Lee Yun-Jin, Kang Hoon-Chul, Kim Heung Dong, Kim Dong-Seok, Shim Kyu-Won, Eom Soyong, Lee Joon Soo
Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, South Korea.
Department of Pediatric Neurology, Pediatric Epilepsy Clinics, Severance Children's Hospital, Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
Pediatr Neurol. 2015 Jan;52(1):88-93. doi: 10.1016/j.pediatrneurol.2014.09.006. Epub 2014 Sep 18.
We assessed the postoperative neurocognitive function after temporal lobectomy in children with temporal lobe epilepsy.
This was a retrospective analysis of the data of 20 patients with Engel's class I or II outcomes after anterior temporal lobectomy with amygdalohippocampectomy between 2005 and 2008. Twenty children underwent resection of either dominant (n = 8) or nondominant (n = 12) temporal lobes, and their median age at surgery was 12.8 ± 3.2 years. We serially assessed intelligence and memory function as measured by the Korean-Wechsler Scales of Intelligence and Rey-Kim Memory test both before and after surgery.
Intelligence quotient (IQ) and memory quotient scores remained stable during a 3.6-year median follow-up in these children after the surgery. There was no decrease of IQ or memory quotient scores in either the dominant or non-dominant hemisphere groups. Later onset of epilepsy, a shorter epilepsy duration, a smaller number of antiepileptic drugs, and postoperative seizure-free outcomes were significant good predictors of the postoperative IQ.
Temporal lobectomy in children did not provoke a significant decline in intelligence or memory function. Early surgical treatment in children with intractable seizures of temporal lobe origin may result in better neurocognitive outcomes.
我们评估了颞叶癫痫患儿颞叶切除术后的神经认知功能。
这是一项对2005年至2008年间接受前颞叶切除加杏仁核海马切除术且Engel分级为I级或II级的20例患者的数据进行的回顾性分析。20名儿童接受了优势侧（n = 8）或非优势侧（n = 12）颞叶切除术，手术时的中位年龄为12.8±3.2岁。我们在手术前后通过韩国韦氏智力量表和雷伊 - 金记忆测试对智力和记忆功能进行了连续评估。
在这些儿童术后的3.6年中位随访期间，智商（IQ）和记忆商数得分保持稳定。优势半球组和非优势半球组的IQ或记忆商数得分均未下降。癫痫发病较晚、癫痫病程较短、抗癫痫药物数量较少以及术后无癫痫发作是术后IQ的显著良好预测指标。
儿童颞叶切除术不会导致智力或记忆功能显著下降。对颞叶起源的难治性癫痫患儿进行早期手术治疗可能会带来更好的神经认知结果。
