Cirugía de la Epilepsia: Estudio Neuropsicológicos


En esta sección se ponen a disposición de todos los usuarios y pacientes, una lista de publicaciones relacionadas con la Cirugía de la Epilepsia en los que han participado activamente miembros del equipo médico de la Unidad de Neurocirugía.

Esta sección dada su importancia se subdivide en otras cuatros subsecciones:

Tratamiento Quirúrgico

Estudios Clínicos Neurofisiológicos

Estudios Neuroradiológicos

Estudios Neuropsicológicos

Estudios Anatomopatológicos

Alteraciones de memoria en pacientes epilépticos. Estudio de seguimiento pre-posquirúrgico

P. Martín-Plasencia, F. Maestu-Unturbe , E. Koronis, P. Pulido, R. García de Sola

Resumen:

In general terms, epileptic patients with temporal lobe epilepsy (TLE) show mnesic deficits. In the case of medically intractable epilepsy (around 20%) the neurosurgery intervention is a widely accepted treatment. The cognitive effects of surgery have been reported in last years; they emphasize the mnesic positive changes of contralateral area. In the same sense they have reported a negative change on mnesic modality in ipsilateral area. This paper present a study in which the mnesic deficits of twenty eight pharmaco resistant epileptic patients have been evaluated and followed up. These patients have been submittes to a surgical treatment at the Epilepsy Surgical Unit of the Hospital de La Princesa (Madrid). The assessment pre and postoperative tested six months apart. The most common cognitive deficit affect bimodally to mnesic functions: so in the verbal as in the viso- spatial modality. This deficit correlated with the years epilepsy. Meanwhile, the following up study indicates that a relevant numbers of these patients show an improvement in the function of the contralateral hemisphere with respect to the area surgically treated. This finding probably is the consequence of seizure free (REV NEUROL 1997; 25: 205-207).

Palabras clave: Epilepsy. Temporal lobe. Memory. Followed up.

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Neuropsicología y deterioro cognitivo en la epilepsia

F. Maestú, P. Martín a, R.G. Sola b, T. Ortiz

Resumen:

To carry out a critical evaluation of the international literature on the neuropsychology of epilepsy. The variables which lead to cognitive deterioration in epilepsy and the effect on cognition of different treatments available (pharmacological and surgical). Development. We evaluate the influence of different neurological variables on the higher functions (aetiology, age of onset, type of crises, duration of illness, frequency and anti-epileptic drugs). We also describe the cognitive functions most affected in epilepsy (memory, attention, executive function, language). Studies of the surgery of epilepsy show that this may lead to both beneficial and undesirable effects on cognition. Conclusions. The variables which in general most affect higher functions are the duration of the illness and the frequency and types of crises. The commonest neuropsychological effects are those of memory deficit. These studies show that neuropsychological studies should be done from the time of onset of the disorder. Finally, from the surgical point of view, young patients with considerable crisis reduction or free of crises, with moderate preoperative deterioration of memory have the greatest possibility of post-operative improvement in cognition. Older persons with intact cognitive function and major surgical resection have more possibilities of post-surgical deterioration [REV NEUROL 1999; 28: 793-8].

Palabras clave: Epilepsy. Memory. Neuropsychology. Surgery of epilepsy.

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Neuropsicología de la epilepsia parcial temporal: comparación entre pacientes farmacorresistentes y controlados farmacológicamente

F. Maestú, P. Martín, R.G. de Sola, M.aC.D. Obregón, E. Gómez-Utrero, A. Fernandez, A. Sánchez, N. Paúl, T. Ortiz

Resumen:

To carry out a critical evaluation of the international literature on the neuropsychology of epilepsy. The variables which lead to cognitive deterioration in epilepsy and the effect on cognition of different treatments available (pharmacological and surgical). Development. We evaluate the influence of different neurological variables on the higher functions (aetiology, age of onset, type of crises, duration of illness, frequency and anti-epileptic drugs). We also describe the cognitive functions most affected in epilepsy (memory, attention, executive function, language). Studies of the surgery of epilepsy show that this may lead to both beneficial and undesirable effects on cognition. Conclusions. The variables which in general most affect higher functions are the duration of the illness and the frequency and types of crises. The commonest neuropsychological effects are those of memory deficit. These studies show that neuropsychological studies should be done from the time of onset of the disorder. Finally, from the surgical point of view, young patients with considerable crisis reduction or free of crises, with moderate preoperative deterioration of memory have the greatest possibility of post-operative improvement in cognition. Older persons with intact cognitive function and major surgical resection have more possibilities of post-surgical deterioration [REV NEUROL 1999; 28: 793-8].

Palabras clave: Epilepsy. Neuropsychology. Surgery of epilepsy.

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Dominancia hemisférica para el lenguaje y resonancia magnética funcional: comparación de tres tareas

J. Álvarez-Linera, P. Martín-Plasencia, F. Maestú, R. García de Sola, J. Iglesias, J.M. Serrano

Resumen:

The aim of this study is to analyse and compare the efficiency of three classic language tasks (repetition, phonological fluency and lexical decision) in order to identify the dominant hemisphere for language by means of a functional magnetic resonance (fMR). Patients and methods. The three tasks were performed by a group of 10 right-handed subjects aged between 22 and 40, and evaluation was carried out with a 1.5 T fMR machine (General Electric), in eight gradient echo planar sequences (BOLD technique) which were done in the oblique axial plane, and which coincided with the line between the anterior and posterior commissure and covered the whole brain (AC-PC line). Results. Dominance was calculated by means of the lateralization index, by comparing the activation in each hemisphere in two situations. Firstly, the temporal and the right and left frontal lobes were considered, and then only the right and left frontal lobes. Conclusions. The results obtained showed that the most effective test to determine the dominant hemisphere is that of phonological fluency, and that the activation of the frontal areas shows a greater participation of the left hemisphere. [REV NEUROL 2002; 34:]

Palabras clave: Fluency. Functional magnetic resonance. Hemispheric dominance. Language. Lexical decision. Repetition.

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Evaluación en la Cirugía de la Epilepsia

F. Maestú, P. Martin, A. Gil-Nagel, O. Franch, R. García de Sola

Resumen:

Neuropsychology is a discipline included in the neurosciences which, over the past twenty years, has shown its value in the assessment and rehabilitation of cognitive functions in different disorders. In particular, in epilepsy it has permitted the description of the different factors which affect cognitive deterioration; permitted the establishment of profiles of cognitive deterioration and also the evaluation of the adverse effects of some anti-epileptic drugs on cognition. Development. In this paper we confirm the value of neuropsychology in an Epilepsy Unit and describe different procedures for evaluation, as well as the cognitive consequences of the surgery of epilepsy. [REV NEUROL 2000; 30: 477-82] .

Palabras clave: Cognitive deterioration. Epilepsy. Evaluation. Neuropsychology. Surgery of epilepsy.

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