Recurrent seizures may cause hippocampal damage in temporal lobe epilepsy
Recurrent seizures may cause hippocampal damage in temporal lobe epilepsy
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DOI：
10.1212/wnl.50.5.1377
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发表时间：
1998-05-01
期刊：
影响因子：
9.9
通讯作者：
Pitkänen, A
中科院分区：
文献类型：
--
作者：
Kälviäinen, R;Salmenperä, T;Pitkänen, A
目的：探讨颞叶癫痫（TLE）反复发作是否对海马造成损害。患者：研究了18例新诊断的隐源性TLE患者，14例慢性控制良好的隐源性TLE患者，32例慢性耐药隐源性TLE患者和25例健康受试者。测量：使用海马MRI容量测定法和T2弛豫测定法。结果如下：与对照组相比，癫痫灶位于左颞叶的慢性耐药患者的左侧海马小18%，癫痫灶位于右颞叶的慢性耐药患者的右侧海马小14%（p < 0.05）。癫痫病灶位于左侧的慢性耐药患者左侧海马体的T2弛豫时间长于对照组（p < 0.001），癫痫病灶位于右侧的慢性耐药患者右侧海马体的T2弛豫时间长于对照组（p < 0.01）。在所有左侧癫痫病灶的患者中，左侧海马体积与患者经历的部分性（r =-0.391，p < 0.01）或全身性（r =-0.312，p < 0.05）癫痫发作的估计总数呈负相关。海马体左侧T2弛豫时间的延长与部分性（r = 0.670，p < 0.001）和全身性（r = 0.481，p < 0.001）发作的总次数以及TLE症状的持续时间相关（r = 0.580，p < 0.001）。结论：在隐源性癫痫患者中，反复发作可能导致患者终生海马损伤。
Objective: To investigate whether recurrent seizures cause hippocampal damage in temporal lobe epilepsy (TLE). Patients: Eighteen patients with newly diagnosed cryptogenic TLE, 14 patients with chronic well-controlled cryptogenic TLE, 32 patients with chronic drug-resistant cryptogenic TLE, and 25 healthy subjects were studied. Measurements: Hippocampal MRI volumetry and T2 relaxometry were used. Results: Chronic drug-resistant patients with seizure focus in the left temporal lobe had an 18% smaller left hippocampus and chronic drug-resistant patients with seizure focus in the right temporal lobe had a 14% smaller right hippocampus than did the control group (p < 0.05). Chronic drug-resistant patients with seizure focus on the left side had longer T2 relaxation times in the body of the left hippocampus than did the control group (p < 0.001) and chronic drug-resistant patients with seizure focus on the right side had longer T2 relaxation times in the body of the right-hippocampus than did the control subjects (p < 0.01). In all patients with a left seizure focus, the left hippocampal volume correlated inversely with the estimated total number of partial (r = -0.391, p < 0.01) or generalized (r = -0.312, p < 0.05) seizures the patient had experienced. The prolongation of the left T2 relaxation time in the body of the hippocampus correlated with the total number of both partial (r = 0.670, p < 0.001) and generalized (r = 0.481, p < 0.001) seizures and with the duration of TLE symptoms (r = 0.580, p < 0.001). Conclusions: In patients with cryptogenic epilepsy, recurrent seizures may cause damage to the hippocampus throughout the lifetime of the patient.