| 내측두엽간질 환자에서 재단식 전측두엽절제술이 사고력과 기억력에 미치는 효과 |
| 권오대, 김지언*·김진석·이상도 |
| 계명대학교 의과대학 신경과학교실,대구가톨릭대학교 의과대학 신경과학교실*,안동병원 신경과 |
| Effects of Tailored Anterior Temporal Lobectomy on Intelligence and Memory Function in Patients with Mesial Temporal Lobe Epilepsy |
| O-Dae Kwon, M.D., Ji-Eun Kim, M.D.*, Jin-Suk Kim, M.D.†, Sang-Doe Yi, M.D., Ph.D |
| Department of Neurology, Keimyung University, School of Medicine Department of Neurology, Catholic University of Daegu, School of Medicine*Department of Neurology, Andong Medical Center† |
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| Abstract |
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"Background : There exist considerable debates concerning about the effects of epilepsy surgery on cognitive func-tion.
To evaluate the effects of tailored anterior temporal lobectomy with amygdalohippocampectomy (ATLAH) on
intelligence and memory, we compared the pre- and post-operative cognitive function in patients with mesial temporal
lobe epilepsy (MTLE). Methods : Thirty six patients who received unilateral tailored ATLAH from 1993 to 1997 and
had been seizure-free for at least two years postoperatively were selected. Mean age at the time of surgery was 26.8
years and mean period of postoperative follow-up was 47 months. The change of cognitive function was assessed pre-and
post-operatively using Korean Wechsler Adult Intelligence Scale (K-WAIS) and Rey memory test. We also
assessed the correlation between the extent of hippocampal and lateral temporal cortical resection and cognitive changes
respectively. Results : In total patients (N=36), there was statistically significant improvement in performance IQ (PIQ,
p<0.05), full scale IQ (FIQ, p<0.05), and auditory verbal learning test (AVLT). In the right temporal lobectomy group
(N=16), improvement in PIQ, FIQ, and AVLT reached to statistical significance (p<0.05). In the left temporal lobecto-my
group (N=20), improvement in PIQ was significant (p<0.05). In terms of the size of resection, there were tendencies
that the cognitive function is more improved in patients with larger hippocampal resection (>2 cm) and in patients with
smaller temporal cortical resection (4 cm). Conclusions : Patients became seizure free after tailored ATLAH may have
improvement in performance IQ and full scale IQ. Right side resection, larger hippocampal resection, and smaller later-al
temporal resection show better postoperative cognitive function.
J Korean Neurol Assoc 19(2):116~124, 2001
Key Words : Temporal lobe epilepsy, Surgical outcome, Intelligence, Memory" |
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