[儿童脑肿瘤合并癫痫的治疗]

[Treatment of epilepsy in children with brain tumors].

作者信息

Kholin A A, Khalilov V S, Vasiliev I G, Il'ina E S, Zavadenko N N

机构信息

Pirogov Russian National Research Medical University, Moscow, Russia; Russian Children Clinical Hospital, Moscow, Russia.

Pirogov Russian National Research Medical University, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2016;116(9. Vyp. 2):37-43. doi: 10.17116/jnevro20161169237-43.

DOI:10.17116/jnevro20161169237-43

PMID:28005045

Abstract

AIM

Symptomatic focal epilepsy is frequently caused by supratentorial brain tumors that may be surgically removed. The authors studied outcomes of surgical treatment depending on the use of electrocorticography c (ECoG).

MATERIAL AND METHODS

Seventy-five children, aged 5-7 years, with supratentorial brain tumors were examined. Symptomatic epilepsy was found in 52 (69.3%) patients. Dysembryoplastic neuroepithelial tumors (DNET) and fibrillary astrocytomas were the most epileptogenic tumors.

RESULTS AND CONCLUSION

The outcomes on the Engel scale were as follows: in 27 patients with surgical intervention without ECoG: class I - 9 patients, class II - 7 patients, class III - 5 patients, class IV - 6 patients and in 25 patients operated with ECoG: class I - 19 patients, class II - 4 patients and class III - 2 patients. The significant difference (p<0.01) between I+II Engel classes in comparison with III+IV Engel classes in operated patients demonstrated the necessity of ECoG during surgery in the resection of supratentorial brain tumors in patients with symptomatic epilepsy.

摘要

目的

症状性局灶性癫痫常由幕上脑肿瘤引起，这些肿瘤可能可通过手术切除。作者研究了根据皮层脑电图（ECoG）的使用情况进行手术治疗的结果。

材料与方法

对75名5至7岁患有幕上脑肿瘤的儿童进行了检查。52名（69.3%）患者发现有症状性癫痫。胚胎发育不良性神经上皮肿瘤（DNET）和纤维性星形细胞瘤是最易引发癫痫的肿瘤。

结果与结论

恩格尔量表的结果如下：在27例未使用ECoG进行手术干预的患者中：I级 - 9例患者，II级 - 7例患者，III级 - 5例患者，IV级 - 6例患者；在25例使用ECoG进行手术的患者中：I级 - 19例患者，II级 - 4例患者，III级 - 2例患者。手术患者中I + II级恩格尔分类与III + IV级恩格尔分类之间的显著差异（p<0.01）表明，对于有症状性癫痫的患者，在切除幕上脑肿瘤的手术过程中使用ECoG是必要的。