Briellmann R S, Berkovic S F, Jackson G D
Brain Research Institute, and Department of Neurology, Austin and Repatriation Medical Center and Department of Medicine, University of Melbourne, Victoria, Australia.
Neurology. 2000 Nov 28;55(10):1479-85. doi: 10.1212/wnl.55.10.1479.
Repetitive seizures may be associated with progressive neuronal damage measurable by quantitative MRI.
To investigate whether gender is a risk factor for this damage.
Sixty patients with refractory temporal lobe epilepsy (TLE) (28 men, 32 women) and 54 healthy controls (28 men, 26 women) were compared by quantitative MRI methods.
Male patients had ipsilateral hemicranial volume loss of 12% (CI 8% to 16%) and contralateral volume loss of 7% (CI:3% to 11%) compared with male controls (p < or =0.004, analysis of variance). Female patients were 4% (CI:0.3% to 8%, p = 0.04) smaller than controls in the ipsilateral hemicranium, and not different contralaterally. The patient-to-control difference was greater in men than in women for the ipsilateral (p = 0.003) and contralateral hemicranial volume (p = 0.02). In men, 14% of the ipsilateral (F = 4.7, p = 0.004) and 16% of the contralateral (F = 5.1, p = 0.03) hemicranial volume loss could be attributed to generalized tonic clonic seizures. Compared with controls, patients averaged a 29% smaller ipsilateral and a 5% smaller contralateral hippocampus.
Men with TLE have more brain atrophy than women with TLE. Seizure frequency is a factor contributing to reduced brain volumes in men but not in women. Men, therefore, may be more vulnerable to seizure-associated brain abnormalities.
重复性癫痫发作可能与通过定量磁共振成像（MRI）测量的进行性神经元损伤有关。
研究性别是否是这种损伤的危险因素。
采用定量MRI方法对60例难治性颞叶癫痫（TLE）患者（28例男性，32例女性）和54例健康对照者（28例男性，26例女性）进行比较。
与男性对照组相比，男性患者患侧半颅体积损失12%（可信区间8%至16%），对侧体积损失7%（可信区间：3%至11%）（方差分析，p≤0.004）。女性患者患侧半颅比对照组小4%（可信区间：0.3%至8%，p = 0.04），对侧无差异。患侧和对侧半颅体积的患者与对照者差异男性大于女性（患侧p = 0.003，对侧p = 0.02）。在男性中，患侧半颅体积损失的14%（F = 4.7，p = 0.004）和对侧的16%（F = 5.1，p = 0.03）可归因于全身强直阵挛性发作。与对照组相比，患者患侧海马平均小29%，对侧小5%。
男性TLE患者比女性TLE患者脑萎缩更严重。癫痫发作频率是导致男性脑体积减小的一个因素，而女性则不然。因此，男性可能更容易受到癫痫相关脑异常的影响。
