White Matter Tracts in Patients with Temporal Lobe Epilepsy: Pre- and Postoperative Assessment.
White Matter Tracts in Patients with Temporal Lobe Epilepsy: Pre- and Postoperative Assessment.
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DOI：
10.7759/cureus.1735
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发表时间：
2017-10-01
期刊：
影响因子：
--
通讯作者：
Khan AR
中科院分区：
文献类型：
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作者：
Salehi F;Sharma M;Peters TM;Khan AR
顽固性颞叶癫痫（TLE）患者接受手术切除前颞叶。TLE患者的术前评估涉及多学科评估，可能涉及使用侵入性脑电图（EEG）记录在不明确的情况下癫痫发作病灶的侧化。了解TLE中受影响的白质纤维束有助于术前侧位和规划。我们研究了6例接受手术切除的TLE患者术前和术后白质纤维束的变化。我们的研究结果表明，胼胝体的变化具有高度特异性，100%的患者（6 / 6）具有侧化致痫侧的能力。所有白质束不同受累程度的患者均发现对侧改变。术后，大多数患者（6名患者中的5名）表现出同侧神经束的进一步改变，其中3名患者表现出对侧异常。我们提供了TLE患者术前和术后白质纤维束的详细评估，并证实同侧胼胝体的异常可能有助于术前侧化和避免侵入性脑电图监测的需要。
Patients with intractable temporal lobe epilepsy (TLE) undergo surgical resection of the anterior temporal lobe. Preoperative assessment of TLE patients involves a multidisciplinary assessment and may involve the use of invasive electroencephalogram (EEG) recording for lateralization of seizure focus in ambiguous cases. Understanding the white matter fibre tracts affected in TLE may assist in preoperative lateralization and planning. We studied pre- and postoperative white matter fibre tract changes in six patients with TLE who underwent surgical resection. Our results indicate that changes in the corpus callosum are highly specific, with the ability to lateralize the epileptogenic side in 100% of our patients (six of six). Contralateral changes were found in all patients with variable involvement of white matter tracts. Postoperatively, most patients (five of six) exhibited further changes to the tracts on the ipsilateral side, with three patients showing contralateral abnormalities. We provide a detailed assessment of pre- and postoperative white matter fibre tracts in patients with TLE and confirm that abnormalities in the ipsilateral corpus callosum may aid in preoperative lateralization and obviate the need for invasive EEG monitoring.