Neuropsychological characteristics of the syndrome of mesial temporal lobe epilepsy
Neuropsychological characteristics of the syndrome of mesial temporal lobe epilepsy
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DOI：
10.1001/archneur.1997.00550160019010
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发表时间：
1997-04-01
影响因子：
--
通讯作者：
Davies, K
中科院分区：
文献类型：
--
作者：
Hermann, BP;Seidenberg, M;Davies, K
目的：使用广泛而全面的神经心理学测试组，确定内侧颞叶癫痫 (MTLE) 综合征的神经心理学特征，MTLE 是一种通过手术可治愈的癫痫综合征，定义为存在海马硬化。地点：癫痫手术中心。患者：经过头皮和侵入性脑电图监测，连续系列 107 名成人被发现患有单侧左侧难治性复杂部分性癫痫发作(n=62) 或右 (n=45) 颞叶起源。如果患者没有发育迟缓，且左半球有言语优势，但除海马硬化外没有磁共振成像异常，则患者被纳入研究。切除海马的组织病理学分析显示，66 名患者患有海马硬化症 (MTLE+)，41 名患者没有明显海马硬化症 (MTLE-) 的证据。干预措施：无。主要相关测量：一系列全面的神经心理学测试，包括智力、学业成绩、语言、视觉知觉或视觉空间功能、记忆和学习、注意力和解决问题的测量结果：MTLE 综合征与相当大的广泛性认知障碍（智力、学业成绩、语言和视觉空间功能）相关，但与其他选定认知领域（注意力或集中力、执行功能）的表现是否充分相关。获得了材料特异性记忆效应——主要是与左侧 MTLE 相关的言语记忆。结论： MTLE 综合征的特征是幸存、受损和侧向特异性认知障碍的独特神经心理学特征。该信息需要纳入正式的综合征标准。
Objective: To identify the neuropsychological features of the syndrome of mesial temporal lobe epilepsy (MTLE), a surgically remediable epileptic syndrome defined by the presence of hippocampal sclerosis, using a broad and comprehensive neuropsychological test battery.Setting: Epilepsy surgery center.Patients: After scalp and invasive electroencephalographic monitoring, a consecutive series of 107 adults were found to have intractable complex partial seizures of unilateral left (n=62) or right (n=45) temporal lobe origin. Patients were included if they were not retarded and had left hemisphere dominance for speech but no magnetic resonance imaging abnormalities other than hippocampal sclerosis. Histopathological analyses of resected hippocamppi showed that 66 patients had hippocampal sclerosis (MTLE+), and 41 did not have evidence of significant hippocampal sclerosis (MTLE-).Interventions: None.Main Dependent Measures: A comprehensive battery of neuropsychological tests that included measures of intelligence, academic achievement, language, visuoperceptual or visuospatial function, memory and learning, attention, and problem-solving abilities.Results: The syndrome of MTLE was associated with considerable generalized cognitive impairment (in intelligence, academic achievement, language, and visuospatial functions), but not related to adequacy of performances in other selected cognitive domains (attention or concentration, executive functions). Material-specific memory effects were obtained--primarily for verbal memory in association with left-sided MTLE.Conclusions: Distinct neuropsychological features of spared, compromised, and laterality-specific cognitive impairments characterize the syndrome of MTLE. This information needs to be incorporated into formal syndrome criteria.