颞叶癫痫发作后患者语言评估的初步研究  

Postictal language testing in patients with temporal lobe epilepsy： a preliminary study

作　　者：俞群[1,2] 王钟瑾[1,2] 王爽[1,2] 朱君明[1,2] 丁美萍[1,2] 

机构地区：[1]浙江大学医学院附属第二医院神经内科,杭州310009 [2]浙江大学医学院附属第二医院癫痫中心,杭州310009

出　　处：《中华神经科杂志》2014年第10期707-710,共4页Chinese Journal of Neurology

基　　金：国家自然科学基金资助项目（91332202,81271435）;浙江省医药卫生研究计划资助项目（2012KYA097,2009QN015）;浙江省教育厅科研项目（Y201330273）

摘　　要：目的 评估癫痫发作后的患者语言功能障碍能提供有价值的诊断信息,但目前还无基于汉语的研究.我们观察了颞叶癫痫发作后患者语言功能恢复的潜伏期与致痫灶定侧的关系.方法 选择视频脑电数据库中记录到的起源于颞叶的复杂部分性癫痫发作,所有患者在发作后立即接受意识评估,当患者能配合测试者后,给予患者印有“昨晚他们听到老李在电台里讲话”的卡片进行阅读,将患者连续朗读出语句的时刻标记为语言恢复时刻.结果 纳入左侧和右侧颞叶癫痫各11例,复杂部分性发作共65次,其中54次（83.1％）发作中患者能够配合语言功能评价.癫痫发作后患者的意识和语言恢复潜伏期与癫痫持续时间无关联,但受到致痫灶侧别的影响,左侧颞叶癫痫组的意识恢复潜伏期（161 s）和语言恢复期（281 s）均显著长于右侧颞叶癫痫组（中值分别为30 s,54 s）.以150 s的恢复时间为界,右侧颞叶癫痫组发作后恢复比例为87％ （27/31）,而左侧颞叶癫痫组恢复比例为13％ （3/23）.结论 发作后的患者汉语功能评估能帮助颞叶癫痫发作的定侧.Objective Postictal language testing can provide useful diagnostic information for seizure lateralization.However no such a study based on non-English language was done previously.We investigated the latency of language recovery in Chinese patients with temporal lobe epilepsy （TLE）.Methods Complex partial seizures in patients with TLE were extracted from our video-electroencephalogram （EEG） database.For all patients,consciousness testing started as soon as seizures were detected.When they were alert and cooperative,they were asked to read out a sentence “昨晚他们听到老在电台里讲话”which was printed on a card.When the patients were able to read the sentence correctly,the language function was considered recovered.Results Totally 65 complex partial seizures from 22 cases of TLE （11 left and 11 right） were included.Patients were cooperative to language testing in 54 seizures （83%）.The latency for consciousness recovery （CRL） and latency for consciousness language recovery （LRL） were not associated with seizure duration,but the seizure lateralization.The CRL （median,161 s） and LRL （281 s） in the left TLE were statistically significantly longer than that in the right TLE （30 s,54 s respectively）.Using 150 s recovery time as bound language recovery ratio was 87% （27/31） in right TLE and 13% （3/23） in left TLE.Conclusion Postictal language testing based on ideographic Chinese words helps to establish seizure lateralization in patients with TLE.

关 键 词：癫痫 颞叶 发作 语言障碍 脑电描记术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]