Hixson John D, Kirsch Heidi E
UCSF Department of Neurology, UCSF Epilepsy Center, San Francisco, CA 94143-0138, USA.
Neurocase. 2009 Jun;15(3):206-16. doi: 10.1080/13554790802632876.
Epilepsy creates significant morbidity, disability, and loss of productivity worldwide. Although unpredictable seizures define epilepsy, the cognitive and emotional difficulties encountered by people with epilepsy may have an even greater impact on everyday function. Epilepsy is associated with lower quality of life (QOL); while this is partially attributable to ongoing seizures, QOL is independently affected by comorbid affective disorders like depression and anxiety. These can accompany all types of epilepsy, but may be especially noteworthy in partial epilepsy syndromes with foci in the frontal or temporal lobes. There is growing evidence that epileptogenic lesions disrupt cortical networks that carry out emotional processing. In addition to epilepsy itself, treatment strategies also affect cognitive functioning and mood. Antiepileptic drugs, vagal nerve stimulation, and surgical resection have all been associated with changes in mood, emotional processing, and social cognition. Overall, the relationship between epilepsy and emotion is vastly complex; when assessing emotional difficulties in a person with epilepsy, we must consider the psychosocial impact of the disease on the patient, the underlying pathophysiology of the disease, and the effects of ongoing treatments.
癫痫在全球范围内造成了严重的发病、残疾和生产力丧失。尽管不可预测的癫痫发作是癫痫的定义特征，但癫痫患者所面临的认知和情感困难可能对日常功能产生更大影响。癫痫与较低的生活质量（QOL）相关；虽然这部分归因于持续发作，但生活质量独立地受到诸如抑郁和焦虑等共病情感障碍的影响。这些情感障碍可伴随所有类型的癫痫，但在额叶或颞叶有病灶的部分性癫痫综合征中可能尤为显著。越来越多的证据表明，致痫性病变会破坏进行情感处理的皮质网络。除了癫痫本身，治疗策略也会影响认知功能和情绪。抗癫痫药物、迷走神经刺激和手术切除都与情绪、情感处理和社会认知的变化有关。总体而言，癫痫与情绪之间的关系极为复杂；在评估癫痫患者的情感困难时，我们必须考虑该疾病对患者的心理社会影响、疾病的潜在病理生理学以及正在进行的治疗的效果。
