Rausch Rebecca
Department of Neurology and Psychiatry, UCLA School of Medicine, Los Angeles, California 90095-1769, USA.
Curr Opin Neurol. 2002 Apr;15(2):185-9. doi: 10.1097/00019052-200204000-00010.
In patients with pharmacologically intractable, complex-partial seizures, surgical excision of the involved temporal lobe may have significant therapeutic benefit. Resection of mesial structures of the temporal lobes, however, entails a significant risk of decreased memory function. Recent advances in the assessment of memory changes following temporal lobectomy surgery emphasize the complexity of subjective ratings of memory functioning in this population. Neuroimaging tools useful in the diagnostic evaluation of epilepsy surgical candidates have now been shown to be useful in predicting memory change in the post-surgical period. Functional magnetic resonance imaging appears to provide significant information regarding hemispheric representation of language in the temporal lobe epilepsy patient, and the use of this technique to predict memory status following surgery appears promising. Clinical studies involving patients who had temporal lobectomy surgeries have also revealed changes in emotional learning related to the degree of amygdala involvement. Moreover, there is increasing evidence to suggest that differential changes in emotional learning occur among patients with right versus left temporal lobe resections.
对于药物治疗无效的复杂部分性癫痫患者，手术切除受累的颞叶可能具有显著的治疗益处。然而，切除颞叶内侧结构会带来记忆功能下降的重大风险。近期在评估颞叶切除术后记忆变化方面的进展强调了该人群记忆功能主观评分的复杂性。现已证明，对癫痫手术候选者进行诊断评估时有用的神经影像学工具，在预测术后记忆变化方面也很有用。功能磁共振成像似乎能提供有关颞叶癫痫患者颞叶语言半球表征的重要信息，利用该技术预测术后记忆状态似乎很有前景。涉及接受颞叶切除术患者的临床研究还揭示了与杏仁核受累程度相关的情绪学习变化。此外，越来越多的证据表明，右颞叶与左颞叶切除患者在情绪学习方面存在差异变化。
