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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.27 no.1 São Paulo Mar. 1969

http://dx.doi.org/10.1590/S0004-282X1969000100002 

A epilepsia nos tumores cerebrais

 

Epilepsy in cerebral tumors

 

 

Luís Marques-AssisI; Daniel Guenni-BejarII; Evaldo J. Faria LinsII

IDepartamento de Neurologia (Prof. Adherbal Tolosa) da Faculdade de Medicina da Universidade de São Paulo: Assistente
IIDepartamento de Neurologia (Prof. Adherbal Tolosa) da Faculdade de Medicina da Universidade de São Paulo: Médicos estagiários

 

 


RESUMO

De 411 casos de tumores cerebrais foram estudados 86 (19,4%) que apresentaram manifestações epilépticas. A epilepsia foi estudada quanto à duração, ao tipo de manifestação e à severidade, em relação à natureza e à localização dos tumores cerebrais.
A análise dos resultados permitiu aos autores chegarem às seguintes conclusões: 1) a epilepsia incidiu em 19,4% dos casos; 2) o oligodendroglioma, as metástases carcinomatosas e o glioblastoma multiforme foram, pela ordem, os tumores mais epileptogênicos; 3) as áreas frontal, parietal e temporal foram, nessa ordem, as localizações mais epileptogênicas; 4) os carcinomas metastáticos predominaram nos casos com epilepsia com menos de um ano de evolução, enquanto que os astrocitomas predominaram nos casos com mais de três anos; quanto à topografia, predominou a região frontal no primeiro grupo e a temporal, no segundo; 5) nas formas mais severas de epilepsia predominaram os oligodendrogliomas e os meningeomas, quanto à natureza, e a região frontotemporal e a foice, quanto à localização; 6) os craniofaringeomas e os meduloblastomas foram os tumores que mais freqüentemente determinaram o aparecimento de convulsões puras; nesses casos, a sela túrsica e a fossa posterior foram as sedes mais freqüentes; 7) os carcinomas metastáticos e os meningeomas, quanto à natureza, e as regiões frontoparietal e parietal, quanto à localização, foram os mais freqüentemente encontrados nos casos com crises de tipo bravais-jacksoniano.


SUMMARY

In 411 cases of cerebral tumors, 86 (19,4%) with epileptic manifestations were studied. The duration, the manifestations and the severity of epilepsy, in regard to the nature and site of the tumor, were investigated.
The analysis of the results lead the authors to the following conclusions: 1) 19.4% of the cerebral tumors showed epileptic symptoms; 2) oligodendroglioma, metastatic carcinomas and glioblastoma multiforme were, in this order, the most epileptogenic tumors; 3) the frontal, parietal and temporal areas were, in this order, the most epileptogenic localizations; 4) concerning the duration of epilepsy, the metastatic carcinomas were more frequent when the duration of epilepsy was lower than one year, while the astrocytoma were more frequent in the cases with more than three years; regarding the location, the frontal area was more frequent in the first group and the temporal area in the second one; 5) regarding the frequency of seizures, oligodendroglioma and meningeoma, and the frontotemporal and falx cerebri locations were found more frequently in the more severe cases; 6) concerning the pattern of epileptic manifestations, cranio-pharyngiomas and meduloblastomas were the tumors that induced most seizure without aura; in these cases the pituitary region and the posterior fossa were the more frequent sites; 7) metastatic carcinomas and meningeomas, as well as frontoparietal and parietal areas, were most frequently found in the cases with jacksonian seizures.


 

 

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REFERÊNCIAS

1. GIBBS, F. A. — Frequency with which tumors in various parts of the brain produce certain symptoms. Arch. Neurol. Psychit. (Chicago) 28:969-989, 1931.         [ Links ]

2. GÜVENER, A.; BAGGHI, B. K.; KOOI, K. A. & CALHOUN, H. D. — Mental and seizure manifestations in relation to brain tumors. A statistical study. Epilepsia 5:166-176, 1964.         [ Links ]

3. LIST, C. F. — Epileptiform attacks in cases of glioma of the cerebral hemispheres. Relation to the location and histologic type of the glioma. Arch. Neurol. Psychiat. (Chicago) 35:323-350, 1936.         [ Links ]

4. LUND, M. — Epilepsy in association with intracranial tumor. Acta psychiat. neurol. scand. supl. 81, 1952.         [ Links ]

5. PAILLAS, J. E.; COMBALBERT, A.; BERARD-BADER, M.; BILLE, J. & FRANK, R. — Etude sur 1'évolution de oligodendrogliomes de l'encéphale. A propos d'une série opératoire de 34 cas. Acta neurol. psychiat. belg. 64: 537-551, 1964.         [ Links ]

6. PENFIELD, W.; ERICKSON, T. C. & TARLOV, I. — Relation of intracranial tumors and symptomatic epilepsy. Arch. Neurol. Psychiat. (Chicago) 44:300-315, 1940.         [ Links ]

7. PENFIEL, W.; JASPER, H. — Epilepsy and the Functional Anatomy of the Human Brain. Little-Brown Co., Boston, 1954.         [ Links ]

8. WEBSTER, J. E. & WEINBERGER, L. M. — Convulsions associated with tumors of the cerebelum. Clinical and pathophysiologic features. Arch. Neurol. Psychiat. (Chicago) 43:1163-1184, 1940.         [ Links ]

9. WHITE, J. C.; LIU, C. T. & MIXTER, W. J. — Focal epilepsy. A statistical study of its causes and the results of surgical treatment. I: Epilepsy secondary to intracranial tumors. New Engl. J. Med. 238:891-899, 1948.         [ Links ]

 

 

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