Childrens Hospital Boston, Neurology, Boston, MA 02115, USA.
Epilepsy Behav. 2009 Nov;16(3):431-5. doi: 10.1016/j.yebeh.2009.08.008. Epub 2009 Sep 19.
We assessed the impact of age at onset of epilepsy and duration and frequency of seizures on cognitive development in children less than 3 years old. Retrospective analysis was conducted on clinical data and neuropsychological testing of 33 infants with epilepsy. Developmental quotients were calculated and were correlated with age at epilepsy onset, duration of epilepsy, seizure frequency, brain pathology, and types of seizures (with/without spasms) as potential predictors. Infants with longer duration and earlier onset of epilepsy performed worse on developmental neuropsychological testing. Regression analyses showed that age at epilepsy onset and percentage of life with epilepsy were both strongly associated (regression model P<0.0001) with developmental quotient. There was no correlation with seizure frequency. Infants with spasms had worse developmental quotients than infants without spasms (P<0.001). These results suggest that duration of epilepsy and age at onset may be the best developmental predictors during the first years of life in patients with epilepsy. Early aggressive intervention should be considered.
我们评估了癫痫发病年龄、发作持续时间和频率对 3 岁以下儿童认知发育的影响。对 33 例癫痫婴儿的临床资料和神经心理学测试进行回顾性分析。计算发育商并与癫痫发病年龄、癫痫持续时间、发作频率、脑病理学以及发作类型（有/无痉挛）等潜在预测因素相关。癫痫持续时间较长和发病年龄较早的婴儿在发育神经心理学测试中表现较差。回归分析表明，癫痫发病年龄和癫痫病程占生命百分比均与发育商呈强相关（回归模型 P<0.0001）。与发作频率无关。有痉挛的婴儿发育商较无痉挛的婴儿差（P<0.001）。这些结果表明，癫痫的持续时间和发病年龄可能是癫痫患儿生命最初几年中最佳的发育预测因素。应考虑早期积极干预。
