40例癫癎患者术前韦达试验的结果分析

Clinical analysis of Wada test before operation among 40 patients with epilepsy

目的：探讨癫癎患者术前行韦达试验（Wada test）检测的意义。方法：回顾性分析广东三九脑科医院2012年2月-2013年10月收治的40例癫癎患者术前治疗韦达试验检测结果。结果：在临床上诊断的40例癫癎患者中，左利手3例，右利手37例。韦达试验结果，37例患者可以正确判断出语言及记忆优势半球，3例患者无法判断出语言及记忆优势半球。左侧大脑半球为语言、记忆优势半球的患者30例；双侧均参与语言功能的患者1例，左侧为语言优势半球，双侧记忆无侧别优势的患者4例；左侧为语言优势半球，双侧均有记忆代偿能力1例；右侧为语言、记忆优势半球7例；右侧为语言优势半球，双侧语言独立的患者1例；双侧均有记忆代偿能力的患者4例；双侧语言独立，双侧大脑半球无记忆侧别优势1例。39例患者可以判断运动功能的侧别，1例患者因麻醉药物过敏试验被迫中途终止。上述临床检测的结果分析，韦达试验术前评估患者语言及记忆功能优势侧半球及肢体肌力有效率达90％以上，具有很高的临床意义。结论：韦达试验是癫癎术前评估患者语言及记忆功能优势侧半球及肢体肌力的重要手段，以及预测癫癎术后患者语言、记忆及肢体功能的残疾程度，评估癫癎手术可能风险，有利于癫癎患者选择正确的治疗方式。

Objective：To explore the clinical value of Wada test before operation for patients with epilepsy .Methods：A retrospective analysis of Wada test was made among 40 patients with epilepsy in the former Guangdong 999 Brain Hospital from February 2012 to October 2013 .Results：Through Wada clin‐cal tests among 40 patients with epilepsy including 3 left‐haded cases and 37 right‐handed cases ,37 pa‐tients could correctly cognize the words and memory dominant hemisphere ,while 3 cases could not ideati‐fy them .Left cerebral hemisphere as language and memory dominant hemisphere was found in 30 cases;1 case had bilateral language function;4 cases had left hemisphere as language advantage ,but without side advantage in bilateral memory ;I case had languge dominant hemisphere on left side with bilateral compen‐satory ablity ;7 cases had languge and memory dominant hemispbere on right side;I case had language dominant hemisphoere on right side with independant language ability ;4 cases had language compensatorg ability on both sides;I case had independant language ability ,but without memory advantage on both sides .All the 39 patients could judge the side diffenence of motor function ,while one case terminated dur‐ing anesthesia drug test .Conclusion：Wada test is an important means to assess the language and memory functions of dominant side hemisphere and limb muscle strength of patiemts with epilepsy ,and predict the degrees of language ,memory and physical function disability .It contribatses to selecting proper treatment through the assessment of possible risks of epilepstic surgery .