丙泊酚Wada实验在颞叶癫痫功能评估中的应用

Propofol wada test for speech and memory dominance in temporal epilepsy

目的探讨丙泊酚Wada实验在颞叶癫痫语言和记忆功能评估中的临床应用。方法回顾性分析了我院12例颞叶癫痫病人经颈内动脉注射丙泊酚进行Wada实验的临床资料。其中9例行前颞叶切除。结果丙泊酚单侧注射剂量为8～13mg。12例病人均能确定语言优势侧，其中10例在左侧，2例在右侧。8例病人能确定记忆优势侧，其余4例病人为双侧不能区分。5例出现短暂并发症．其中2例较为明显。术后6例病人癫痫得到完全控制，2例为稀少发作。术后8例病人语言功能正常，1例短暂失语，3周后恢复。记忆力和智力测试结果与术前比较无统计学差异。结论丙泊酚可替代阿米妥钠应用于wada实验测试，在国人颞叶癫痫功能评估中8～13mg可能是一个适合的单侧注射剂量。

Objective Objective To evaluate the usefulness of propofol as an alternative drug for the wada test to determine speech and memory dominance in temporal epilepsy. Methods The authors analyzed 12 patients with temporal epilepsy who underwent the intracarotid propofol wada test as a preoperative evaluation. Nine patients underwent anterior temporal lobe resection. Results Dose of unilateral intracarotid propofol ranged from 8-13 mg. With propofol injection, lateralities of language and memory function were identified in12 and 8 of 12 patients. Five patients had an tempoary adverse effect, severely in two patients, six of 9 patients had an seizure free outcome after surgery and an additional two patients had rare seizure. One patient experienced temporary aphasia and recoveried in three weeks. There is no signifficant difference between pre- and postoperative memory and intelligence quotient. Conelusion Propofol is an effective alternative to amobarbital in the wada test, and a suitable dose of unilateral intracarotid injection maybe 8--12 mg in chinese.