Katz A, Awad I A, Kong A K, Chelune G J, Naugle R I, Wyllie E, Beauchamp G, Lüders H
Department of Neurology, Cleveland Clinic Foundation, Ohio 44195-5228.
Epilepsia. 1989 Nov-Dec;30(6):763-71. doi: 10.1111/j.1528-1157.1989.tb05336.x.
We present correlations of extent of temporal lobectomy for intractable epilepsy with postoperative memory changes (20 cases) and abnormalities of visual field and neurologic examination (45 cases). Postoperative magnetic resonance imaging (MRI) in the coronal plane was used to quantify anteroposterior extent of resection of various quadrants of the temporal lobe, using a 20-compartment model of that structure. The Wechsler Memory Scale-Revised (WMS-R) was administered preoperatively and postoperatively. Postoperative decrease in percentage of retention of verbal material correlated with extent of medial resection of left temporal lobe, whereas decrease in percentage of retention of visual material correlated with extent of medial resection of right temporal lobe. These correlations approached but did not reach statistical significance. Extent of resection correlated significantly with the presence of visual field defect on perimetry testing but not with severity, denseness, or congruity of the defect. There was no correlation between postoperative dysphasia and extent of resection in any quadrant. Assessment of extent of resection after temporal lobectomy allows a rational interpretation of postoperative neurologic deficits in light of functional anatomy of the temporal lobe.
我们展示了难治性癫痫颞叶切除术范围与术后记忆变化（20例）以及视野和神经学检查异常（45例）之间的相关性。术后冠状面磁共振成像（MRI）用于使用颞叶结构的20区模型量化颞叶各象限切除的前后范围。术前和术后均进行韦氏记忆量表修订版（WMS-R）测试。言语材料保留百分比的术后下降与左颞叶内侧切除范围相关，而视觉材料保留百分比的下降与右颞叶内侧切除范围相关。这些相关性接近但未达到统计学意义。切除范围与视野检查中视野缺损的存在显著相关，但与缺损的严重程度、密度或一致性无关。术后任何象限的失语症与切除范围之间均无相关性。根据颞叶的功能解剖，评估颞叶切除术后的切除范围有助于合理地解释术后神经功能缺损。
