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颞叶癫痫(TLE)和颞叶外癫痫患者的发作间期抑郁、焦虑、人格特质及心理解离

Interictal depression, anxiety, personality traits, and psychological dissociation in patients with temporal lobe epilepsy (TLE) and extra-TLE.

作者信息

Swinkels Wilhelmina A M, van Emde Boas Walter, Kuyk Jarl, van Dyck Richard, Spinhoven Philip

机构信息

Department of Psychology, Epilepsy Institute of The Netherlands, Heemstede, The Netherlands.

出版信息

Epilepsia. 2006 Dec;47(12):2092-103. doi: 10.1111/j.1528-1167.2006.00808.x.

Abstract

PURPOSE

This study was performed to investigate the relation between symptoms of interictal depression, anxiety, personality traits, and psychological dissociation with the localization and lateralization of the epileptogenic zone in patients with partial epilepsy.

METHODS

All patients were diagnosed according to the localization-related concept of the 1989 International League Against Epilepsy (ILAE) Classification of Epilepsies and Epileptic Syndromes, and the localization and lateralization of the epileptogenic zone was established by using the clinical criteria for noninvasive presurgical evaluation. This resulted in 67 patients with temporal lobe epilepsy (TLE) and 64 patients with extra-TLE. All patients were assessed on the various aspects of psychopathology by using a comprehensive battery of standardized diagnostic instruments.

RESULTS

We did not find the hypothesized excess of psychiatric symptoms in patients with (mesial) TLE in comparison with patients with extra-TLE. We also found no differences between patients with the lateralization of epilepsy in the left versus the right hemisphere.

CONCLUSIONS

TLE per se cannot be considered a risk factor in developing more or more severe symptoms of psychopathology in patients with partial epilepsy. Concomitant factors, such as the duration of epilepsy, seizure frequency, and frontal lobe dysfunction may play an additional role. Our findings support the hypothesis of a multifactorial explanation for the psychiatric symptoms in patients with epilepsy.

摘要

目的

本研究旨在探讨部分性癫痫患者发作间期抑郁、焦虑症状、人格特质及心理解离与致痫区定位和侧化之间的关系。

方法

所有患者均根据1989年国际抗癫痫联盟(ILAE)癫痫和癫痫综合征分类的定位相关概念进行诊断,并采用无创术前评估的临床标准确定致痫区的定位和侧化。这产生了67例颞叶癫痫(TLE)患者和64例颞叶外癫痫(extra-TLE)患者。所有患者均使用一系列标准化诊断工具对精神病理学的各个方面进行评估。

结果

与颞叶外癫痫患者相比,我们未发现(内侧)颞叶癫痫患者存在假设的精神症状过多情况。我们还发现癫痫在左半球与右半球侧化的患者之间没有差异。

结论

颞叶癫痫本身不能被视为部分性癫痫患者出现更多或更严重精神病理学症状的危险因素。诸如癫痫持续时间、发作频率和额叶功能障碍等伴随因素可能起额外作用。我们的研究结果支持对癫痫患者精神症状进行多因素解释的假设。

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