Lehrner J, Kalchmayr R, Serles W, Olbrich A, Pataraia E, Aull S, Bacher J, Leutmezer F, Gröppel G, Deecke L, Baumgartner C
Neurological University Clinic, Vienna, Austria.
Seizure. 1999 Apr;8(2):88-92. doi: 10.1053/seiz.1999.0272.
We determined the interrelations of chronological age, age at seizure onset, duration of seizure disorder, cognitive functioning (IQ), scales of activities of daily living, depressive mood disorder and measures of health-related quality of life (HRQOL). Furthermore, we investigated the association of the laterality of seizure onset zone and absence/presence of hippocampal atrophy and/or sclerosis (HA/HS) with measures of HRQOL, activities of daily living (ADL) and depressive mood disorder. In the setting of pre-surgical epilepsy evaluation, a sample of 56 patients with temporal lobe epilepsy (TLE) was studied using the Bonner Skalen für Epilepsie (BPSE) and the depression inventory D-S of von Zerssen. Patients reported high levels of dependency on others and poor coping capabilities. Our data also showed specific ADL-behaviour suggesting social withdrawal and isolation. Our results indicate emotional impairment as a major problem in TLE, because 45% of our patients scored in the depressive range of the D-S depression scale. Depression score was found to be a powerful predictor of self-reported quality of life after adjusting for seizure-related variables, demographic variables and cognitive functioning (IQ). The only scale showing a significant laterality effect was ADL-home. No relationship between the dependent measures of HRQOL, ADL-social, ADL-cultural, depressive mood disorder and laterality of the epileptogenic zone or absence/presence of HA/HS was found. HRQOL and depressive mood disorder are strongly interrelated indicating that patients with depressive symptoms report lower quality of life and specific patterns of ADL. HRQOL, ADL and depressive mood disorder are largely independent of biological markers such as laterality of seizure onset zone and absence/presence of HA/HS in TLE.
我们确定了实际年龄、癫痫发作起始年龄、癫痫障碍持续时间、认知功能（智商）、日常生活活动量表、抑郁情绪障碍以及健康相关生活质量（HRQOL）指标之间的相互关系。此外，我们研究了癫痫发作起始区的侧别以及海马萎缩和/或硬化（HA/HS）的有无与HRQOL指标、日常生活活动（ADL）和抑郁情绪障碍之间的关联。在术前癫痫评估的背景下，使用癫痫邦纳量表（BPSE）和冯·泽尔森的抑郁量表D-S对56例颞叶癫痫（TLE）患者进行了研究。患者报告对他人的依赖程度高且应对能力差。我们的数据还显示了特定的ADL行为，表明社交退缩和孤立。我们的结果表明情绪障碍是TLE中的一个主要问题，因为我们45%的患者在D-S抑郁量表的抑郁范围内得分。在对癫痫相关变量、人口统计学变量和认知功能（智商）进行调整后，发现抑郁评分是自我报告生活质量的有力预测指标。唯一显示出显著侧别效应的量表是ADL-家庭。未发现HRQOL、ADL-社交、ADL-文化、抑郁情绪障碍等相关指标与癫痫病灶区的侧别或HA/HS的有无之间存在关联。HRQOL和抑郁情绪障碍密切相关，表明有抑郁症状的患者报告的生活质量较低且有特定的ADL模式。HRQOL、ADL和抑郁情绪障碍在很大程度上独立于生物学标志物，如TLE中癫痫发作起始区的侧别以及HA/HS的有无。
