摘要
目的探讨神经节细胞胶质瘤的脑电图特点及手术预后的相关因素。方法回顾2014年7月至2020年12月昆明三博脑科医院神经外科诊治的35例经手术切除并病理证实神经节细胞胶质瘤患者的病例资料并进行分析总结,定期随访,并通过对患者的术前脑电图、影像学检查、病史等进行统计分析,预测影响癫痫预后的因素。结果神经节细胞胶质瘤放电的部位与病变部位一致,且与病灶及周边相关。35例患者中,正常脑电图3例(9%)、异常脑电图32例(91%),其中,2例仅有慢波活动,30例记录到间期放电,19例记录到癫痫发作。脑电图存在3种间期放电模式和3种发作期放电模式,间期放电常见模式为脑区性棘慢复合波、尖慢复合波(53%),发作期常见模式为低电压快活动(53%)。术后平均随访46.67个月,28例为EngelⅠ级(80%),7例为EngelⅡ~Ⅲ级(20%),术后复查肿瘤无1例复发。对35例患者的临床特点及脑电图进行多因素统计学分析发现,病程对于癫痫预后具有统计学意义。结论脑电图结合影像学检查可提高癫痫患者致痫灶定位的准确性。对于神经节细胞胶质瘤导致癫痫发作的患者,手术切除病灶可有效治愈癫痫。
Objective To explore the electroencephalogram(EEG)characteristics of ganglioglioma and postoperative prognosis-related factors.Methods Thirty-five patients with ganglioglioma were verified by surgery and pathology in Kunming Sanbo brain hospital from July 2014 to December 2020 were reviewed,analyzed,summarized and given with routinely follow-up visits.The patients'preoperative EEG,imaging examination and medical history were used to analyze the factors that affect the prognosis of epilepsy.Results The discharge sites in scalp EEG were consistent with the lesion sites of ganglioglioma and related to the lesions and lesion surroundings.Among 35 patients,there were 3 patients with normal EEG(9%)and 32 patients with abnormal EEG(91%).Two patients had only slow wave activity,and 30 patients were recorded with intermittent discharge.Nineteen patients were found to have seizures.There were 3 intermittent discharge patterns and 3 ictal discharge patterns in EEG.The common patterns of intermittent discharge were the cerebral spike and wave discharge and the sharp-slow wave(53%).The common pattern during the onset is low-voltage and fast activity(53%).The average follow-up time was 46.67 months.Twenty-eight patients were EngelⅠ(80%),and 7 patients with EngelⅡ-Ⅲ(20%).Re-examination reveled that there was no relapse of tumors.Multivariate analysis of the clinical characteristics and EEG of 35 patients showed that the disease course was statistically significant for the prognosis of epilepsy.Conclusion EEG combined with imaging examination can improve the accuracy of locating epileptic focus in patients with epilepsy.For patients with epilepsy caused by ganglioglioma,surgical removal of the lesion can effectively cure epilepsy.
作者
和磊洁
任杰
赵永彬
高菁
许金诚
王静
HE Leijie;REN Jie;ZHAO Yongbin(Department of Neurosurgery-the first ward,Kunming Sanbo Brain Hospital,Kunming 650100,Yunnan China)
出处
《癫痫与神经电生理学杂志》
2022年第1期12-21,共10页
Journal of Epileptology and Electroneurophysiology(China)
