Fujimoto Ayataka, Okanishi Tohru, Nishimura Mitsuyo, Kanai Sotaro, Sato Keishiro, Enoki Hideo
Seirei Hamamatsu General Hospital, Comprehensive Epilepsy Center, Japan.
Seirei Hamamatsu General Hospital, Comprehensive Epilepsy Center, Japan.
J Clin Neurosci. 2017 Nov;45:319-323. doi: 10.1016/j.jocn.2017.08.011. Epub 2017 Sep 7.
Cerebral hemispherotomy is a surgical method with a high rate of seizure reduction in patients with intractable epilepsy. However, there is a probability of postoperative motor deficits. The objective of this study was to investigate whether the Wada test can help predict motor function outcomes after hemispherotomy and, therefore, may be useful in decision-making and patient selection.
A total of 13 patients with hemispherical intractable epilepsy underwent hemispherical disconnection surgeries. Six of them underwent the Wada test to evaluate motor function and language function followed by peri-insula hemispherotomy. The patients' age ranged from 11 to 45years (mean 27years).
Three of six patients had reduced dexterity on the Wada test. The finger motor function in the other patients did not change on the Wada test. Postoperatively, all patients who had decreased fine motor movement on the Wada test showed postoperative clumsiness of their hands and fingers.
The Wada test might predict postoperative fine finger motor deficit after hemispherotomy. This study showed that gross motor function was compensated in the ipsilateral hemisphere, whereas fine finger motor movement function remained in the contralateral frontal cortex.
大脑半球切除术是一种可有效减少顽固性癫痫患者癫痫发作频率的手术方法。然而，术后存在出现运动功能障碍的可能性。本研究的目的是探究Wada试验是否有助于预测大脑半球切除术后的运动功能结果，进而在决策制定和患者选择方面发挥作用。
共有13例半球性顽固性癫痫患者接受了半球离断手术。其中6例患者接受了Wada试验以评估运动功能和语言功能，随后进行了岛周半球切除术。患者年龄在11至45岁之间（平均27岁）。
6例患者中有3例在Wada试验中表现出灵活性下降。其他患者的手指运动功能在Wada试验中未发生变化。术后，所有在Wada试验中精细运动减少的患者均出现了手部和手指术后笨拙的情况。
Wada试验可能预测大脑半球切除术后的手指精细运动功能障碍。本研究表明，同侧半球的总体运动功能得到了代偿，而手指精细运动功能仍保留在对侧额叶皮质中。
