慢性难治性癫痫作为原发性脑肿瘤的唯一症状。

Chronic intractable epilepsy as the only symptom of primary brain tumor.

作者信息

Morris H H, Estes M L, Gilmore R, Van Ness P C, Barnett G H, Turnbull J

机构信息

Department of Neurology, Cleveland Clinic Foundation, Ohio 44195-5221.

出版信息

Epilepsia. 1993 Nov-Dec;34(6):1038-43. doi: 10.1111/j.1528-1157.1993.tb02131.x.

DOI:10.1111/j.1528-1157.1993.tb02131.x

PMID:8243354

Abstract

We identified 39 patients with chronic epilepsy (seizures > or = 2 years) proven to have primary brain tumors. These cases represent approximately 12% of the surgery cases for epilepsy in the same period. Mean age of seizure onset was 13.2 years: mean duration before operation was 10.5 years. Thirty-eight of 39 had normal neurologic examination. Twenty-six tumors were temporal, 7 were frontal, 4 were parietal, and 2 were occipital. Nine of 26 (34.6%) of the temporal group had contralateral interictal EEG spikes. Pathology was 15 ganglioglioma, 13 low-grade astroctoma, 4 oligodendroglioma, 2 low-grade mixed glioma, 1 pleomorphic xanthoastrocytoma, 2 dysembryoplastic neuroepithelial tumor, and 1 ependymoma. Postoperative seizure frequency (minimum follow-up 6 months) ranged from 15 to 16 seizure-free auras only in patients with temporal tumors and total gross tumor removal (mean follow-up 28 months) to 0 of 6 seizure-free in patients with extratemporal tumors who underwent subtotal resection or biopsy.

摘要

我们确定了39例慢性癫痫患者（癫痫发作≥2年），经证实患有原发性脑肿瘤。这些病例约占同期癫痫手术病例的12%。癫痫发作的平均起始年龄为13.2岁：术前平均病程为10.5年。39例中有38例神经系统检查正常。26例肿瘤位于颞叶，7例位于额叶，4例位于顶叶，2例位于枕叶。颞叶组26例中有9例（34.6%）在发作间期脑电图出现对侧棘波。病理诊断为15例神经节胶质瘤、13例低级别星形细胞瘤、4例少突胶质细胞瘤、2例低级别混合性胶质瘤、1例多形性黄色星形细胞瘤、2例胚胎发育不良性神经上皮肿瘤和1例室管膜瘤。术后癫痫发作频率（最短随访6个月）范围从仅颞叶肿瘤且肿瘤全切患者（平均随访28个月）的15次发作至16次无发作先兆，到颞叶外肿瘤行次全切除或活检患者的6次发作中0次无发作。