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目的分析神经节细胞胶质瘤并癫痫的临床特点及影响发作控制结果的因素,并探讨其手术治疗策略。方法回顾2007年至2010年间21例神经节细胞胶质瘤并癫痫患者的临床资料,并统计分析各因素对发作控制结果的影响。结果 21例中,病变手术全切除17例,大部切除4例。10例联合癫痫灶处理。术后3例肢体轻偏瘫,1例部分性视野缺损。发作控制:EngleⅠ级15例,Ⅱ级4例,Ⅲ级1例,Ⅳ级1例。术后无发作(EngleⅠ级)与性别、病变是否全切相关,而与起病年龄、病程、发作类型、是否位于颞叶、是否难治性、病理级别、手术方式(单纯切除还是结合癫痫灶处理)等无明显相关性。结论对神经节细胞胶质瘤伴癫痫患者,应在保障安全前提下尽可能全切,必要时结合神经导航、术中唤醒皮层电刺激功能区定位或颅内电极等技术,对顽固性癫痫应同时处理癫痫灶;神经节细胞胶质瘤手术后发作控制相对良好。
Objective To analyze the clinical characteristics of gliomas and epilepsy and the factors influencing the outcome of the attack and to discuss the surgical treatment strategies. Methods The clinical data of 21 patients with ganglionic glioma and epilepsy from 2007 to 2010 were retrospectively analyzed. The influence of various factors on the outcome of seizures was analyzed. Results Of the 21 cases, 17 cases were completely resected and 4 cases were mostly resected. 10 cases of joint epileptic foci treatment. Three cases of postoperative hemiplegia limbs, one case of partial visual field defect. Seizure control: Engle Ⅰ grade in 15 cases, Ⅱ grade in 4 cases, Ⅲ grade in 1 case, Ⅳ grade in 1 case. No postoperative episodes (Engle Ⅰ grade) and sex, the lesion is completely related, and the onset age, duration, type of attack, is located in the temporal lobe, is refractory, pathological grade, surgical approach (simple resection or combined with epileptic foci Treatment) and so no significant correlation. Conclusion Ganglione cell glioma patients with epilepsy should be as full as possible under the premise of ensuring safety, combined with neuronavigation, intraoperative arousal cortical stimulation of functional zone positioning or intracranial electrodes and other techniques, if necessary, refractory epilepsy While dealing with epileptic foci; ganglion glioma postoperative seizure control is relatively good.