Germanò Eva, Gagliano Antonella, Magazù Angela, Sferro Caterina, Calarese Tiziana, Mannarino Erminia, Calamoneri Filippo
Division of Child Neurology and Psychiatry, University of Messina, Gazzi-Messina, Italy.
Epilepsy Res. 2005 May;64(3):137-50. doi: 10.1016/j.eplepsyres.2005.03.004.
Benign childhood epilepsy with occipital paroxysms is classified among childhood benign partial epilepsies. The absence of neurological and neuropsychological deficits has long been considered as a prerequisite for a diagnosis of benign childhood partial epilepsy. Much evidence has been reported in literature in the latest years suggesting a neuropsychological impairment in this type of epilepsy, particularly in the type with Rolandic paroxysms. The present work examines the neuropsychological profiles of a sample of subjects affected by the early-onset benign childhood occipital seizures (EBOS) described by Panayotopulos. The patient group included 22 children (14 males and 8 females; mean age 10.1+/-3.3 years) diagnosed as having EBOS. The patients were examined with a set of tests investigating neuropsychological functions: memory, attention, perceptive, motor, linguistic and academic (reading, writing, arithmetic) abilities. The same instruments have been given to a homogeneous control group as regards sex, age, level of education and socio-economic background. None of the subjects affected by EBOS showed intellectual deficit (mean IQ in Wechsler Full Scale 91.7; S.D. 8.9). Results show a widespread cognitive dysfunction in the context of a focal epileptogenic process in EBOS. In particular, children with EBOS show a significant occurrence of specific learning disabilities (SLD) and other subtle neuropsychological deficits. We found selective dysfunctions relating to perceptive-visual attentional ability (p<0.05), verbal and visual-spatial memory abilities (p<0.01), visual perception and visual-motor integration global abilities (p<0.01), manual dexterity tasks (p<0.05), some language tasks (p<0.05), reading and writing abilities (p<0.01) and arithmetic ability (p<0.01). The presence of cognitive dysfunctions in subjects with EBOS supports the hypothesis that epilepsy itself plays a role in the development of neuropsychological impairment. Supported by other studies that have documented subtle neuropsychological deficits in benign partial epilepsy, we stress the importance of reconsidering its supposed "cognitive benignity", particularly in occipital types.
儿童良性枕叶癫痫发作属于儿童良性部分性癫痫。长期以来,神经和神经心理功能无缺陷一直被视为诊断儿童良性部分性癫痫的前提条件。近年来,文献报道了大量证据表明,此类癫痫存在神经心理损害,尤其是伴有罗兰多发作的类型。本研究调查了受Panayotopulos所描述的早发性儿童良性枕叶癫痫发作(EBOS)影响的一组受试者的神经心理特征。患者组包括22名被诊断为患有EBOS的儿童(14名男性和8名女性;平均年龄10.1±3.3岁)。对这些患者进行了一系列测试,以调查其神经心理功能:记忆、注意力、感知、运动、语言和学业(阅读、写作、算术)能力。针对一个在性别、年龄、教育水平和社会经济背景方面均一的对照组,使用了相同的测试工具。所有受EBOS影响的受试者均未表现出智力缺陷(韦氏全量表平均智商为91.7;标准差为8.9)。结果显示,在EBOS的局灶性致痫过程中存在广泛的认知功能障碍。特别是,患有EBOS的儿童出现特定学习障碍(SLD)和其他细微神经心理缺陷的情况显著。我们发现,与感知 - 视觉注意力能力(p<0.05)、言语和视觉空间记忆能力(p<0.01)、视觉感知和视觉运动整合整体能力(p<0.01)、手部灵巧任务(p<0.05)、一些语言任务(p<0.05)、阅读和写作能力(p<0.01)以及算术能力(p<0.01)相关的选择性功能障碍。EBOS患者中存在认知功能障碍,这支持了癫痫本身在神经心理损害发展中起作用的假说。在其他已记录良性部分性癫痫存在细微神经心理缺陷的研究支持下,我们强调重新审视其所谓“认知良性”的重要性,尤其是在枕叶类型中。