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小儿大脑半球低级别胶质瘤的癫痫手术:神经外科的考量与结果

Epilepsy surgery for pediatric low-grade gliomas of the cerebral hemispheres: neurosurgical considerations and outcomes.

作者信息

Brown Matthew T, Boop Frederick A

机构信息

Department of Neurosurgery, University of Tennessee Health Science Center, 847 Monroe Ave., Suite 427, Memphis, TN, 38163, USA.

Semmes-Murphey Clinic, 6325 Humphreys Blvd, Memphis, TN, 38120, USA.

出版信息

Childs Nerv Syst. 2016 Oct;32(10):1923-30. doi: 10.1007/s00381-016-3162-7. Epub 2016 Sep 20.

Abstract

INTRODUCTION

Pediatric low-grade tumors are found in roughly 1-3 % of patients with childhood epilepsy; seizures associated with these tumors are often medically refractory and often present a significant morbidity, greater than the presence of the tumor itself.

DISCUSSION

The unique morbidity of the seizures often requires an epilepsy surgical approach over a standard oncologic resection to achieve a reduction in morbidity for the child. Multiple quality-of-life studies have shown that unless a patient is seizure-free, they remain disabled throughout their life; the best way to achieve this in our patient population is with a multidisciplinary team approach with treatment goals focusing primarily on the epilepsy.

CONCLUSION

In those patients treated with gross total resection, roughly 80 % will have an Engel class I outcome and 90 % will achieve some reduction in seizure frequency with a significant improvement in quality of life.

摘要

引言

小儿低度恶性肿瘤约占儿童癫痫患者的1% - 3%;与这些肿瘤相关的癫痫发作通常药物难治,且往往导致严重的发病率,比肿瘤本身造成的影响更大。

讨论

癫痫发作独特的发病率通常需要采用癫痫外科手术方法,而非标准的肿瘤切除手术,以降低患儿的发病率。多项生活质量研究表明,除非患者无癫痫发作,否则他们一生都会残疾;在我们的患者群体中实现这一目标的最佳方法是采用多学科团队方法,治疗目标主要集中在癫痫上。

结论

在那些接受了肿瘤全切术的患者中,约80%的患者将达到恩格尔一级结局,90%的患者癫痫发作频率会有所降低,生活质量显著改善。

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