Perrine K, Westerveld M, Sass K J, Devinsky O, Dogali M, Spencer D D, Luciano D J, Nelson P K
Department of Neurology, NYU School of Medicine, New York, USA.
Epilepsia. 1995 Sep;36(9):851-6. doi: 10.1111/j.1528-1157.1995.tb01627.x.
We examined the efficacy of a memory difference score (DS: right minus left hemisphere memory) during the Wada test (intracarotid amobarbital procedure, IAP) for predicting seizure laterality and postoperative seizure outcome in 70 left speech dominant patients from two epilepsy centers. DS > or = 2, after addition of 1 point to the left hemisphere injection score to account for aphasia, were noted in 71.4% of patients and correctly predicted surgery side for 98.0% of these patients. The DS related significantly to seizure outcome at 1-year follow-up (p < 0.002) and correctly predicted 80% of patients who were seizure-free. Patients whose DS did not correctly predict seizure laterality more frequently required invasive studies to establish seizure onset. The relationship of the DS to laterality did not differ significantly by class of IAP memory stimuli. When seizures originate from the temporal lobe, the IAP memory DS predicts seizure laterality by assessing the functional adequacy of the involved hemisphere and is predictive of seizure control.
我们在来自两个癫痫中心的70例左侧语言优势患者中，研究了在Wada测试（颈动脉内注射异戊巴比妥试验，IAP）期间记忆差异评分（DS：右半球记忆减去左半球记忆）对预测癫痫发作侧别和术后癫痫发作结局的有效性。在71.4%的患者中观察到DS≥2，为解释失语症，给左半球注射评分加1分后，这些患者中有98.0%的手术侧别预测正确。DS与1年随访时的癫痫发作结局显著相关（p<0.002），并正确预测了80%无癫痫发作的患者。DS未正确预测癫痫发作侧别的患者更频繁地需要进行侵入性检查以确定癫痫发作起始部位。DS与侧别的关系在IAP记忆刺激类别之间无显著差异。当癫痫发作起源于颞叶时，IAP记忆DS通过评估受累半球的功能充足性来预测癫痫发作侧别，并可预测癫痫控制情况。
