Temporal lob epilepsili hastalarda serebral dominansı saptamada kullanılan çeşitli yöntemlerin wada testi ile karşılaştırılması ve 'kalabalıklaşma' hipotezi
Özet
Comparing Various Methods Used To Determine Cerebral Domainance With Wada Test In Temporal Lobe Epilepsy Patients and 'Crowding' Hypothesis Temporal lobe epilepsy patients that are drug resistant undergo Wada test to determine cerebral dominance. This test is the 'gold standart' for determining cerebral dominance. In this study, handedness questionnaire, grooved pegboard test and angiography results of 57 patients (31 male, 26 female) that are preoperatively evaluated are compared with Wada test to estimate their sensitivity and specificifity. According to A.U.F.M. (Ankara University Faculty of Medicine) Neurology Departmant Dominance Questionnaire general preference scores have 83,8 % specificifity and 92,1 % sensitivity for determining right handedness if the score is 8/10 and up. This test is found to have 85,4 % specificifity and 92,1 % sensitivity for determining right handedness if the score is 5/6 and up. According to laterality scores, +71,4 is the cut-off point for determining right handedness (89,5 % specificifity and 87,2 % sensitivity) For A.U.F.M. Physiology Departmant Dominance Questionnaire, this cut-off point is +60,0 (85,4 % specificifity and 92,1 % sensitivity). According to these results, A.U.F.M. Physiology Departmant Dominance Questionnaire is valid. Grooved pegboard test and angiography are not specific and sensitive for determining left cerebral dominance. Multiple factors (gender, education, background characteristics, febrile convulsion, left handedness/ambidexter in the family, convulsion initiation age, neurologic examination findings, epileptic focus side in interictal EEG and hippocampal lesion side in kranial MRI) do not affect cerebral dominance. Febrile convulsion and TLE relation is not found. Although according to 'crowding' hypothesis the patients that have atypic language dominance are thought to have memory deficit in both hemispheres, this result is not seen in the study. But temporal focus side in interictal EEG and memory deficit side are significantly relevant. Key Words: Temporal lobe epilepsy, cerebral dominance, handedness questionnaire, grooved pegboard test, Wada test. 82