1999 Fiscal Year Final Research Report Summary
Brain function analysis using intracranial electrodes in epileptic patients
| Project/Area Number |
09307031
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| Research Category |
Grant-in-Aid for Scientific Research (A)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Cerebral neurosurgery
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| Research Institution | Tokyo Women's Medical University (1998-1999)
Tottori University (1997) |
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Principal Investigator |
HORI Tomokatsu Tokyo Women's Medical University Professor & Chairman, 医学部, 教授 (60010443)
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| Co-Investigator(Kenkyū-buntansha) |
TAKENOBU Atsumi Tokyo Women's Medical University Assistant Professor, 医学部, 助手 (40183454)
TAIRA Takaomi Tokyo Women's Medical University Assistant, 医学部, 助手 (30167481)
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| Project Period (FY) |
1997 – 1999
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| Keywords | Hippocampus / Amygdala / Memory test / Temporal lobe epilepsy / Mapping / Emotion / Language / Eloquent |
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| Research Abstract |
1) In treating low-grade gliomas(10) or intractable nonlesional epielpsy(8), surgical planning must also take into account to escape from serious neurological sequelae resulting from injury of eloquent cortex.. In these patients, pre- or intraoperative mapping of eloquent cortex is indispensable to do sufficient removal of the lesion without damage of eloqunet cortex.. On the other hand, mapping data of these eloquent cortices in individual patient have been standardized using Talairach's orthogonal axes.
2) To predict memory dysfunction after hippocampectomy, the authors tested verbal learning during hippocampal stimulation in eight patients with intractable temporal epilepsy. All patients but one had passed the amytal memory test, and intracranial EEG recording had detected a unilateral temporal focus in five patients and bilateral temporal. The stimulation-recall test was repeated twice using another wored set. Of the five patients with a unilateral focus, three had an unchanged reca
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ll rate during hippocampal stimulation on the focus side, and underwent hippocampectomy without any neurological defcits. The other two had slightly decreased rates during hippocampal stimulation on the focus side. The three patients with bilateral foci had significantly decreased rates after simulation of each hippocampus.
3) By drilling away the retrolabyrinthine presigmoid bone, at leaset 1cm more space below and 1cm more space medially is obtained than in the subtemporal appraoch, and temporal retraction pressure is diminished when approaching from below. Operative results according to the Engel's classification of seizure control, and pre- and postoperative WAIS, revised WAIS, and WISC scores were measured in 16 patients treated by normal or modified amygdalohippocampectomy. Postoperative follow-up ranged from 8 to 79 onths. There has been no morbidity or mortality among these 16 patients, and postoperative seizure frequency has been diminished to less than l0% of the preoperative level in 15 of the 16. In eight patients, seizures have been eliminated totally. Subtemporal amygdalohippocampectomy achieved significantly increased performance and full scale inteligence quotient within 2 months after surgery, compared to preoperative levels. Less
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