Cowie Christopher J A, Cunningham Mark O
Department of Neurosurgery, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK; Institute of Neuroscience, The Medical School, Framlington Place, Newcastle University, Newcastle upon Tyne, UK.
Institute of Neuroscience, The Medical School, Framlington Place, Newcastle University, Newcastle upon Tyne, UK.
Epilepsy Behav. 2014 Sep;38:53-61. doi: 10.1016/j.yebeh.2014.05.009. Epub 2014 Jun 2.
Seizures are a prominent symptom in patients with both primary and secondary brain tumors. Medical management of seizure control in this patient group is problematic as the mechanisms linking tumorigenesis and epileptogenesis are poorly understood. It is possible that several mechanisms contribute to tumor-associated epileptic zone formation. In this review, we discuss key candidates that may be implicated in peritumoral epileptogenesis and, in so doing, hope to highlight areas for future research. Furthermore, we summarize the current role of antiepileptic medications in this type of epilepsy and examine the changes in surgical practice which may lead to improved seizure rates after tumor surgery. Lastly, we speculate on possible future preoperative and intraoperative considerations for improving seizure control after tumor resection.
癫痫发作是原发性和继发性脑肿瘤患者的一个突出症状。由于肿瘤发生与癫痫发生之间的联系机制尚不清楚,因此对该患者群体进行癫痫控制的药物治疗存在问题。可能有几种机制导致肿瘤相关癫痫区域的形成。在这篇综述中,我们讨论了可能与肿瘤周围癫痫发生有关的关键因素,并希望借此突出未来的研究领域。此外,我们总结了抗癫痫药物在这类癫痫中的当前作用,并探讨了手术方式的改变,这可能会提高肿瘤切除术后的癫痫发作控制率。最后,我们推测了未来在术前和术中可能采取的措施,以改善肿瘤切除术后的癫痫控制。