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目的探讨智力评估对耐药性癫痫致痫灶的定侧价值。方法回顾性对比分析2011年8月~2013年8月经手术治疗的耐药性癫痫,筛选出105例有随访记录的且其术前智力评估结果中操作得分(PIQ)和言语得分(VIQ)差值大于15分的成人耐药性癫痫患者,比较IQ低值侧其与电生理+影像学得出的综合定位结果,并结合术后疗效分析。结果两者相一致组78例(78/105),吻合率74%。术后随访2~4年,标准按Engel分级,总优良率79%(Ⅰ级+Ⅱ级),83例。其中一致组有70例,占84.3%,非一致组13例,占15.7%。两组疗效对比,一致组优良率为89.7%(70/78),非一致组为48.1%(13/27),两者经统计学处理有显著差异(P<0.01)。结论智力评定VIQ与PIQ差值大于15分,其低值侧对致痫灶侧评估有参考价值,可作为术前评估定侧参考指标之一。
Objective To investigate the diagnostic value of intellectual evaluation of drug-resistant epilepsy seizure-side value. Methods The clinical data of 105 patients with drug-resistant epilepsy who were treated surgically from August 2011 to August 2013 were retrospectively analyzed. The results of PIQ and VIQ in preoperative assessment of intelligence were screened out. Patients with adult drug-resistant epilepsy with a score greater than 15 were eligible for comprehensive mapping of electrophysiological and radiographic findings on the low IQ side, combined with postoperative efficacy analysis. Results The two were consistent with the group of 78 patients (78/105), anastomosis rate of 74%. The patients were followed up for 2 to 4 years. According to the standard Engel classification, the total excellent rate was 79% (Ⅰ grade + Ⅱ grade) and 83 cases. In the same group, there were 70 cases (84.3%) and 13 cases (15.7%) in the non-consistent group. There was significant difference between the two groups (89.7% (70/78) in the unanimous group and 48.1% (13/27) in the unanimous group) (P <0.01). Conclusions The difference between IQQ and PIQ is greater than 15 points. The low value side is valuable for the evaluation of the side of the epileptic foci, which can be used as one of the reference indexes for the preoperative evaluation.