Evaluation of the Epileptic Cases with Intracranial Space Occupying Lesion During Post Operative Period

Abstract

Of the patients with cranial tumour 30 to 50% have generalised, partial or secondary generalisedseizures. Partial seizures let us to estimate the tumour localisation. In patients with space occupying lesion seizures may continue after the exicion of the tumour. We evaluatedthe post operative period of the patients who had intracranial tumuor. There were 6 patients ( 3 male) whom were operated for their intracranial space occupying lesions between 18-70 ages. All had epileptic seizures preoperatively exept one patient with hyphophysis adenoma.Of these, the duration with seizure onset between operation were minimum one month and maximum five years.Focal motor seizures, partial andsecondary generalised seizures were seen preoperatively. Post operative diagnoses were menengioma.2, astrositoma.1 oligodendroglioma1, glial tumour1 and hyphophysis adenoma1. Neurologic deficit were not seen any of the patients post operatively. The follow up period after operation were minimum 6 months and maximum 9 years. Four patients were operated for the second time who had the diagnosis of menengioma, astrositoma, oligodendroglioma,and hyphophysis adenoma. Seizure characteristics were changed and the seizure frequency were decreased of the patient who had glial tumourafter post operative period.Maximum seizure free period were 6 years. The menegioma patient had her seizures early in time in intensive care unit as focal motor seizures and no decrease were seen in seizure frequency during the post operative follow up.In parasagittal oligodendroglioma patient seizure frequency were increased post operatively. Four patients had poly therapy. Post operative seizure course is associated with the tumour localisation, size, pathologic diagnosis, and second or more operation.Of these patients it is conspicuousthat the seizure control is more difficult who were operated for the second or more times. Key words: epilepsy, intracranial space occupying lesions, post operative status, anticonvulsant treatments

Keywords

• epilepsy, intracranial space occupying lesions, post operative status, anticonvulsant treatments

İntrakranyal Yer Kaplayan Lezyonlu Epileptik Olgularda Postoperatif Değerlendirme

Öz

Beyin tümörlü hastaların %30-50 sinde jeneralize, parsiyel veya parsiyel başlayıp jeneralize olannöbetlere rastlanır. Parsiyel nöbetler tümör yerinin belirlenmesinde yardımcıdır. Yer kaplayan lezyonu (YKL) olan hastalarda lezyonun eksizyonu sonrasında da nöbetler devam edebilir. Burada intrakranyal tümoral lezyonu olan hastaların operasyon sonrası izlemleri değerlendirilmiştir Yaşları 18-70 arasında değişen intrakranyal yer kaplayan lezyon nedeni ile opere olan 3'ü erkek toplam 6 hasta mevcuttu. Bunlardan hipofiz adenomu tanısı alan 1 erkek hasta dışında hepsinin preoperatif dönemde epileptik nöbet öyküsü vardı. Diğer 5 hastada nöbet başlangıcı ve operasyon arası süre 1 ay ila 5 yıl idi. Preoperatif nöbet özellikleri fokal motor nöbet, kötü koku ile karakterize basit parsiyel nöbet ve sekonder jeneralize nöbetler şeklinde idi. Post operatif tanı 2 hastada menengiom, 1 astrositom, 1 oligodendrogliom, 1glial tm ve 1 hipofiz adenomu idi. Post operatif dönemde hiçbir hasta da nörolojik defisit oluşmadı. Post operatif izlem süresi 6 ay ila 9 yıl idi. Astrositom, Oligodendrogliom, Menengiom ve Hipofiz adenomu tanısı alan 4 hasta 1 ila 4 yıl arayla ikinci kez opere edilmişti.Glial tümör tanısı alan 50 yaşındaki bayan hastada post operatif dönemde nöbetler azalmakla beraber karakteristiği değişti. Post operatif en uzun nöbetsizlik süresi 6 yıl idi. Post operatif en erken nöbet, menengioma tanısı alan 1 hastada, yoğun bakımda fokal motor nöbet şeklinde idi. Bu hastanın pre ve post operatif dönemde nöbet sıklığında değişiklik olmadı. Parasagittal oligodendrogliom nedeni ile opere olan 18 yaşındaki bayan hasta da post operatif dönemde nöbet sıklığında artış gözlendi. 2 hastada antiepileptik tedavimonoterapi, 4 hastada politerapi şeklinde devam ediyordu. İntrakranyal tümoral lezyonu olan epileptik hastalarda post operatif nöbet seyri lezyonun yeri, büyüklüğü, patolojik tanısı, geçirilen operasyon ile ilişkilidir. Bu hastalardan ikinci kez opere olanların nöbet kontrolünün daha güç olduğu dikkat çekicidir. Anahtar kelimeler: Epilepsi, İntrakranyal Yer Kaplayan Lezyonlar, Post Operatif Dönem, Antikonvülzan Tedavi

Anahtar Kelimeler

• Epilepsi, İntrakranyal Yer Kaplayan Lezyonlar, Post Operatif Dönem, Antikonvülzan Tedavi

Kaynakça

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