脑膜瘤致癫痫的临床和病理研究

Clinical and pathological study of epilepsy secondary to meningioma

目的 :寻求继发性癫痫的病因和发病机理 ,从而提高疗效。方法 :收集近 10年来因脑膜瘤引起癫痫的病例 5 1例 ,将切除的标本作有目的的病理研究 ,并结合临床进一步分析研究。如果 :经半年到 10年的随访 ,5 1例中 ,满意 41例 ,显著改善 6例 ,无改善 1例。无法全切除的 3例中 ,良好 1例 ,无改变 2例 ,总有效率达 94.1%。结论 :脑膜瘤引发癫痫的原因可能为 :(1)肿瘤位于运动、精神情感区。 (2 )因脑组织受损后 ,神经网络形成捷径。 (3)局部微环境变化出现的体液改变三个因素 ,它们共同为局部异常放电提供条件 ,引发癫痫。要取得好的疗效 ,(1)必须争取肿瘤全切除并彻底清除侵入性部分瘤细胞 ;(2 )充分保护正常脑组织、神经和血管。

Objective:To investigate the causative factor and the pathogenesis of the secondary epilepsy in order to raise the therapeutic efficacy.Methods:We studies 51 cases of epileptic seizure caused by meningioma in recent 10 years,including the purposeful pathologic investigation of the resected specimens and being combined with the review of patient's clinical features,thus a further clinic opethogic analysis was made. Results:Outcome was made after the follow-up of 6 months to 10 years.It was excised thoroughly 48 cases. 41 cases Of them was satisfactory,markedly improved 6 cases and unchanged 1 case. Of the 3 patients with unably excised satisfactory, the outcome was evaluated as good in 1 case and unimproved in 2 cases.The total therapeutic effect was 94 1%.Conclusion:The causative factors of epilepsy secondary to meningioma are probably as the follows :1.The location of tumor at the motor,psychosensory areas;2.The short cut of neural network established post the brain damage and;3. The hemodynamic change of the local microcirculation etc.;and all these 3 factors may contribute together to the abnormal electric discharge,hence the epileptic seizure occurred.In order to get good therapeutic effect,the tumor must be thoroughly excised including the epitogenic focus,and the brain tissue as well as its nerves and blood vessels should be well protected from any kind of damage.