측두엽간질에서 수술의 절제범위가 수술 후 발작과 기억력의 예후에 미치는 영향
The Effect of Resection Extent Upon Postoperative Outcome of Seizures and Memory in Anterior Temporal Lobectomywith Amygdalohippocampectomy
주은연, 이은경, 태우석, 김지현, 한선정, 진주희, 서대원, 홍성철, 이문향, 변홍식, 김명희, 김승환, 홍승봉,
소속 상세정보
주은연 ( Joo Eun-Yeon )
성균관대학교 의과대학 삼성서울병원 신경과학교실
이은경 ( Lee Eun-Kyung )
성균관대학교 의과대학 삼성서울병원 신경과학교실
태우석 ( Tae Woo-Suk )
성균관대학교 의과대학 삼성서울병원 신경과학교실
김지현 ( Kim Jee-Hyun )
성균관대학교 의과대학 삼성서울병원 신경과학교실
한선정 ( Han Sun-Jung )
성균관대학교 의과대학 삼성서울병원 신경과학교실
진주희 ( Chin Ju-Hee )
성균관대학교 의과대학 삼성서울병원 신경과학교실
서대원 ( Seo Dae-Won )
성균관대학교 의과대학 삼성서울병원 신경과
홍성철 ( Hong Seung-Chyul )
성균관대학교 의과대학 삼성서울병원 신경외과학교실
이문향 ( Lee Mun-Hyang )
성균관대학교 의과대학 삼성서울병원 소아과학교실
변홍식 ( Byun Hong-Sik )
성균관대학교 의과대학 삼성서울병원 영상의학과
김명희 ( Kim Myoung-Hee )
이화여자대학교 컴퓨터학과
김승환 ( Kim Seung-Hwan )
포항공과대학교 물리학과
홍승봉 ( Hong Seung-Bong )
성균관대학교 의과대학 삼성서울병원 신경과학교실
KMID : 0877220040080010054
Abstract
Purpose：To investigate the relationship of the resection extent of hippocampus and temporal neocortex with the postsurgical outcome in patients with mesial temporal lobe epilepsy (TLE).
Methods：Sixty-eight patients with TLE underwent brain MRI pre- and post-operatively. They were divided into two groups by seizure outcomes：seizure free group (SF, N=54) and non-seizure free group (NSF, N=14). Patients were classified further according to the post-surgical memory changes：MD group (with postsurgical memory decline, N=15) and NMD group (without postsurgical memory decline, N=16). The hippocampal resection was estimated by subtracting the length of post-surgical hippocampus from the pre-surgical length. The resection of temporal neocortex was measured by comparing the resection lengths on superior, middle, inferior and basal temporal gyri shown on three dimensional brain MRI.
Results：The mean extent of hippocampal resection was significantly larger in SF than in NSF (33.2±7.5 mm vs. 24.8±7.4 mm p=0.001) while that between MD and NMD was not significantly different. The resection extent of temporal neocortex was not significantly different between SF and NSF as well as between MD and NMD, but the resection extent of basal temporal gyrus of left TLE was significantly larger in MD than in NMD.
Conclusions：The hippocampal resection was significantly greater in SF. The overall resection extent of the temporal neocortex did not correlate to the surgical outcomes of seizures or memory although that of the basal temporal gyrus of the left TLE was larger in MD.
키워드
Temporal lobe epilepsy;Anterior temporal lobe-ctomy;Hippocampus;Neocortex;Outcome;Memory
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