CAJ | 학술논문

目的探讨胚胎发育不良性神经上皮肿瘤(DNT)致癫痫患者的手术策略.方法回顾性分析自2008年1月至2013年8月首都医科大学宣武医院神经外科手术治疗14例DNT患者的经验,术前常规通过MRI及视频脑电图(VEEG)等检查对肿瘤及致痫灶进行评估,术中行皮层脑电监测(EcoG)对致痫灶定位,手术方式:肿瘤病灶加致痫灶切除.结果 14例患者肿瘤均得到全切,手术后病理证实为DNT,未行放疗和化疗,无肿瘤复发及恶性转化.10例患者术后癫痫发作得到完全控制(Engel Ⅰ级),4例患者术后稀少发作(EngelⅡ级).结论 DNT是低级别神经元～胶质细胞肿瘤,常见于青少年,多伴药物难治性癫痫,除切除肿瘤外,积极处理肿瘤外致痫灶可以很好地控制癫痫.
목적 탐토배태발육불량성신경상피종류(DNT)치전간환자적수술책략.방법 회고성분석자2008년1월지2013년8월수도의과대학선무의원신경외과수술치료14례DNT환자적경험,술전상규통과MRI급시빈뇌전도(VEEG)등검사대종류급치간조진행평고,술중행피층뇌전감측(EcoG)대치간조정위,수술방식:종류병조가치간조절제.결과 14례환자종류균득도전절,수술후병리증실위DNT,미행방료화화료,무종류복발급악성전화.10례환자술후전간발작득도완전공제(Engel Ⅰ급),4례환자술후희소발작(EngelⅡ급).결론 DNT시저급별신경원～효질세포종류,상견우청소년,다반약물난치성전간,제절제종류외,적겁처리종류외치간조가이흔호지공제전간.
Objective To investigate the surgery strategy of patients with epileptogenic dysembryoplastic neuroepithelial tumors (DNTs).Methods The retrospective analysis of surgical experiences of 14 patients with DNTs in our hospital was performed.The tumors and epileptic foci were evaluated preoperatively by MRI and VEEG as routine.Using EcoG monitoring during the operation,we performed the resection of tumors and epileptic foci together.Results The tumors were cut off completely in all the patients.The histological examination confirmed that all lesions were DNTs.Radiotherapy or chemotherapy was not performed after the operation.There was no recurrence of tumors.Engel Ⅰ outcome (seizure-free) was noted in 10 patients and Engel Ⅱ outcome(rare seizure) in 4.Conclusions The DNT is low grade neurons to glial cell tumor.It is common in teenagers and always compares with intractable epilepsy.Management of epileptic foci around the tumor showed favorable results in the controlling of epilepsy.