以癫痫为主要症状的颞叶占位病变的手术治疗

摘要

Objective To investigate the therapy of space-occupying lesions of lobus temporalis with epilepsy as the main symptom. Methods 27 cases with epilepsy as the main symptom were studied retroapectively, all of which were adopted excision. Results All the nidi were excised. EEG monitoring had been applied to all the cases before surgery while intraoperative ECoG monitoring was applied to eleven of them. According to the pathological report, five cases were oligodendroglioma, thirteen were astrocytoma, six were meningioma, and the other three were cavernous hemangioma. The 1-to-2-year follow-up studies showed that the epilepsy of most patients disappeared while few ones still had the symptom, but with lower frequency. Conclusion The epileptic symptom of space-occupying lesions of lobus temporalis could be alleviated by surgery with intraoperative ECoG monitoring.%　　目的探讨以癫痫为主要症状的颞叶占位病变的治疗方法和疗效。方法回顾性分析27例患者资料，均以癫痫为主要临床症状，采取手术切除。结果手术完全切除病灶；27例术前应用脑电图监测，11例术中应用皮层脑电监测；术后病理，少突胶质细胞瘤5例，星形细胞瘤13例，脑膜瘤6例，海绵状血管瘤3例；随访1～2年，大部分患者癫痫症状消失，少数仍有癫痫发作，但发作频率、形式等较术前改善。结论以癫痫为主要症状的颞叶占位病变，经术中皮层脑电监测，手术切除病灶，可以很好地治疗癫痫，改善预后。