Caplan Rochelle, Siddarth Prabha, Vona Pamela, Stahl Lesley, Bailey Caroline, Gurbani Suresh, Sankar Raman, Donald Shields W
Department of Psychiatry, UCLA, Los Angeles, California, USA.
Epilepsia. 2009 Nov;50(11):2397-407. doi: 10.1111/j.1528-1167.2009.02199.x. Epub 2009 Jul 14.
This study examined the severity and range of linguistic impairments in young, intermediate, and adolescent youth with epilepsy and how these deficits were associated with illness effects, nonverbal intelligence, psychopathology, and reading.
Tests of language, intelligence, achievement, and structured psychiatric interviews were administered to 182 epilepsy youth, aged 6.3-8.1, 9.1-11.7, and 13.0-15.2 years, as well as to 102 age- and gender-matched normal children. Parents provided demographic, seizure-related, and behavioral information on their children.
Significantly more epilepsy subjects had language scores 1 standard deviation (SD) below average than the age-matched control groups did. The intermediate and adolescent epilepsy groups also had significantly lower mean language scores compared to their matched controls. The older compared to the younger epilepsy groups had more language impairment and a wider range of linguistic deficits. Longer duration of illness, childhood absence epilepsy, psychiatric diagnosis, and socioeconomic status were associated with linguistic deficits in the young group. Prolonged seizures, lower Performance IQ, and minority status predicted low language scores in the intermediate epilepsy group. In the adolescent group, language impairment was associated with poor seizure control, decreased Performance IQ, and lower socioeconomic status. Linguistic and reading deficits were significantly related in each epilepsy group.
The age-related increase in linguistic impairment, different profiles of predictors in each age group, and the relationship of linguistic deficits with poor reading skills have important clinical, developmental, theoretical, and academic implications.
本研究调查了患有癫痫的幼儿、学龄儿童和青少年语言障碍的严重程度和范围,以及这些缺陷如何与疾病影响、非语言智力、精神病理学和阅读能力相关联。
对182名年龄在6.3 - 8.1岁、9.1 - 11.7岁和13.0 - 15.2岁的癫痫患儿,以及102名年龄和性别匹配的正常儿童进行了语言、智力、学业成就测试和结构化精神科访谈。家长提供了孩子的人口统计学、癫痫发作相关和行为方面的信息。
癫痫患者中语言分数低于平均水平1个标准差(SD)的人数显著多于年龄匹配的对照组。与匹配的对照组相比,学龄期和青少年期癫痫组的平均语言分数也显著更低。与年幼的癫痫组相比,年长的癫痫组语言障碍更多,语言缺陷范围更广。病程较长、儿童失神癫痫、精神科诊断和社会经济地位与年幼组的语言缺陷相关。癫痫发作时间延长、操作智商较低和少数族裔身份预示着学龄期癫痫组语言分数较低。在青少年组中,语言障碍与癫痫控制不佳、操作智商降低和社会经济地位较低相关。各癫痫组的语言和阅读缺陷显著相关。
语言障碍随年龄增长而增加、各年龄组预测因素的不同模式,以及语言缺陷与阅读技能差之间的关系具有重要的临床、发育、理论和学术意义。