Abstract：
OBJECTIVE: This study was performed with the purpose of analysing the relationship between epileptological and surgical variables and post-operative memory performance, following surgery for refractory mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS).
METHODS: Logical memory (LM) and visual memory (VM) scores for immediate and late follow-up of 201 patients operated for MTLE/HS were reviewed. Scores were standardized with a control group of 54 healthy individuals matched for age and education. The Reliable Change Index (RCI) was calculated to verify individual memory changes for late LM and VM scores. A multiple linear regression analysis was carried out with the RCI, using LM and VM scores as well as the clinical variables.
RESULTS: A total of 112 (56%) patients had right HS. The RCI of the right HS group demonstrated that 6 (7%) patients showed improvement while 5 (6%) patients showed decreased scores in late LM; for late VM, 7 (8%) patients presented improvement, and 2 (3%) patients showed poorer scores. RCI of the left HS group showed that 3 (3%) individuals showed improved scores, while scores of 5 (4%) patients worsened for late LM; for late VM, 3 (3%) patients presented higher scores and 6 (5%) showed lower scores. Left HS and advanced age at onset of the first epileptic seizure were predictors of late LM loss (p<.05).
CONCLUSIONS: Left MTLE/HS and seizure onset at advanced ages were predictive factors for the worsening of late LM. We observed poorer baseline LM function in the left HS group and improvement of LM in some patients who had resection of the right MTL. Patients in the right HS group showed a higher percentage of reliable post-operative improvement for both VM and LM scores.
METHODS: Logical memory (LM) and visual memory (VM) scores for immediate and late follow-up of 201 patients operated for MTLE/HS were reviewed. Scores were standardized with a control group of 54 healthy individuals matched for age and education. The Reliable Change Index (RCI) was calculated to verify individual memory changes for late LM and VM scores. A multiple linear regression analysis was carried out with the RCI, using LM and VM scores as well as the clinical variables.
RESULTS: A total of 112 (56%) patients had right HS. The RCI of the right HS group demonstrated that 6 (7%) patients showed improvement while 5 (6%) patients showed decreased scores in late LM; for late VM, 7 (8%) patients presented improvement, and 2 (3%) patients showed poorer scores. RCI of the left HS group showed that 3 (3%) individuals showed improved scores, while scores of 5 (4%) patients worsened for late LM; for late VM, 3 (3%) patients presented higher scores and 6 (5%) showed lower scores. Left HS and advanced age at onset of the first epileptic seizure were predictors of late LM loss (p<.05).
CONCLUSIONS: Left MTLE/HS and seizure onset at advanced ages were predictive factors for the worsening of late LM. We observed poorer baseline LM function in the left HS group and improvement of LM in some patients who had resection of the right MTL. Patients in the right HS group showed a higher percentage of reliable post-operative improvement for both VM and LM scores.
摘要：
目的：本研究旨在分析癫痫和手术变量与术后记忆表现之间的关系，术后因海马硬化（HS）引起的难治性内侧颞叶癫痫（MTLE）。
方法：回顾了201例MTLE/HS手术患者的即时和晚期随访的逻辑记忆（LM）和视觉记忆（VM）评分。用年龄和教育程度相匹配的54名健康个体的对照组对分数进行标准化。计算可靠变化指数(RCI)以验证晚期LM和VM分数的个体记忆变化。使用LM和VM评分以及临床变量对RCI进行多元线性回归分析。
结果：总共112例（56%）患者有正确的HS。右HS组的RCI显示6例(7%)患者在晚期LM中表现出改善,而5例(6%)患者表现出降低的评分;对于晚期VM,7例（8%）患者出现改善，2例（3％）患者的评分较差。左HS组的RCI显示3（3％）个人得分提高，而5例(4%)患者的晚期LM评分恶化；对于晚期VM，3例（3％）患者得分较高，6例（5％）得分较低。左HS和首次癫痫发作时的高龄是晚期LM丢失的预测因素（p<0.05）。
结论：左MTLE/HS和高龄时癫痫发作是晚期LM恶化的预测因素。我们观察到左侧HS组的基线LM功能较差，而一些切除右侧MTL的患者的LM改善。正确的HS组患者的VM和LM评分的术后可靠改善百分比更高。
方法：回顾了201例MTLE/HS手术患者的即时和晚期随访的逻辑记忆（LM）和视觉记忆（VM）评分。用年龄和教育程度相匹配的54名健康个体的对照组对分数进行标准化。计算可靠变化指数(RCI)以验证晚期LM和VM分数的个体记忆变化。使用LM和VM评分以及临床变量对RCI进行多元线性回归分析。
结果：总共112例（56%）患者有正确的HS。右HS组的RCI显示6例(7%)患者在晚期LM中表现出改善,而5例(6%)患者表现出降低的评分;对于晚期VM,7例（8%）患者出现改善，2例（3％）患者的评分较差。左HS组的RCI显示3（3％）个人得分提高，而5例(4%)患者的晚期LM评分恶化；对于晚期VM，3例（3％）患者得分较高，6例（5％）得分较低。左HS和首次癫痫发作时的高龄是晚期LM丢失的预测因素（p<0.05）。
结论：左MTLE/HS和高龄时癫痫发作是晚期LM恶化的预测因素。我们观察到左侧HS组的基线LM功能较差，而一些切除右侧MTL的患者的LM改善。正确的HS组患者的VM和LM评分的术后可靠改善百分比更高。
