目的 探讨以癫痫起病的儿童颞叶肿瘤的病理类型、手术方案及疗效.方法 对34例以癫痫起病的儿童颞叶肿瘤患者的病理、手术方法及治疗效果等临床资料进行回顾性分析.结果 34例患儿中,胚胎发育不良性神经上皮肿瘤15例,节细胞胶质瘤10例,血管中心性胶质瘤3例,星形细胞瘤3例,毛细胞星形细胞瘤2例,恶性肿瘤(非典型性胚胎样/杆状瘤) 1例.肿瘤全切除32例,部分切除2例,仅在恶性肿瘤的1例患者中见肿瘤复发.术后癫痫疗效评定:Engel 1级21例,Engel 2级11例,Engel 3级2例.总有效32 例,总有效率94.1%.结论 以癫痫起病的儿童颞叶肿瘤以良性肿瘤多见,手术治疗预后良好;根据病理类型采用合理的手术方案,并应用术中脑电图监测,可以有效治疗癫痫.%Objective To investigate the pathological results,surgical plans and treatment outcomes of temporal lobe tumors presenting as epilepsy in children.Methods The clinical data such as pathological results,surgical proce-dures and treatment outcomes of 34 pediatric patients,who presented with epilepsy due to temporal lobe tumors,were ret-rospectively analyzed.Results The pathology of the tumor confirmed the diagnosis of dysembryoplastic neuroepithelial tumors in 15 patients,gangliogliomas in 10 patients,angiocentric glioma in 3 patients,astrocytoma in 3 patients,pilocytic astrocytoma in 2 patients,and malignant tumor in 1 patient.The tumor was totally resected in 32 patients,and partly re-sected in 2.Tumor recurrence was seen in only 1 patient whose pathology was malignant tumor.Post-operative Engel As-sessment demonstrated Grade 1 in 21 cases,Grade 2 in 11,and Grade 3 in 2.A total of 32 cases were effectively treated,with an effective rate of 94.1%.Conclusion Temporal lobe tumors presenting as epilepsy in children were mostly benign with good prognosis of surgical treatments.Proper choice of surgical plans based on tumor pathology and using intraopera-tive cortical EEG monitoring were the effective treatment for epilepsy.
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