摘要
目的探讨迷走神经刺激术对药物难治性癫痫患者认知功能的影响及其相关因素。方法 2014年1月至2015年4月收治符合标准药物难治性癫痫40例,均经MRI、视频脑电图、PET或SPECT等检查与评估后行迷走神经刺激术治疗。采用蒙特利尔认知功能量表进行认知功能评定,根据中国修订版韦氏成人智力量表、中国修订版韦氏记忆测验量表等评估言语智商、操作智商。结果术后3、6、12个月蒙特利尔认知功能量表评分分别为(22.3±4.6)分、(23.5±3.1)分、(25.2±2.9)分,均显著高于术前[(18.9±3.5)分;P<0.05]。单因素分析和多元线性回归分析显示年龄、抗癫痫药物服用种类显著影响患者言语智商(P<0.05),致病灶位置、全面强直阵挛发作、癫痫发作频率显著影响患者操作智商(P<0.05)。结论迷走神经刺激术能有效改善药物难治性癫痫患者认知功能,但治疗前需对患者认知功能进行评估,减少或去除相关影响因素,选取对患者认知功能影响较小的药物、手术进行干预治疗,最大程度控制癫痫发作,减轻癫痫对患者认知功能造成的损害。
Objective To study the change in cognitive function in the patients with intractable epilepsy （IE） treated by vagus nerve stimulation （VNS）, and analyze the factors related to the change in the cognitive function. Methods MRI, video electroencephalograph or single photon emission computed tomography were performed in 40 patients with IE admitted to the hospital fron~ January, 2014 to April, 2015. All the patients were treated by VNS. The changes in the cognitive function after VNS were observed and its related factors were analyzed in all the patients. Results The cognitive function scores, which were （22.3±4.6） points, （23.5±3.1） points, （25.2±2.9） points respectively 3, 6, 12 months after the VNS, were significantly higher respectively than that [（18.9±3.5） points] before VNS in these patients （P〈0.05）. The cognitive function was significantly related to the patients＇ age, types of anti-epileptic drug, site of epileptogenie focus, epileptics with generalized tonic clonic seizure and frequency of epileptic seizure in the patients with IE after VNS （P〈0.05）. Conclusion VNS can effectively improve patients＇ cognitive function in the patients with IE. But patients＇ cognition should De evaluated before treatment so as to reduce or eliminate the effects of the related factors. Selecting drug with less effect on the cognitive function, controlling the generalized tonic tonic seizure and frequency of epileptic seizure and so on are helpful to improvement of the cognitive function in the patients with IE after VNS.
出处
《中国临床神经外科杂志》
2017年第3期142-144,共3页
Chinese Journal of Clinical Neurosurgery
