Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India.
Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India.
Clin Neurol Neurosurg. 2020 Oct;197:106104. doi: 10.1016/j.clineuro.2020.106104. Epub 2020 Jul 23.
Tumors with seizures as primary mode of presentation are collectively called Long-term epilepsy associated tumors (LEATs or Epileptomas). The overall survival is good so 'seizure outcome' becomes the primary goal rather than neuro-oncological outcome.
A retrospective analysis of our surgical database (2015-19) was done to find operated patients of intra-axial brain tumors with age less than 25-years and who had presented with seizures.
The mean age at presentation was 16.44 years (SD + 6.82 years). Complex partial seizures/focal unaware seizures were the most common type of seizures encountered (n = 22) with mean duration of seizures was 49.50 months (SD + 31.04 months). The most common pathology was glioneuronal tumors (GNTs) (n = 17). Gross total resection (GTR) group had a significantly better seizure outcome as compared with the Subtotal resection (STR) group (p = 0.006). Presence of focal or partial seizure was a significant factor pointing towards a better seizure control (p = 0.005).
The shorter duration of symptoms, partial/focal seizures and gross total excision were predictors of a good seizure-outcome. Age of the patient and the histopathology of the tumor does not affect seizure-outcome on comparing GNTs with non GNTs.
以癫痫发作为首发表现的肿瘤统称为长期癫痫相关肿瘤（LEAT 或癫痫瘤）。总体生存率良好，因此“癫痫发作结局”成为主要目标，而不是神经肿瘤学结局。
对我们的手术数据库（2015-19 年）进行回顾性分析，以找到年龄小于 25 岁且以癫痫发作为首发症状的颅内轴内肿瘤手术患者。
首发时的平均年龄为 16.44 岁（标准差+6.82 岁）。最常见的癫痫发作类型是复杂部分性发作/局灶性无意识发作（n=22），平均发作持续时间为 49.50 个月（标准差+31.04 个月）。最常见的病理类型是神经胶质神经元肿瘤（GNTs）（n=17）。与次全切除（STR）组相比，完全切除（GTR）组的癫痫发作结局明显更好（p=0.006）。局灶性或部分性癫痫发作的存在是癫痫控制更好的显著因素（p=0.005）。
症状持续时间较短、部分/局灶性癫痫发作和完全切除是癫痫发作结局良好的预测因素。与非 GNTs 相比，患者年龄和肿瘤组织病理学并不影响癫痫发作结局。
