Besag Frank M C
Twinwoods Health Resource Centre, Bedford, United Kingdom.
Epilepsia. 2006;47 Suppl 2:119-25. doi: 10.1111/j.1528-1167.2006.00709.x.
The educational and social progress of a child with epilepsy depends not only on seizure control but also on cognitive and behavioral factors. The various epilepsy syndromes of childhood and adolescence differ greatly in terms of cognitive and behavioral outcome. A high proportion of babies who have West syndrome and children who have Dravet syndrome (severe myoclonic epilepsy in infancy) will have long-term cognitive and behavioral problems. The Lennox-Gastaut syndrome also often has a poor prognosis in this regard. Children with the Landau-Kleffner syndrome have a variable prognosis, some regain speech and others have permanent speech impairment. Benign childhood epilepsy with centrotemporal spikes is now recognised as lying on a spectrum with the Landau-Kleffner syndrome: mild cases have few if any cognitive or behavioral problems but others may have quite severe difficulties. People with juvenile myoclonic epilepsy may have characteristics suggesting frontal lobe impairment. The educational and social impairments associated with the epilepsy syndromes of childhood and adolescence are of major importance but they have been the subject of remarkably few well-performed studies. The impairments are not always necessarily permanent and it seems highly likely that the cognitive and behavioural outcome of at least some of these syndromes can be influenced greatly by early effective treatment with either antiepileptic medication or surgery.
患有癫痫的儿童的教育和社会进步不仅取决于癫痫发作的控制，还取决于认知和行为因素。儿童期和青春期的各种癫痫综合征在认知和行为结果方面差异很大。患有韦斯特综合征的婴儿和患有德雷维特综合征（婴儿严重肌阵挛性癫痫）的儿童中，很大一部分会有长期的认知和行为问题。在这方面，伦诺克斯 - 加斯东综合征的预后通常也很差。患有兰道 - 克莱夫纳综合征的儿童预后不一，一些儿童恢复了语言能力，而另一些则有永久性语言障碍。伴有中央颞区棘波的儿童良性癫痫现在被认为与兰道 - 克莱夫纳综合征属于同一谱系：轻度病例几乎没有认知或行为问题，但其他病例可能有相当严重的困难。青少年肌阵挛性癫痫患者可能具有提示额叶损伤的特征。与儿童期和青春期癫痫综合征相关的教育和社会障碍非常重要，但它们一直是极少有高质量研究的主题。这些障碍不一定总是永久性的，而且至少其中一些综合征的认知和行为结果很可能会受到抗癫痫药物或手术早期有效治疗的极大影响。
