Application of MEG combined with Wada test in preoperative evaluation of epilepsy
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摘要:
目的 探讨脑磁图联合Wada test对癫痫患者语言和记忆功能术前评估的价值。 方法 回顾26例癫痫患者的术前痫灶定位和神经心理评估资料。患者联合应用脑磁图及Wada test确定语言、记忆优势半球，明确语言功能区范围和记忆功能情况，并指导手术治疗。对比分析术前与术后1年患者智商、记忆和语言功能变化。 结果 26例癫痫患者脑磁图和Wada test检查过程顺利，均能确定语言功能区及记忆优势半球，20例语言优势半球为左侧，6例在右侧。14例记忆优势半球位于左侧，8例位于右侧，4例双侧半球。术后1年患者言语智商与总智商提高（P<0.05），记忆商、操作智商无明显变化（P>0.05）。记忆优势半球及非优势半球比较，记忆评分差异明显（P<0.05）。 结论 脑磁图能够精确定位语言功能区位置。Wada test可以评估患者记忆功能。脑磁图联合Wada test可在术前准确定位语言功能区位置，了解记忆功能情况，对指导手术切除范围，避免术后语言、记忆功能损伤具有重要意义。 Abstract:Objective To investigate the role of MEG combined with Wada test in the assessment of language and memory function in epilepsy patients before surgery. Methods Twenty-six cases of epilepsy patients, preoperative localization of epileptogenic focus and neuropsychological assessment; the combination of MEG and Wada test, to determine the language memory, dominant hemisphere, clear language function area and memory function. IQ, Memory, language function of patients were compared before and 1 year after surgery. Results Twenty-six patients with epilepsy were checked by MEG and Wada test the process smoothly, can lateralization of language and memory of the dominant hemisphere, 20 cases of left hemisphere language dominance, 6 cases were located on the left side on the right side of the. 14 memory of the dominant hemisphere, 8 cases located in the right hemisphere, 4 cases of bilateral.MEG can accurately locate the position of the. WADA language function can be evaluated in patients with memory comparison of memory function. The IQ, memory and language function were measured before and after 1 year. Verbal IQ and total IQ increased (P<0.05), and no significant change in memory quotient and operation IQ (P>0.05). The dominant hemisphere and non dominant hemisphere, memory score was significant (P<0.05). Conclusion Wada test recovered well after operation, without serious language and memory impairment. MEG combined with Wada test can accurately locate the lateral language, memory the dominant hemisphere, and understand the memory function before operation. It is of great significance for guiding the resection range and avoiding postoperative complications. -
Key words:
- MEG /
- Wada test /
- language /
- memory /
- preoperative evaluation
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表 1 26例患者Wada test结果对比分析（Mean±SD）
项目 T3/5 T5/5 Tverb Tnverb 记忆评分 语言优势半球 200±116 364±132 246±148 273±159 - 非语言优势半球 215±76 329±111 76±82 72±67 - t 0.721 0.925 2.512 2.715 - P 0.44 0.38 0.02 0.01 - 记忆优势半球 198±121 351±125 252±133 286±154 12±2.9 非记忆优势半球 221±99 338±122 89±91 107±75 5±3.2 t 1.807 0.987 2.103 2.109 2.651 P 0.32 0.36 0.03 0.03 0.01 
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表 2 26例患者手术前后智商对比分析（Mean±SD）
项目 总智商 言语智商 操作智商 记忆商 术前 87.81±10.91 75.37±8.33 101.54±16.18 80.73±9.03 术后 98.17±9.46 86.93±10.16 99.11±12.46 83.82±7.91 t 2.566 2.213 0.972 1.467 P 0.013 0.019 0.348 0.176
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