皮层脑电图监测下切除有癫痫症状的脑肿瘤

Resection of brain tumors with epilepsy by cortical electroencephalogram monitoring

目的 探讨皮层脑电图监测下切除或热灼伴有癫痫症状的脑肿瘤的手术效果。方法 16例伴有癫痫症状的脑肿瘤患者 ,术中通过皮层脑电图确定癫痫灶 ,切除肿瘤后 ,切除或热灼可疑癫痫灶。术后随访患者的癫痫发作情况。结果 16例患者切除肿瘤前均可通过皮层脑电图探及痫波 ,肿瘤及痫灶完全切除后 ,痫波消失者 15例 ,1例功能区患者虽多次皮层热灼 ,仍可见偶发棘波。术后 15例未再有癫痫发作 ,1例有部分性发作 ,用抗癫痫药可控制。

Objective To study the effects of resection of brain tumors with epilepsy by cortical electroencephalogram monitoring.Methods 16 patients with brain tumors with epilepsy were surgically treated by intra-operative cortical electroencephalogram(ECoG) monitoring.The epileptogenic foci detected by ECoG were resected,or the functional cortex were thermo-coagulated after the tumor removal.The attack of epilepsy was followed-up for all patients.Results The epilepsy waves were detected in all 16 patients.And that were disappeared in 15 patients after removal of tumor or epileptogenic foci.One case with epileptogenic foci on eloquent area still could be detected with accidental epilepsy wave even after several times of cortical thermo-coagulation.No epilepsy were found in 15 patients,and partial epilepsy in one patient after 2～48 months follow-up.Conclusions Removal of ECoG monitoring is a good way to control the epilepsy after the tumor removal.