Vega Clemente, Brenner Laurie A, Madsen Joseph, Bourgeois Blaise, Waber Deborah P, Boyer Katrina
Boston Children's Hospital, USA; Harvard Medical School, USA.
Boston Children's Hospital, USA; Harvard Medical School, USA.
Epilepsy Behav. 2015 Jan;42:61-5. doi: 10.1016/j.yebeh.2014.10.003. Epub 2014 Dec 11.
This study aimed to evaluate lexical retrieval, presurgery and postsurgery, among children and adolescents who had undergone temporal lobe resection for intractable epilepsy and to compare outcomes in patients whose surgery involved the left temporal lobe or the right temporal lobe.
A retrospective chart review identified 36 patients from a major pediatric epilepsy treatment center who had undergone temporal lobe resection (21 underwent left temporal lobe resection; 15 underwent right temporal lobe resection) for intractable epilepsy and who had completed neuropsychological testing that included a measure of confrontation naming (Boston Naming Test, BNT) and verbal fluency (Delis-Kaplan Executive Function System (D-KEFS) Fluency) prior to and after surgery. Linear mixed effects regression models were used to evaluate presurgery and postsurgery changes and to compare the left temporal lobe resection group with the right temporal lobe resection group.
Confrontation naming performance declined after left, but not right, temporal lobe resection (p<0.05). This effect was not documented for verbal fluency.
Left temporal lobe resection for intractable epilepsy is associated with a decline in lexical retrieval. The risk of decline in specific language functions following surgery involving the left temporal lobe should be incorporated in the counseling of patients and families in decision-making with regard to surgery.
本研究旨在评估接受颞叶切除术治疗难治性癫痫的儿童和青少年术前及术后的词汇检索能力,并比较手术涉及左颞叶或右颞叶的患者的结果。
一项回顾性病历审查从一家主要的儿科癫痫治疗中心确定了36例因难治性癫痫接受颞叶切除术的患者(21例接受左颞叶切除术;15例接受右颞叶切除术),这些患者在手术前后均完成了神经心理学测试,包括一项对命名的测量(波士顿命名测试,BNT)和语言流畅性测试(德利斯-卡普兰执行功能系统(D-KEFS)流畅性测试)。使用线性混合效应回归模型评估术前和术后的变化,并比较左颞叶切除术组和右颞叶切除术组。
左颞叶切除术后命名表现下降,但右颞叶切除术后未下降(p<0.05)。语言流畅性方面未记录到这种影响。
难治性癫痫的左颞叶切除术与词汇检索能力下降有关。在就手术进行决策时,向患者及其家属提供咨询时应纳入涉及左颞叶手术导致特定语言功能下降的风险。