海马横切术对颞叶癫痫患者认知及记忆功能的影响  

The effect of hippocampal transection on cognitive and memory function in intractable medial temporal epilepsy

作　　者：王伟[1] 赵全军[2] 王涛[2] 崔绍杰[2] 史铁钧[2] 王培新[2] 李连峰[2] 黑博[2] 

机构地区：[1]南方医科大学第三临床医学院,广州510515 [2]中国人民解放军第306医院神经外科

出　　处：《立体定向和功能性神经外科杂志》2017年第1期6-10,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：首都临床特色应用研究项目(编号:Z141107002514053);首都临床特色应用研究与成果推广项目(编号:Z161100000516199)

摘　　要：目的观察海马横切术对顽固性颞叶内侧型癫痫的治疗效果及其对认知及记忆功能的影响。方法对同一位术者实施的8例海马横切术及10例前颞叶切除术的各项基本资料(癫痫病程,患者年龄,性别等),术前检查(头颅核磁检查,视频脑电起源灶定位),癫痫控制率以及术前、术后神经心理学检查(包括韦氏智力检查:言语智商、操作智商、总智商,以及记忆商)结果进行统计分析。结果海马横切术组与前颞叶切除术组基本资料及术前检查均无明显差异。2组术后患者癫痫控制率均在80%以上,无明显统计学差异。海马横切术组术前及术后2周神经心理学检查结果比较:言语智商、操作智商、总智商、记忆商均无显著差异(P>0.05);而前颞叶切除术组所有商值均显著降低(P<0.05);针对两组神经心理学检查术前与术后差值比较,记忆商下降程度有明显差异(P<0.05)。结论海马横切术在有效控制癫痫发作的同时对患者智力及记忆损害较小。与前颞叶切除术相比,海马横切术对患者的记忆功能有较好的保护作用,对于顽固性颞叶内侧型癫痫是一种值得提倡和推广的外科术式。Objective To observe the seizure control and the effect on cognitive and memo- ry function of hippocampal transection in intractable medial temporal epilepsy patients. Methods Eight cases of hippocampal transection and 10 cases of anterior temporal lobectomy were selected in which were all performed by the same operator. All the patients＂ basic information（ including age,gender, seizure time and so on）, preoperative examination（head magnetic resonance imaging, video electroencephalogram）, seizure control and neuropsychological examinations （ including VIQ. verbal intelligence quotient, PIQ. performance intelligence quotient, FIQ. full intelligence quotient and memory quotient） before and after the operation were collected and analyzed. Results The basic information and preoperative examinations have no significant difference in two groups. The seizure control were all high than 80% in two groups and there is also no significant difference. All the neuropsychological examinations＂ scores before operation have no significant difference compared with the that of two weeks after operation in the hippocampal transection group （P〈0.05）. However,in the anterior temporal lobectomy group, all scores were significant- ly declined （P〈0.05）. According to the span D--value of the scores before and after operation, the decline of MQ was found with significant difference in two groups （P〈0.05）. Conclusion In the meanwhile of seizure control,hippocampal transection will not cause significant damage of in- telligence and memory function. Compared with anterior temporal lobectomy, the memory func- tion can be preserved well after hippocampal transection. So it is a good surgical approach for in- tractable medial temporal epilepsy.

关 键 词：癫痫 海马横切 前颞叶切除 神经心理学 记忆 

分 类 号：R742.1[医药卫生—神经病学与精神病学]