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纸质出版:2016
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张远超,黎振声,康健捷,王伟,彭凯润,王伟民.颞叶癫痫发作间期海马放电对患者言语智商的影响[J].陆军军医大学学报(原第三军医大学学报),2016,38(18):2060-2065.
Zhang Yuanchao,Li Zhensheng,Kang Jianjie,Wang Wei,Peng Kairun,Wang Weimin.Impact of interictal discharge in hippocampus on verbal intelligence quotient of patients with temporal lobe epilepsy[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(18):2060-2065.
张远超,黎振声,康健捷,王伟,彭凯润,王伟民.颞叶癫痫发作间期海马放电对患者言语智商的影响[J].陆军军医大学学报(原第三军医大学学报),2016,38(18):2060-2065. DOI:
Zhang Yuanchao,Li Zhensheng,Kang Jianjie,Wang Wei,Peng Kairun,Wang Weimin.Impact of interictal discharge in hippocampus on verbal intelligence quotient of patients with temporal lobe epilepsy[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(18):2060-2065. DOI:
目的 探讨发作间期海马放电对于颞叶癫痫(temporal lobe epilepsy
TLE)患者手术前后言语智商(verbal intelligence quotient,vIQ)的影响。 方法 收集我院2011年1月至2015年1月48例TLE患者临床资料,行韦氏智力量表评分。头皮脑电及术中植入深部电极,探测发作间期海马放电情况。将患者性别、起病年龄、病程、颞叶癫痫类型、发作形式、发作频率、发作间期海马放电、病理类型、教育程度等因素进行分层后就术前vIQ受损进行单因素比较和多因素Logistic回归分析。分析患者术后1年vIQ变化情况。 结果 发作间期海马放电(P=0.030,OR=11.341)、低年龄起病(P=0.045,OR=7.567)、高发作频率(P=0.023,OR=6.241)是TLE患者术前vIQ受损的危险因素,伴有发作间期海马放电者出现vIQ受损的风险最高,而与海马硬化、颞叶癫痫类型、病程、病灶侧及病理类型等无关(P0.05)。伴发作间期海马放电组术前vIQ明显低于无海马放电组及健康对照组。无海马放电患者术后vIQ与术前相比无明显变化(P0.05)。在有发作间期海马放电的患者中,病灶位于右侧者术后vIQ有明显改善。术后疗效达到Engel Ⅰ~Ⅱ级者vIQ有明显改善,而Engel Ⅲ~Ⅳ级者会出现言语功能的恶化(P0.05)。 结论 伴有发作间期海马放电,尤其是低年龄起病及发作频率高的颞叶癫痫患者,出现语言障碍的风险更大。
Objective To investigate the effect of interictal discharge in hippocampus on verbal intelligence quotient (vIQ) of patients with temporal lobe epilepsy (TLE) before and after operative treatment. Methods Clinical data of 48 patients with refractory TLE receiving surgical treatment from January 2011 to January 2015 in our hospital were collected. The patients were assessed with the Wechsler Adult Intelligence Scale (WAIS-RC)
and intraoperatively implanted with electrodes for detecting the hippocampal discharge. Univariate analysis and logistic regression analysis were used to reveal the relationship between the impairment of vIQ and related factors
such as gender and education
age at seizure onset
duration of epilepsy
types and frequency of the TLE
pathology
and hippocampal abnormalities. The change of vIQ was comparatively studied after 1year operation. Results Interictal discharge in hippocampus (P=0.030
OR=11.341)
earlier age of seizure onset (P=0.045
OR=7.567) and high frequency of seizure (P=0.023
OR=6.241) were the risk factors of pre-operative vIQ impairment. Of these
the interictal discharge in hippocampus was the most dangerous one
whereas hippocampal sclerosis
type and duration of the TLE
lesion side and pathological types were not closely related. Before the operation
the vIQ was significant lower in patients with interictal discharge in hippocampus compared to those of the patients without hippocampal discharge and the health control (P0.05). No significant difference of vIQ was found in patients without interictal discharge in hippocampus between pre-operation and post-operation (P0.05). By contrast
the vIQ of patients with interictal discharge in hippocampus and lesion occurred in the right side was significantly improved after the operation. Additionally
patients with curative level of Engel Ⅰ-Ⅱ had a higher vIQ after the operation
but the patients with level of Engel Ⅲ-Ⅳ suffered a significant decline of the vIQ (P0.05). Conclusion The patients with the interictal discharge in the hippocampus
particularly with the earlier age of seizure onset and high frequency of seizure
would have worse linguistic function.
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