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脑肿瘤患儿的难治性癫痫。神经外科手术的紧迫性。

Refractory epilepsy in children with brain tumors. The urgency of neurosurgery.

作者信息

Bernardino Marília Rosa Abtibol, Funayama Carolina, Hamad Ana Paula Andrade, Machado Hélio, Sakamoto Américo, Thome Ursula, Terra Vera Cristina, Santos Antonio Carlos Dos

机构信息

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brasil.

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neuroradiologia, Seção de Ressonância Magnética, Ribeirão Preto SP, Brasil.

出版信息

Arq Neuropsiquiatr. 2016 Dec;74(12):1008-1013. doi: 10.1590/0004-282X20160157.

Abstract

In order to verify indications for surgery, 27 patients with refractory epileptic seizures and brain tumor, aged up to 19 years at the time of surgery, were studied between 1996 and 2013 and followed up for at least one year. The mean interval between the onset of seizures and the diagnosis of the tumor was 3.6 years, and from diagnosis to the surgery, 18 months. The location of the tumor was in the temporal lobe in 16, with ganglioglioma and dysembryoplastic neuroepithelial tumors being the most frequent. Among the patients, 92.5% and 90.4% were seizure-free in the first and fifth year after surgery, respectively. Twelve of 16 children were successful in becoming drug-free, with complete withdrawal by 3.2 years. Surgery proved to be potentially curative and safe in these cases, suggesting that the tumor diagnosis and surgery cannot be postponed.

摘要

为了验证手术指征,对1996年至2013年间研究的27例难治性癫痫发作且患有脑肿瘤的患者进行了研究,这些患者手术时年龄最大为19岁,并进行了至少一年的随访。癫痫发作开始至肿瘤诊断的平均间隔时间为3.6年,从诊断到手术为18个月。肿瘤位于颞叶的有16例,其中神经节细胞胶质瘤和胚胎发育不良性神经上皮肿瘤最为常见。在这些患者中,术后第一年和第五年分别有92.5%和90.4%的患者无癫痫发作。16名儿童中有12名成功停药,在3.2岁时完全停药。在这些病例中,手术证明具有潜在的治愈性和安全性,这表明肿瘤诊断和手术不能推迟。

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