Department of Research and Development, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands.
Child Neuropsychol. 2008 Jul;14(4):291-302. doi: 10.1080/09297040701503319.
Up to one third of the epilepsy population consists of children with cryptogenic localization related epilepsy (CLRE). Unfortunately, the effect of CLRE on the development is still unclear. Behavioral and academic problems have been reported, but no conclusive study concerning the impact of CLRE on neuropsychological functioning is yet published. This study was a systematic cross-sectional open clinical and nonrandomized investigation, which included 68 children with CLRE. Several neuropsychological tests were analyzed and age-related normative values were used as reference. Differences between CLRE and reference values were tested with Paired-Samples t-tests. Z scores were computed to compare the different neuropsychological tests and to inspect whether a characteristic neuropsychological profile exists for CLRE. The Independent-Samples t-test was used to explore which epilepsy factors (seizure type, seizure frequency, age at onset, duration of epilepsy, and drug load) were influencing the cognitive profile of CLRE. There seems to be a characteristic cognitive profile for children with CLRE; children with CLRE experience cognitive difficulties on a wide range of areas-in particular, alertness, mental speed, and memory. Seizure type, seizure frequency, duration of epilepsy, and drug load do not influence this neuropsychological profile. Age at onset was an important risk factor; the earlier the age at onset, the worse the cognitive performance. In spite of the influence of age at onset, the revealed profile can be seen as a stable, independent of temporary factors, neuropsychological profile for children with CLRE.
多达三分之一的癫痫患者是由隐源性局部相关癫痫(CLRE)引起的。不幸的是,CLRE 对发育的影响尚不清楚。已经报道了行为和学习问题,但尚未发表关于 CLRE 对神经心理功能影响的结论性研究。本研究是一项系统的横断面开放性临床和非随机研究,共纳入 68 例 CLRE 患儿。分析了多项神经心理学测试,并使用年龄相关的常模作为参考。使用配对样本 t 检验检验 CLRE 与参考值之间的差异。计算 Z 分数以比较不同的神经心理学测试,并检查 CLRE 是否存在特征性的神经心理学特征。使用独立样本 t 检验探讨了哪些癫痫因素(发作类型、发作频率、发病年龄、癫痫持续时间和药物负荷)会影响 CLRE 的认知特征。CLRE 患儿似乎存在特征性的认知特征;CLRE 患儿在广泛的领域存在认知困难,特别是警觉性、思维速度和记忆力。发作类型、发作频率、癫痫持续时间和药物负荷不会影响这种神经心理学特征。发病年龄是一个重要的危险因素;发病年龄越早,认知表现越差。尽管受到发病年龄的影响,但所揭示的特征可以被视为 CLRE 患儿一种稳定的、独立于暂时因素的神经心理学特征。