外科治疗以癫痫为主要症状的脑膜瘤124例

Surgical treatment of meningiomas with epilepsy as the main symptom

目的探讨以癫痫为主要症状的脑膜瘤的手术疗效。方法回顾性分析2010年1月至2016年1月以癫痫为主要症状的脑膜瘤患者124例,随访术后癫痫控制情况。结果手术达到SimpsonⅠ、Ⅱ级切除的有94例,SimpsonⅢ级切除27例,SimpsonⅣ级切除3例。EngelⅠ级98例(79.0%),EngelⅡ级11例(8.9%),EngelⅢ级12例(9.7%),EngelⅣ级3例(2.4%)。其中SimpsonⅠ、Ⅱ级切除的94例患者术后87例癫痫基本消失,癫痫控制满意率为92.6%。结论以癫痫为主要症状的脑膜瘤术前需要明确癫痫发作起始区,特别注意是否存在肿瘤远隔部位的独立发作起始区;治疗上应以肿瘤切除为主,同时处理异常发放的皮质可有效地提高术后癫痫控制的疗效。

Objective To explore the surgical efficacy of meningioma patients with epilepsy as the main symptoms. Methods A retrospective analysis of 124 meningioma patients with epilepsy as the main symptoms between January 2010 and January 2016, follow-up effect of epilepsy control. Results There were 94 cases of Simpson Ⅰ or Ⅱ grade resection, 27 cases of grade Ⅲresection and 3 cases of grade Ⅳ resection. The surgical out- comes of patients were evaluated based on Engel＇s classification. There were 98 cases （79.0%） of Engel Ⅰ grade, 11 cases （8.9%） of Engel 11 grade, Engel m and Ⅳ grade were 12 cases （9.7%） and 3 cases （2.4%）. Among them, 87 of 94 patients with Simpson Ⅰ or Ⅱ grade resection epilepsy were well controlled, the satisfaction rate of epilepsy control was 92.6%. Conclusions Epilepsy as the main symptoms of meningioma patients need to clear about the seizure onset area preoperative, need to pay special attention to whether there is an independent epilepsy starting area of the distant site of the tumor. On the basis of the tumor resection as much as possible, at the same time dealing with the abnormal release of the cortex can effectively improve the efficacy of postoperative epilepsy control.