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目的使用皮层电极监测切除致痫性脑胶质瘤,探讨致痫性脑胶质瘤的治疗方法。方法本组病人43例。EEG示轻度异常脑电图9例。中度异常脑电图26例,重度异常脑电图8例。CT或MRJ检查皆可见占位病变。常规手术开颅显露相应部位脑皮层使用皮层电极对脑电进行监测。确定大体致痫范围,行肿瘤切除。肿瘤切除后再行脑电监测,若仍有癫痫波,根据皮层电极之定位切除致痫灶。结果22例病人行显微镜下肿瘤全切除,15例病人近全切除肿瘤,6例病人次全切除肿瘤。术后随访6个月-年。34例(79.1%)病人癫痫症状消失,7例(16.3%)病人癫痫发作次数明显减少,2例(4.7%)病人癫痫症状未见好转。总有效率(93.7%)。结论以癫痫为主要症状的脑肿瘤病人,只有在切除胶质瘤时一并切除致痫灶,才是治疗肿瘤并根治癫痫的最佳方法。皮层电极监测下切除致痫性脑胶质瘤是治疗有癫痫症状的脑胶质瘤的有效方法。
Objective To detect epileptogenic glioma by cortical electrode and to explore the treatment of epileptiform glioma. Methods This group of 43 patients. EEG showed mild abnormal EEG in 9 cases. 26 cases of moderate abnormal EEG, severe abnormal EEG in 8 cases. CT or MRJ examination are visible lesions. Conventional surgical craniotomy revealed the corresponding parts of the cortex using cortical electrodes to monitor EEG. Determine the general range of epilepsy, line tumor resection. Tumor resection and then EEG monitoring, if there is still epileptic waves, according to the location of cortical electrodes resection of epileptogenic lesions. Results Twenty-two patients underwent microsurgical resection of the tumor, 15 patients underwent total resection of the tumor, and 6 patients underwent total excision of the tumor. After 6 months of follow-up - year. Seizure symptoms disappeared in 34 patients (79.1%), seizure frequency was significantly reduced in 7 patients (16.3%), and epileptic symptoms did not improve in 2 patients (4.7%). The total efficiency (93.7%). Conclusion Epilepsy as the main symptom of brain tumor patients, only resection of epileptogenic lesions in excision of glioma, is the best way to treat cancer and cure epilepsy. Excision of epileptiform gliomas under cortical electrode monitoring is an effective method of treating gliomas with symptoms of epilepsy.