Motamedi Gholam, Meador Kimford
Department of Neurology, Georgetown University School of Medicine, Washington, DC, USA.
Epilepsy Behav. 2003 Oct;4 Suppl 2:S25-38. doi: 10.1016/j.yebeh.2003.07.004.
Patients with epilepsy are more prone to cognitive and behavioral deficits. Epilepsy per se may induce or exacerbate an underlying cognitive impairment, a variety of factors contribute to such deficits, i.e., underlying neuropathology, seizure type, age of onset, psychosocial problems, and treatment side effects. Epilepsy treatment may offset the cognitive and behavioral impairments by stopping or decreasing the seizures, but it may also induce untoward effects on cognition and behavior. The neurocognitive burden of epilepsy may even start through in utero exposure to medications. Epilepsy surgery can also induce certain cognitive deficits, although in most cases this can be minimized. Clinicians should consider cognitive side effect profiles of antiepileptic medications, particularly in extreme age groups. While no effective treatments are available for cognitive and behavioral impairments in epilepsy, comprehensive pretreatment evaluation and meticulous selection of antiepileptic drugs or surgical approach may minimize such untoward effects.
癫痫患者更容易出现认知和行为缺陷。癫痫本身可能诱发或加重潜在的认知障碍，多种因素导致了这些缺陷，即潜在的神经病理学、癫痫发作类型、发病年龄、心理社会问题以及治疗副作用。癫痫治疗可通过停止或减少癫痫发作来抵消认知和行为障碍，但也可能对认知和行为产生不良影响。癫痫的神经认知负担甚至可能始于子宫内接触药物。癫痫手术也可能诱发某些认知缺陷，尽管在大多数情况下这种影响可以降至最低。临床医生应考虑抗癫痫药物的认知副作用，尤其是在极端年龄组。虽然目前尚无有效的治疗方法来治疗癫痫的认知和行为障碍，但全面的治疗前评估以及精心选择抗癫痫药物或手术方法可能会将此类不良影响降至最低。
