选择性海马切除对颞叶内侧型癫痫患者认知功能的影响

Cognitive function of patients with mesial temporal lobe epilepsy following selective amygdalohippocampectomy

目的通过对颞中回入路选择性海马杏仁核切除颞叶内侧型癫痫患者认知功能的短期观察,提供选择性海马杏仁核切除对认知功能的影响的临床证据。方法 30例颞叶癫痫选择性海马杏仁核切除患者,手术前后均由研究者对患者行韦氏成人认知功能评估,对评估结果进行分析。结果右侧手术后患者记忆商数、语言功能(语言的流畅度和波士顿命名)得分较术前升高,操作功能(抗干扰实验和连线实验)评分较术前下降,差异有统计学意义(P<0.05);左侧手术患者记忆商数、操作功能得分手术前后差异无统计学意义(P>0.05),而语言功能评分较术前下降,差异有统计学意义(P<0.05)。结论选择性海马杏仁核切除术对颞叶内侧型癫痫患者认知功能有一定的影响,左侧手术对语言功能有损害,右侧手术对注意力等有损害。

Objective To evaluate the short-term effects of amygdalohippocampectomy on cognitive function in intractable ep- ilepsy patients. Methods A total number of 30 hippocampectomy patients with MTLE from April 2008 to December 2008 were in- volved in our study. The pre-operation cognitive function and the three mouths post-operation cognitive function were evaluated. A battery of neuropsychological tests including Stroop Test, Verbal Fluency, Trail Making Test, Boston Naming Test, and Digital Span Test was used. Results Compared to the pre-operation,right memory quotient and scores of Boston Naming Test and Verbal Fluency after operation were significantly elevated（P 〈 0.05 ）while scores of Stroop Test and Trail Making Test in the post-operation were signifi- cantly declined（ P 〈 0.05 ）. Scores of left Boston Naming Test and Verbal Fluency were significantly declined in the post-operation compared to the pre-operation（P 〈 0.05 ）while no significant changes were found in left memory quotient and scores of Stroop Test and Trail Making Test between pre-and post-operation. Conclusion Cognitive function of patients with temporal lobe epilepsy is signifi- cantly impacted by amygdalohippocampectomy：left operation may produce impairment on language function while right operation may have impact on the concentration.