Senbongi M, Funakoshi A, Watanabe Y, Mihara T, Inoue Y, Seino M
National Epilepsy Center, Shizuoka Higashi Hospital, Japan.
No To Shinkei. 1990 Aug;42(8):755-8.
Verbal dichotic listening test was conducted before and after anterior temporal lobectomy on 25 patients who underwent the operation because of their medication-resistant epileptic seizures. Their speech dominance by Wada test was all left sided. 1. Preoperatively, patients having the epileptogenic focus in the right temporal lobe (R-TLE) and those having the focus in the left (L-TLE) were, as expected, all right-ear dominant. The mean number of correct responses was fewer in L-TLE than in R-TLE group. 2. Postoperatively, no detrimental effects for recognition of verbal auditory stimuli by the ear contralateral to the focus was observed both in L-TLE and in R-TLE group. 3. Postoperatively, the ear-dominance shifted: to the left in patients with L-TLE, and to the right more conspicuously in patients with R-TLE compared to the preoperative scores. In other words, the recognition ability by the ears ipsilateral to the side of focus, or of resected temporal lobe, was ameliorated. Summarizing, the unilateral anterior temporal lobectomy did not cause "lesion effect" but yielded improvement of verbal auditory recognition by ears ipsilateral to the epileptogenic focus. Diminished epileptic bombardment resulted in by the resection surgery may be a possible explanation.
对25例因药物难治性癫痫发作而接受手术的患者,在颞叶前部切除术前后进行了言语双耳分听测试。通过Wada测试,他们的语言优势半球均为左侧。1.术前,正如预期的那样,右侧颞叶癫痫(R-TLE)患者和左侧颞叶癫痫(L-TLE)患者均以右耳优势为主。L-TLE组的正确反应平均数比R-TLE组少。2.术后,在L-TLE组和R-TLE组中,均未观察到病灶对侧耳对言语听觉刺激识别的有害影响。3.术后,耳优势发生了转变:与术前分数相比,L-TLE患者的耳优势转向左侧,而R-TLE患者的耳优势更明显地转向右侧。换句话说,病灶侧或切除颞叶同侧耳的识别能力得到了改善。总之,单侧颞叶前部切除术并未产生“病灶效应”,反而使致痫灶同侧耳的言语听觉识别能力得到了改善。切除手术导致的癫痫放电减少可能是一个合理的解释。