Chieffo Daniela, Lettori Donatella, Contaldo Ilaria, Perrino Francesca, Graziano Alessandra, Palermo Concetta, Mittica Antonio, Tamburrini Giampiero, Battaglia Domenica, Di Rocco Concezio, Guzzetta Francesco
Child Neurology and Psychiatry Unit, Catholic University, Largo Gemelli 8, Rome, Italy.
Brain Dev. 2011 Apr;33(4):310-5. doi: 10.1016/j.braindev.2010.06.006. Epub 2010 Nov 5.
was to provide new data about the evolution of neuropsychological findings in patients with lesional frontal lobe epilepsy (FLE) operated on with lesion excision.
Twelve patients with lesional FLE underwent full clinical examination including neurological, neuropsychological and developmental assessments, high-resolution magnetic resonance imaging (MRI), ictal and interictal prolonged EEG monitoring and evaluation of seizure semeiology before and after surgery. The mean follow-up duration was 2 years and 10 months (range=14 months-7 years). Another group of lesional temporal lobe epilepsy, matched for the age at surgery and side of surgery, was likewise studied in order to compare neuropsychological patterns and to try to find out specific features in frontal lobe epilepsy evolution.
All patients resulted seizure free at outcome except one belonging to Engel's class II. Before surgery general intelligence was similar in FLE as well as in TLE group. Executive functions and motor coordination were frequently affected in FLE whereas patients with TLE often presented with deficits in naming, visual memory and visuo-spatial attention. After surgery there was a frequent decline of IQ in FLE group together with a slight deterioration, especially of executive functions in some patients. An improvement of behaviour was often observed in both groups.
As already reported in literature, neuropsychological pre-surgical data confirms the involvement of attention and executive functions in lesional FLE. No significant neuropsychological improvement was produced by surgery that determined in some cases a slight decline of general intelligence and specific frontal abilities. Yet, generally behaviour improved and seizures were controlled.
旨在提供有关接受病灶切除术的额叶癫痫（FLE）患者神经心理学结果演变的新数据。
12例患有病灶性FLE的患者接受了全面的临床检查，包括神经学、神经心理学和发育评估、高分辨率磁共振成像（MRI）、发作期和发作间期长时间脑电图监测以及手术前后发作症状学评估。平均随访时间为2年10个月（范围=14个月至7年）。另一组与手术年龄和手术侧相匹配的病灶性颞叶癫痫患者也进行了同样的研究，以比较神经心理学模式，并试图找出额叶癫痫演变的特定特征。
除1例属于恩格尔II级外，所有患者术后均无癫痫发作。术前FLE组和TLE组的一般智力相似。FLE患者的执行功能和运动协调经常受到影响，而TLE患者经常出现命名、视觉记忆和视觉空间注意力方面的缺陷。术后FLE组智商经常下降，一些患者的执行功能略有恶化。两组患者的行为通常都有改善。
正如文献中已经报道的那样，术前神经心理学数据证实了注意力和执行功能在病灶性FLE中的作用。手术并未产生显著的神经心理学改善，在某些情况下反而导致一般智力和特定额叶能力略有下降。然而，总体而言，行为得到改善，癫痫发作得到控制。
