Han Su Hyun, Lee Eun Mi, Choi Eun Ju, Ryu Han Uk, Kang Joong Koo, Chung Jong Woo
Department of Neurology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
Department of Neurology, Chung-Ang University College of Medicine, Seoul, Korea.
J Clin Neurol. 2016 Apr;12(2):151-9. doi: 10.3988/jcn.2016.12.2.151.
This study aimed to determine the effects of anterior temporal lobectomy with amygdalohippocampectomy (ATL-AH) on central auditory processing (CAP) in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE-HS), and to identify factors that may contribute to the postoperative worsening of CAP.
Frequency-pattern, duration-pattern, and dichotic tests were performed before and after epilepsy surgery in 22 patients with normal hearing according to pure-tone audiometry.
No significant difference in CAP scores was detected between pre- and postoperative tests, but there was a strong association between surgery in the language-dominant temporal lobe and postoperative worsening in the non-dominant-side dichotic test (p<0.05). The probability of a decreased performance in a non-dominant-side dichotic test after surgery was 7.5-fold greater in patients who underwent surgery on the dominant temporal lobe compared with the nondominant temporal lobe. No significant association of postoperative worsening in CAP with the verbal, nonverbal intelligence quotient, or right- or left-side lobectomy was noted.
These results suggest that ATL-AH on the dominant side in patients with mTLE-HS worsens the CAP ability in the non-dominant-side dichotic test.
本研究旨在确定前颞叶切除术联合杏仁核海马切除术（ATL-AH）对内侧颞叶癫痫伴海马硬化（mTLE-HS）患者中枢听觉处理（CAP）的影响，并确定可能导致术后CAP恶化的因素。
对22例根据纯音听力测定听力正常的癫痫患者在癫痫手术前后进行频率模式、时长模式和双耳分听测试。
术前和术后测试的CAP评分无显著差异，但语言优势侧颞叶手术与非优势侧双耳分听测试术后恶化之间存在强关联（p<0.05）。与非优势侧颞叶手术的患者相比，优势侧颞叶手术的患者术后非优势侧双耳分听测试表现下降的可能性高7.5倍。未发现CAP术后恶化与言语、非言语智商或右侧或左侧叶切除术有显著关联。
这些结果表明，mTLE-HS患者优势侧的ATL-AH会使非优势侧双耳分听测试中的CAP能力恶化。
