Linguistic deficits following left selective amygdalohippocampectomy: a prospective study
Linguistic deficits following left selective amygdalohippocampectomy: a prospective study
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DOI：
10.1016/j.yebeh.2004.02.004
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发表时间：
2004-06-01
影响因子：
2.6
通讯作者：
Benke, T
中科院分区：
文献类型：
--
作者：
Bartha, L;Trinka, E;Benke, T
本文报告了10例难治性左侧颞叶癫痫患者选择性杏仁核-海马区切除术前后的语言障碍。在手术前，在三名患者中观察到了轻微的语言缺陷；在另外一名患者中检测到了孤立的轻微命名缺陷。术后3个月，6例患者的语言功能无变化，而4例患者的语言功能明显下降。所有四名患者都表现出非常相似的语言综合征，特征是语言理解和流利性降低，说话清晰，经常找词困难，迂回和语义性错语，没有任何语音障碍。这些赤字在12个月的随访期内保持稳定。然而，磁共振成像没有显示任何切除区域外的新皮质病变。这些发现的可能解释包括皮质区域的神经细胞丢失和去感觉化，基本的颞叶语言区通路的中断，慢性颞叶癫痫的语言网络的重组，以及手术干预引起的新皮质损伤。此外，我们的患者的语言和人口统计学数据之间的相关性表明，癫痫发作时年龄较大的患者发生术后语言障碍的风险更大。(C)2004 Elsevier Inc.保留所有权利。
Language deficits in 10 patients with medically intractable left-sided temporal lobe epilepsy prior to and following selective amygdalohippocampectomy are described. Preoperatively, a pattern of minor linguistic deficits was observed in three patients; isolated minor naming deficits were detectable in one additional patient. Three months after surgery, six patients' linguistic functions were unchanged, whereas in four patients, a significant decline in linguistic functions could be observed. All four patients revealed a very similar language syndrome characterized by reduced language comprehension and fluency, well-articulated speech, frequent word-finding difficulties, circumlocutions, and semantic paraphasias in the absence of any phonological disorder. These deficits remained stable during the 12-month follow-up period. However, magnetic resonance imaging did not show any neocortical lesions outside the resection area. Possible explanations for these findings include neuronal cell loss and deafferentiation in cortical areas, disruption of the basal temporal language area pathways, reorganization of the language network in chronic temporal lobe epilepsy, and neocortical lesions due to the surgical intervention. Furthermore, correlations between linguistic and demographic data for our patients suggest that patients older at epilepsy onset are at greater risk for developing postoperative language deficits. (C) 2004 Elsevier Inc. All rights reserved.