单侧颞叶内侧癫痫发作间期癫痫放电模式对智商的影响  

Effect of interictal epileptiform discharge mode in unilateral mesial temporal lobe epilepsy on intelligence quotient

作　　者：黎振声 高曲文 齐自娟 王伟 林健 郭晓绯 彭凯润 王伟民 Li Zhensheng;Gao Quwen;Qi Zijuan;Wang Wei;Lin Jian;Guo Xiaofei;Peng Kairun;Wang Weimin(Department of Neurology,General Hospital of the Southern Theatre Command,Guangzhou,Guangdong 510010,China;Department of Neurosurgery,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou,Guangdong 510120,China;Department of Neurosurgery,General Hospital of the Southern Theatre Command,Guangzhou,Guangdong 510010,China)

机构地区：[1]南部战区总医院神经内科,广州510010 [2]南部战区总医院神经外科,广州510010 [3]中山大学孙逸仙纪念医院神经外科,广州510120

出　　处：《中国微侵袭神经外科杂志》2021年第6期258-261,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：广东省医学科学技术研究基金项目(编号:A2019137)。

摘　　要：目的探讨单侧颞叶内侧癫痫病人发作间期癫痫放电模式分型及其对智商的影响。方法回顾性分析130例单侧颞叶内侧癫痫病例资料,针对病人发作间期癫痫放电模式进行分型,对比不同分型病例之间的智商差异。结果颞叶内侧癫痫病例的发作间期癫痫放电模式,左侧分为3型:Ⅰ型放电局限于同侧额、颞区49例(63.64%),Ⅱ型放电波及对侧额、颞区12例(15.58%),Ⅲ型放电波及对侧额、颞区及同侧顶区16例(20.78%)。右侧亦分为3型:Ⅰ型放电局限于同侧额、颞区32例(60.38%),Ⅱ型放电波及对侧额、颞区9例(16.98%),Ⅲ型放电无固定部位12例(22.64%)。病程较长与发作频率较高的病人,言语智商、操作智商及总体智商均降低(均P<0.05)。左侧Ⅲ型放电病人,言语智商较其他分型病人降低,而操作智商及总体智商较Ⅰ型病人降低(均P<0.05)。右侧颞叶内侧癫痫各分型的操作智商与总体智商比较无明显差异,Ⅲ型病人言语智商较Ⅰ型病人有所提升(P<0.05)。结论单侧颞叶内侧癫痫放电模式可对病人智商产生重要影响。Objective To explore the mode of the interictal epileptiform discharge in patients with unilateral mesial temporal lobe epilepsy(mTLE)and its influence on intelligence quotient(IQ).Methods The clinical data of 130 patients unilateral mTLE were retrospectively analyzed,the patient's interictal epileptiform discharge modes were classified,and the IQ differences between different modes of unilateral mTLE were compared.Results The interictal epileptiform discharge modes of unilateral mTLE were divided into 3 types on the left side:typeⅠdischarges confined to the ipsilateral frontal and temporal regions in 49 cases(63.64%),typeⅡdischarges spreading to contralateral frontal and temporal regions in 12(15.58%),typeⅢdischarges spreading to contralateral frontal,temporal regions and ipsilateral parietal regions in 16(20.78%).The right side modes were also divided into 3 types:TypeⅠdischarges confined to ipsilateral frontal and temporal regions in 32 cases(60.38%),typeⅡdischarges spreading to contralateral frontal and temporal regions in 9(16.98%),and typeⅢdischarges with no fixed regions in 12(22.64%).The patients with longer courses and higher seizure frequencies had lower total IQ,verbal IQ(vIQ)and performance IQ(pIQ)(all P<0.05).The vIQ of left mTLE patients with typeⅢdischarge was lower than that of other types,while the pIQ and total IQ were lower than typeⅠpatients(all P<0.05).There was no significant difference between the pIQ and the total IQ of each type of right mTLE patients.The vIQ of right mTLE patients with typeⅢdischarge was higher than that of typeⅠ(P<0.05).Conclusion The intelligence of mTLE patients could be greatly influenced by the interictal epileptiform discharge modes.

关 键 词：癫痫 颞叶 癫痫放电 智商 

分 类 号：R742.1[医药卫生—神经病学与精神病学]