【作者】 周波；

【导师】 周东；

【作者基本信息】 四川大学 ， 神经病学， 2004， 硕士

【摘要】 目的 了解新诊断部分发作癫痫患者额叶相关的神经认知功能的改变,以及抗癫痫药物对认知功能的早期影响。 方法 本研究采用前瞻、随机对照研究,按1981年国际抗癫痫联盟的癫痫发作分类及1989年癫痫和癫痫综合征定义,对新诊断为部分发作伴或不伴全面发作的癫痫患者48例,以及与之在性别、年龄、受教育程度相匹配的健康对照35例,进行6项神经心理学测验,包括数字广度、词语流畅、连线测验、Stroop字色干扰测验、威斯康星卡片分类测验及汉罗塔测验。然后将癫痫患者随机给予卡马西平(CBZ)、丙戊酸钠(VAP)和托吡更多还原

【Abstract】 Objective: To explore the cognitive function related to the frontal lobe among the newly diagnosed patients with partial epilepsy and the early effect on it of the antiepileptic drugs (AEDs).Methods: This is a prospective, randomized and controlled study. According to the diagnostic criteria for epilepsy of the ILAE in 1981 and 1989, the 48 newly diagnosed patients with partial epilepsy and 35 healthy people with the same features of gender, age and education level were enrolled in the study. They were given 6 neuropsychological tests including Digit span, Verbal fluency, Trail Making Test(TMT), Stroop-test, Wisconsin card sorting test (WCST) and Tower of Hanoi. After the first test all patients were randomly divided into 3 groups: carbamazepine(CBZ), valproate(VAP) and topiramate(TPM).They were retested by the same tests after 1 month’s therapy. Results: Before the administration of the AEDs the patient group wascompared with the control group. The test time of TMT parts B increased (p<0.05) and the error number increased (p<0.01). The error number in reading words of Stroop-test increased (p<0.01) and the time of reading colors increased (p<0.05). The mean executive time of Tower of Hanoi increased (p<0.01) and the total scores declined (p<0.05). Before treatment there were no statistical different in neuropsychological index among CBZ, VAP and TPM groups. After therapy the neuropsychological index among 3 groups had significant difference. They include forwards Digit span (p<0.05), the total number of vocabulary (p<0.01), the reading words time of Stroop-test (p<0.01), t the error number of reading words (p<0.01), the correcting number of Stroop-test reading colors (p<0.05) and the mean planning time of the Tower of Hanoi (pO.Ol).Conclusion: l.The newly diagnosed patients with partial epilepsy had neuropsychological dysfunction before administrating AEDs. It might have links with the brain diseases, the frequent seizures and the subclinical epilepsy discharge. 2. Different AEDs have different effects on the neuropsychological function because of their different chemical structure and mechanism. 3.We believe that Digit span and Verbal fluency mirroring the cognitive function of the frontal lobe might be used as a sensitive neuropsychological test to examine the cognition early affected by topiramate.更多还原