无创性识别儿童癫痫病灶侧别：猜猜这是什么。
Noninvasive identification of seizure lateralization in children: Name that thing.
机构信息
From the Department of Neurology (M.J.H.), Columbia University, New York; New York University (W.S.M.), NY; Tris Pharma, Inc. (W.T.S.), Monmouth Junction, NJ; Epilepsy Center (R.M.B.), and Department of Psychiatry and Psychology (P.K.), Cleveland Clinic, OH; Department of Psychology (C.M.S.), University of Florida Hospital for Children, Orlando; and Department of Psychology (M.L.S.), University of Toronto, Mississauga, Canada. W.S.M. is currently at Alberta Children's Hospital Research Institute, Canada. C.M.S. is currently at Space Coast Neuropsychology Center, Melbourne, FL.
出版信息
Neurology. 2019 Jan 1;92(1):e1-e8. doi: 10.1212/WNL.0000000000006691. Epub 2018 Dec 5.
OBJECTIVE
With this prospective, observational study, we aimed to determine whether noninvasive language tasks, developed specifically for children, could reliably identify the hemisphere of seizure onset in pediatric epilepsy.
METHODS
Seventy-eight children with unilateral epilepsy (44 left), aged 6-15 years (mean age = 11.8, SD = 2.6), completed the Children's Auditory Naming and Visual Naming Tests, the Boston Naming Test, and other verbal and nonverbal tasks. Multivariate analysis of variance was used to compare test performance between left and right hemisphere epilepsy groups, and χ analyses and odds ratios were used to examine classification of left vs right hemisphere epilepsy for individual patients based on test performance.
RESULTS
Group comparisons revealed poorer auditory naming in children with left hemisphere epilepsy ( = 0.02), yet no significant differences on measures of visual naming, general intelligence, or other cognitive functions. Moreover, χ analyses using auditory naming cutoff scores to define intact vs impaired performance correctly classified seizure laterality in a significant proportion of children ( = 0.004). The odds of left hemisphere epilepsy were 4.2 times higher (95% confidence interval 1.4-11.7) than the odds of right hemisphere epilepsy with poor auditory naming performance. In the subset of patients with temporal lobe epilepsy (TLE), the odds of left TLE were 11.3 times higher (95% confidence interval 2.00-63.17) than the odds of right TLE with poor auditory naming performance.
CONCLUSION
Contrary to previous findings, naming performance can lateralize hemisphere of seizure onset in children with epilepsy, thereby assisting in the preoperative workup for pediatric epilepsy surgery.
目的
本前瞻性观察研究旨在确定专门针对儿童开发的非侵入性语言任务是否能够可靠地确定儿科癫痫患者的癫痫起始半球。
方法
78 名单侧癫痫儿童（44 名左侧），年龄 6-15 岁（平均年龄=11.8，标准差=2.6），完成了儿童听觉命名和视觉命名测试、波士顿命名测试和其他言语和非言语任务。使用多元方差分析比较左、右半球癫痫组之间的测试表现，使用 χ 分析和优势比检查基于测试表现对个体患者的左、右半球癫痫进行分类。
结果
组间比较显示，左半球癫痫儿童的听觉命名能力较差（ = 0.02），但在视觉命名、一般智力或其他认知功能方面无显著差异。此外，使用听觉命名截断分数来定义完整与受损表现的 χ 分析正确地在相当一部分儿童中分类了癫痫的侧别（ = 0.004）。听觉命名表现差的左半球癫痫的可能性是右半球癫痫的 4.2 倍（95%置信区间 1.4-11.7）。在颞叶癫痫（TLE）患者亚组中，听觉命名表现差的左 TLE 的可能性是右 TLE 的 11.3 倍（95%置信区间 2.00-63.17）。
结论
与先前的发现相反，命名表现可以在癫痫儿童中确定癫痫起始半球的侧别，从而有助于儿科癫痫手术的术前评估。
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