Abstract：
Although epilepsy is the most common comorbidity of brain tumors, epileptic spasms rarely occur. Brain tumors associated with epileptic spasms are mostly low-grade gliomas. To date, few studies in the literature have reported on malignant (Grades 3-4) brain tumors associated with epileptic spasms. Thus, we aimed to investigate the characteristics of malignant brain tumor-associated epileptic spasms. We retrospectively reviewed patients with malignant brain tumors and epileptic spasms in our institution. Data on demographics, tumor histology, magnetic resonance imaging, epileptic spasm characteristics, electroencephalography, and treatment responsiveness were also collected. Six patients were included. In all cases, the brain tumors occurred in infancy in the supratentorial region and epileptic spasm onset occurred after the completion of brain tumor treatment. Anti-seizure medication did not control epileptic spasms; two patients were seizure-free after epileptic surgery. Although all patients had developmental delays caused by malignant brain tumors and their treatment, developmental regression proceeded after epileptic spasm onset. Two patients who achieved seizure-free status showed improved developmental outcomes after cessation of epileptic spasms. This is the first report of the characteristics of malignant brain tumor-associated epileptic spasms. Our report highlights a difficulties of seizure control and possibillity of efficacy of epileptic surgery in this condition. In malignant brain tumor-associated epileptic spasms, it is important to proceed with presurgical evaluation from an early stage, bearing in mind that epileptic spasms may become drug-resistant.
摘要：
虽然癫痫是脑肿瘤最常见的合并症，癫痫性痉挛很少发生。与癫痫性痉挛相关的脑肿瘤大多是低度胶质瘤。迄今为止,文献中很少有研究报道与癫痫性痉挛相关的恶性（3-4级）脑肿瘤。因此，我们的目的是探讨恶性脑肿瘤相关癫痫性痉挛的特点。我们回顾性分析了我们机构中患有恶性脑肿瘤和癫痫性痉挛的患者。人口统计数据，肿瘤组织学,磁共振成像，癫痫性痉挛的特点，脑电图,和治疗反应性也被收集。包括6名患者。在所有情况下,脑肿瘤发生在婴儿期的幕上区域，癫痫性痉挛发生在脑肿瘤治疗完成后。抗癫痫药物不能控制癫痫痉挛；两名患者在癫痫手术后无癫痫发作。尽管所有患者都有由恶性脑肿瘤及其治疗引起的发育迟缓，癫痫性痉挛发作后，发育消退继续进行。两名获得无癫痫发作状态的患者在癫痫性痉挛停止后表现出改善的发育结果。这是关于恶性脑肿瘤相关癫痫痉挛特征的首次报道。我们的报告强调了在这种情况下控制癫痫发作的困难和癫痫手术疗效的可能性。在恶性脑肿瘤相关的癫痫痉挛中，从早期开始进行术前评估很重要，记住癫痫性痉挛可能会变得耐药。
