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目的 探讨应用术中皮质脑电图监测下显微手术切除肿瘤组织并切除或热灼癫痫灶对伴癫痫症状脑肿瘤患者的治疗效果。方法 1 6例伴有癫痫症状的脑肿瘤患者 ,术中通过皮质脑电图确定癫痫灶 ,应用显微手术切除肿瘤组织后 ,再根据皮质脑电图所确定的癫痫灶进行切除或热灼 ,术后随访 2～ 4 8个月。结果 1 6例患者切除肿瘤前均可通过皮质脑电图描记到癫痫波 ,肿瘤及癫痫灶完全切除后 ,癫痫波完全消失者 1 5例 ,1例功能区脑肿瘤患者虽多次皮质热灼 ,但仍可见偶发棘波。术后 1 5例癫痫发作停止 ,1例有部分性发作 ,术后应用丙戊酸钠抗癫痫治疗后效果良好。结论 应用术中皮质脑电图监测下切除脑肿瘤并同期切除和 (或 )热灼癫痫灶 ,是一种控制脑肿瘤切除术后癫痫发作的较为有效的治疗方法
Objective To investigate the therapeutic effect of microsurgical removal of tumor tissue and removal of epileptic foci or epileptic foci on patients with brain tumor with epilepsy under the monitoring of intraoperative cortical electroencephalography. Methods Twenty-six patients with brain tumor with epilepsy were identified intracortical epileptic foci by cortical electroencephalography. The tumors were excised microsurgically and then excised or cauterized according to the epileptic foci defined by cortical electroencephalogram (EEG) The patients were followed up for 2 ~ 48 months. Results 16 cases of patients with tumor before excision can be traced by cortical EEG epilepsy waves, tumors and epileptic foci after complete excision, epileptic wave completely disappeared in 15 cases, 1 case of functional brain tumor in patients with cortical cauterization , But sporadic spikes are still visible. Fifteen cases of epileptic seizures stopped after operation, and one case had partial seizures. After the application of valproate antiepileptic treatment, the effect was good. Conclusions The removal of brain tumor with intraoperative monitoring of cortical EEG and concurrent resection and / or thermal epileptogenic foci is a more effective treatment for seizures after brain tumor resection