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目的探讨以癫痫起病岛叶胶质瘤的治疗方法。方法对23例以癫痫起病、影像检查岛叶区域有病灶的病例,在服用抗癫痫药物同时,行翼点入路显微手术病灶切除。结果全切12例,次全切除11例;术后有3例出现对侧肢体的不完全瘫痪,1个月后均有恢复。2例出现短期的语言障碍,1~2周恢复。病理检查示星形细胞瘤Ⅰ~Ⅱ级14例,Ⅲ级3例,少突胶质细胞瘤2例,多形性胶质母细胞瘤3例。随访1个月~5年,18例生存良好,服药情况下癫痫控制良好,复查MR肿瘤区域无明显变化,4例复发,2例死亡。结论药物治疗加早期显微手术是以癫痫起病岛叶胶质瘤病人理想的治疗方法。
Objective To explore the treatment of epilepsy island glioma. Methods Twenty-three cases of epilepsy onset and imaging examination of lesions in the insular region were treated with anti-epileptic drugs and microsurgical resection of the pterional approach. Results The total resection in 12 cases, subtotal resection in 11 cases; 3 cases of contralateral limb paralysis, 1 month after recovery. 2 cases of short-term language problems, 1 to 2 weeks recovery. Pathological examination revealed astrocytoma in grade Ⅰ ~ Ⅱ 14 cases, grade Ⅲ in 3 cases, oligodendroglioma in 2 cases, pleomorphic glioblastoma in 3 cases. During follow-up of 1 month to 5 years, 18 patients survived well and had good control of epilepsy with medication. There was no significant change in MR tumor area, 4 patients relapsed and 2 patients died. Conclusion Drug treatment combined with early microsurgery is an ideal treatment for patients with epilepsy island glioma.