Artigas J
Unidad de Neuropediatría, Hospital de Sabadell, Corporació Sanitària Parc Taulí, Barcelona, España.
Rev Neurol. 1999 Feb;28 Suppl 2:S135-41.
Epilepsy in infancy, far from being a condition in which only convulsive phenomena occur, also has important cognitive and behavioral components, which may be more important than the epileptic seizures itself. The psychological repercussions of epilepsy are the sum of various factors due to the epilepsy itself, the treatment given, the side-effects of drugs given and the manner in which the patient copes with his illness. The epilepsy itself shows the effect of the causal lesion, lesions associated with this causal lesion and the immediate and long-term effects of the resulting paroxystic discharges. The most significant manifestations are: attention disorders, problems of social relationships and problems of conduct. Treatment and diagnosis should not be limited to treatment of the crises. In all epileptic children neuropsychological assessment should be directed towards the detection and surveillance of the most common problems. This has a considerable effect on the quality of life of the epileptic patient. In cases of benign idiopathic epilepsies, which occur most frequently in childhood, evaluation of conduct using Achenbach's questionnaire (CBCL) may be sufficient, together with assessment of the ability to pay attention on Continuous Performance Test (CPT) and a quantitative and qualitative evaluation of intellectual capacity using the WISC-R or K-ABC scales.
婴儿期癫痫远非仅出现惊厥现象的病症,它还具有重要的认知和行为成分,这些成分可能比癫痫发作本身更为重要。癫痫的心理影响是由癫痫本身、所接受的治疗、所用药物的副作用以及患者应对疾病的方式等多种因素共同作用的结果。癫痫本身显示出病因性病变的影响、与此病因性病变相关的病变以及所产生的阵发性放电的即时和长期影响。最显著的表现为:注意力障碍、社会关系问题和行为问题。治疗和诊断不应局限于对发作的治疗。对于所有癫痫患儿,神经心理学评估应旨在检测和监测最常见的问题。这对癫痫患者的生活质量有相当大的影响。对于最常见于儿童期的良性特发性癫痫病例,使用阿肯巴克问卷(儿童行为量表)评估行为,同时使用连续性能测试评估注意力能力,并使用韦氏儿童智力量表修订版或考夫曼儿童成套评估测验量表对智力进行定量和定性评估,可能就足够了。