肿瘤相关性癫痫发作间峰的临床相关性:一项皮质电图研究。

Journal of epilepsy research Pub Date : 2019-12-31 eCollection Date: 2019-12-01 DOI:10.14581/jer.19015
Changik Lee, Woorim Jeong, Chun Kee Chung
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引用次数: 3

摘要

背景和目的:尽管一些外科医生在对肿瘤相关性癫痫患者进行肿瘤周围大范围切除时利用皮质电图(ECoG)记录的间期尖峰,但间期尖峰与癫痫发生之间的关系尚未得到充分描述。我们研究了ECoG记录的间期尖峰切除是否与肿瘤相关性癫痫的手术结果更有利相关。方法:选取2006 - 2013年收治的132例因肿瘤相关性癫痫而行癫痫手术的患者,其中7例患者行术外ECoG。在每个患者中,使用标准化的低分辨率脑电磁断层扫描定位ECoG间期尖峰源,并将其共同登记到重建的脑模型中。通过计算间隔尖峰源在切除体积中的百分比来估计与切除体积的对应关系。结果:所有患者均获得大体全切除,无肿瘤复发。5例患者手术效果良好,2例患者手术效果不佳。手术结果有利组和不利组与切除体积的对应率分别为44.6%±27.8%和43.5%±22.8% (p=0.96)。无论癫痫发作结果如何,所有患者在切除体积外均存在间期尖峰源簇。结论:在这些肿瘤相关性癫痫病例中,脑电图间期尖峰切除的程度与术后癫痫发作结果无关。此外,切除区域外的间期尖峰源的存在与癫痫发作结果无关。相反,更专注于完全切除脑肿瘤似乎是一种合理的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical Relevance of Interictal Spikes in Tumor-Related Epilepsy: An Electrocorticographic Study.

Clinical Relevance of Interictal Spikes in Tumor-Related Epilepsy: An Electrocorticographic Study.

Clinical Relevance of Interictal Spikes in Tumor-Related Epilepsy: An Electrocorticographic Study.

Clinical Relevance of Interictal Spikes in Tumor-Related Epilepsy: An Electrocorticographic Study.

Background and purpose: Although some surgeons utilize interictal spikes recorded via electrocorticography (ECoG) when planning extensive peritumoral resection in patients with tumor-related epilepsy, the association between interictal spikes and epileptogenesis has not been fully described. We investigated whether the resection of interictal spikes recorded by ECoG is associated with more favorable surgical outcomes in tumor-related epilepsy.

Methods: Of 132 patients who underwent epilepsy surgery for tumor-related epilepsy from 2006 to 2013, seven patients who underwent extraoperative ECoG were included in this study. In each patient, ECoG interictal spike sources were localized using standardized low-resolution brain electromagnetic tomography and were co-registered into a reconstructed brain model. Correspondence to the resection volume was estimated by calculating the percentage of interictal spike sources in the resection volume.

Results: All patients achieved gross total resection without oncological recurrence. Five patients achieved favorable surgical outcomes, whereas the surgical outcomes of two patients were unfavorable. Correspondence rates to the resection volume in the favorable and unfavorable surgical outcome groups were 44.6%±27.8% and 43.5%±22.8%, respectively (p=0.96). All patients had interictal spike source clusters outside the resection volume regardless of seizure outcome.

Conclusions: In these cases of tumor-related epilepsy, the extent of the resection of ECoG interictal spikes was not associated with postoperative seizure outcomes. Furthermore, the presence of interictal spike sources outside of the resection area was not related to seizure outcomes. Instead, concentrating more on the complete removal of the brain tumor appears to be a rational approach.

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