有关，这些变化深刻影响周围的神经网络，并可能部分解释癫痫的发生。事实上，癫痫发作在胶质肿瘤患者中非常常见，在胶质母细胞瘤患者中达到近 50%，在低级别星形细胞瘤患者中几乎达到 90%。这里提出的总体假设讨论了肿瘤细胞代谢异常可能直接作用于神经网络的可能性，这导致了癫痫易感性。恶性神经胶质细胞的进一步侵袭和生长加剧了这种初始病理状态，从而促进了反复发作的癫痫（癫痫发生）。
