Epileptic seizures during follow-up of patients treated for primary brain tumors
Epileptic seizures during follow-up of patients treated for primary brain tumors
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DOI：
10.1212/01.wnl.0000168903.09277.8f
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发表时间：
2005-07-26
期刊：
影响因子：
9.9
通讯作者：
Delattre, JY
中科院分区：
文献类型：
--
作者：
Hildebrand, J;Lecaille, C;Delattre, JY
目的：探讨原发性脑肿瘤患者癫痫发作的表现、发生率和严重程度。方法：对234例连续在门诊接受幕上脑肿瘤化疗的患者进行检查。结果：183例患者发生癫痫发作。所有癫痫患者均给予抗癫痫药物治疗。与非癫痫患者相比，癫痫患者低级别胶质瘤比例（p < 0.001）和皮质肿瘤位置（p < 0.001）较高。在158例（86.4%）患者中，癫痫发作是该疾病的早期表现，只有25例（13.6%）患者在恶性疾病过程中出现癫痫。50%的早期癫痫发作有普遍性，但只有19.1%的患者在开始使用aed和特异性抗肿瘤治疗后癫痫发作持续。癫痫发作泛化率显著降低（p = 0.001）。尽管AED和各种抗肿瘤治疗，一半的患者在1个月内癫痫发作，三分之二的患者在最后一次评估前3个月内癫痫发作。结论：大多数肿瘤相关癫痫发作首先出现在病程早期，通常作为一个表现。抗癫痫药物联合特异性抗肿瘤治疗可显著降低癫痫普遍化率。然而，大多数患者在随访期间仍有局灶性癫痫。
Objective: To determine the presentation, incidence, and severity of seizures in follow-up of patients treated for primary brain tumors. Methods: A total of 234 consecutive patients attending an outpatient clinic for chemotherapy of a supratentorial brain tumor were examined. Results: Seizures occurred in 183 patients. All patients with epilepsy were on antiepileptic drugs ( AEDs). Compared with patients without epilepsy, patients with epilepsy had a higher proportion of low-grade gliomas (p < 0.001) and cortical tumor location ( p < 0.001). In 158 (86.4%) patients, seizures were an early manifestation of the disease, and epilepsy developed in only 25 (13.6%) individuals in the course of the malignant disease. Generalization occurred in 50% of early seizures, but in only 19.1% of patients with seizures persisting after the initiation of AEDs and specific antitumor therapies. The reduction in seizure generalization was significant (p = 0.001). Despite AED and various antitumor treatments, one-half of the patients had a seizure within 1 month and two-thirds within 3 months before the last evaluation. Conclusions: Most tumor-related seizures first appear early in the course of disease, usually as a presenting manifestation. Antiepileptic drugs combined with specific antitumor treatments significantly reduce the rate of seizure generalization. However, most patients continue to have focal epilepsy during follow-up.