智力评估在耐药性癫痫定侧中的价值  

The clinical significance of the neuropsychological assessment in patients with drug-resistance epilepsy

作　　者：刘立红[1] 石先俊[1] 廖白军[1] 刘仕勇[1] 安宁[1] 杨辉[1] 杨梅华[1] 

机构地区：[1]第三军医大学新桥医院神经外科全军癫痫诊治中心,重庆400037

出　　处：《立体定向和功能性神经外科杂志》2016年第4期221-224,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：国家自然科学基金资助项目(编号:81201011);中国抗癫痫协会UCB基金资助项目(编号:2011009)

摘　　要：目的探讨智力评估对耐药性癫痫致痫灶的定侧价值。方法回顾性对比分析2011年8月～2013年8月经手术治疗的耐药性癫痫，筛选出105例有随访记录的且其术前智力评估结果中操作得分（PIQ）和言语得分（VIQ）差值大于15分的成人耐药性癫痫患者，比较IQ低值侧其与电生理＋影像学得出的综合定位结果，并结合术后疗效分析。结果两者相一致组78例（78／105），吻合率74％。术后随访2～4年，标准按Engel分级，总优良率79％（Ⅰ级＋Ⅱ级），83例。其中一致组有70例，占84．3％，非一致组13例，占15．7％。两组疗效对比，一致组优良率为89．7％（70／78），非一致组为48．1％（13／27），两者经统计学处理有显著差异（P〈0．01）。结论智力评定VIQ与PIQ差值大于15分，其低值侧对致痫灶侧评估有参考价值，可作为术前评估定侧参考指标之一。Objective To investigate the role of neuropsychological assessment in pre -operative evaluation of patients with drug-resistance epilepsy. Methods From our epilepsy center series in past four years from 2011.8 to 2013.8,we identified 105 adult patients in whom intelligence quotient＇s difference is greater than or equal 15 scores between performance intelligence quotient and verbal intelligence quotient. Comared the localization come from the findings of combination of MRI and EEG with the lateralization with a lower VIQ or PIQ that indicated hemisphere was insulted. Results The rate of accordance between the two group data was 74% （78/ 105）. At follow-up 2-4years,79%（83）of patients were seizure-free（Engel Ⅰ） or rare seizures （Engel Ⅱ）. The excellent rate is higher（89.7% vs 48.1%） in the consistent group that are combination neuro-electrophysiology, MRI with neuropsychological evaluation than non-consistent group that just combined neuro-electrophysiology and MRI findings（P value〈0.01）. Conclusion It＇s with a certain value in lateralization of pre-operative evaluation for drug-resistance epilepsy patient while the difference is greater than or equal 15 scores between VIQ and PIQ.

关 键 词：IQ评估 耐药性癫痫 定位 

分 类 号：R742.1[医药卫生—神经病学与精神病学]