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一名患有癫痫的儿童的胚胎发育不良性神经上皮肿瘤和颞部蛛网膜囊肿。该切除哪一个?病例报告及文献综述。

Dysembryoplastic neuroepithelial tumor and temporal arachnoid cyst on a child with epilepsy. Which one to operate? Case report and literature review.

作者信息

Martínez-Luna Ariam A, Aguado-Carrillo Gustavo, Velasco-Campos Francisco, Velasco-Monroy Ana L, Gómez-Apo Erick

机构信息

Department of Functional and Stereotactic Neurosurgery, Hospital General de México, Mexico City, Mexico.

Department of Neuropathology, Hospital General de México. Mexico City, Mexico.

出版信息

Cir Cir. 2020;88(Suppl 1):9-13. doi: 10.24875/CIRU.20001234.

Abstract

A 6 year-old male, with seizures characterized by abnormal epigastric sensation, behavioral arrest, upper extremities search automatisms and secondary tonic-clonic generalization. Magnetic resonance imaging showed a hypointense cystic extra-axial image with an increase in the thickness of the convolutions in the first and second gyri of the right frontal lobe. It was decided to resect the frontal lesion with transoperative motor mapping. Morphological and immunohistochemical findings corresponded to dysembryoplastic neuroepithelial tumor with focal cortical dysplasia. Adequate semiology, analysis of the electroencephalogram, and imaging studies allowed treating adequately the cortical dysplasia. At present, the patient is seizure-free without medication (Engel IA).

摘要

一名6岁男性,癫痫发作表现为上腹部异常感觉、行为停止、上肢摸索自动症及继发性强直阵挛发作。磁共振成像显示右侧额叶第一和第二脑回处有一个轴外低信号囊性影像,脑回厚度增加。决定通过术中运动功能定位切除额叶病变。形态学和免疫组化结果符合伴有局灶性皮质发育异常的胚胎发育不良性神经上皮肿瘤。充分的癫痫发作症状学、脑电图分析及影像学检查使得能够对皮质发育异常进行充分治疗。目前,患者无需药物治疗且无癫痫发作(恩格尔一级A)。

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