Dept. Neuropediatrics, Medical Center of Schleswig-Holstein, Campus Kiel, Germany.
Brain Cogn. 2011 Jul;76(2):310-5. doi: 10.1016/j.bandc.2011.03.014. Epub 2011 Apr 14.
Dichotic listening test (DL) is an important tool to disclose speech dominance in healthy subjects and in clinical cases. The aim of this study was to probe if focal epilepsy in children reveals a corresponding suppression of the ear reports contralateral to seizure onset site. Thus, 15 children and adolescents with clinically and electroencephalographically diagnosed focal epilepsy selected for left-hemisphere speech dominance without mental retardation were compared to matched controls according to age, gender, IQ and handedness. All children were assessed with DL for three times: Interictally (t(0)), postictally 5' (t(1)) and 1h (t(2)). At t(0), all groups revealed a right ear advantage (REA), indicating a left-hemisphere speech dominance. There was a continuous increase in right correct score (REC) over the trials for normal controls. Five minutes postictally, there was an abrupt decrease in REC with a sustained left ear correct score (LEC) for children with epilepsy, independent of which side suffered from seizures. This effect was maintained even after 1h. Thus, in children with left-hemisphere speech dominance the epileptic discharges caused a suppression of REC regardless of origin. The seizures may have a prolonged impact on attention and auditory perception for a considerable time after consciousness has been regained.
双耳分听测试(DL)是一种重要的工具,可以揭示健康受试者和临床病例中的言语优势。本研究的目的是探讨儿童局灶性癫痫是否会导致与发作起源部位相对应的对侧耳报告的抑制。因此,选择了 15 名具有临床和脑电图诊断的局灶性癫痫且无智力障碍的左半球言语优势的儿童和青少年,根据年龄、性别、智商和利手与匹配的对照组进行比较。所有儿童均接受了 3 次 DL 评估:发作间期(t(0))、发作后 5 分钟(t(1))和 1 小时(t(2))。在 t(0)时,所有组均显示右耳优势(REA),表明左半球言语优势。正常对照组的右耳正确得分(REC)随试验连续增加。发作后 5 分钟,癫痫患儿的 REC 突然下降,左侧耳正确得分(LEC)持续,与哪一侧发作无关。这种影响甚至在 1 小时后仍持续存在。因此,在具有左半球言语优势的儿童中,癫痫发作引起的 REC 抑制与起源无关。癫痫发作可能会在意识恢复后相当长的一段时间内对注意力和听觉感知产生持久的影响。