Shin Min-Sup, Lee Sangkun, Seol Soon-Ho, Lim Young-Jin, Park Eun-Hee, Sergeant Joseph A, Chung Chunkee
Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea.
Neurol Res. 2009 Sep;31(7):692-701. doi: 10.1179/174313209X389848. Epub 2009 Mar 23.
This study was conducted to evaluate the changes in neuropsychological functioning in patients with temporal lobe epilepsy (TLE) after temporal lobe resection.
Fifty-four TLE patients were evaluated before and after surgery using comprehensive neuropsychological tests to assess general intelligence, executive functioning, language, verbal and visual memory, working memory, visuo-spatial ability, attention and motor function.
The patients with left TLE showed no impairment of neuropsychological functioning after surgery, with the exception of auditory immediate memory. Furthermore, they showed significant improvement in performance IQ, executive function, working memory, visual memory, attention and psychomotor speed. The patients with right TLE did not show any significant impairment in post-operative neuropsychological functioning. They showed improvements in intellectual and executive functions, language, visual memory, visuo-spatial ability, attention and motor function post-operatively. The patients with hippocampal sclerosis showed greater post-operative improvements than the patients without hippocampal sclerosis regardless of the side. Patients with better pre-operative neuropsychological function had a higher chance of successfully discontinuing all seizure medications after surgery.
The results of this study suggest that temporal lobectomy does not harm the neuropsychological functioning of patients with intractable TLE and that it improves cognitive functions of the contralateral hemisphere.
本研究旨在评估颞叶癫痫（TLE）患者在颞叶切除术后神经心理功能的变化。
54例TLE患者在手术前后接受了全面的神经心理测试，以评估一般智力、执行功能、语言、言语和视觉记忆、工作记忆、视觉空间能力、注意力和运动功能。
左侧TLE患者术后除听觉即时记忆外，神经心理功能无损害。此外，他们在操作智商、执行功能、工作记忆、视觉记忆、注意力和心理运动速度方面有显著改善。右侧TLE患者术后神经心理功能未显示出任何显著损害。他们术后在智力和执行功能、语言、视觉记忆、视觉空间能力、注意力和运动功能方面有改善。无论哪一侧，海马硬化患者术后的改善都比无海马硬化的患者更大。术前神经心理功能较好的患者术后成功停用所有抗癫痫药物的机会更高。
本研究结果表明，颞叶切除术不会损害难治性TLE患者的神经心理功能，并且能改善对侧半球的认知功能。
