Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
Epilepsy Behav. 2011 Nov;22(3):428-32. doi: 10.1016/j.yebeh.2011.07.029. Epub 2011 Sep 1.
There is a long-recognized association between obsessive-compulsive disorder (OCD) and chronic epilepsy, most notably refractory temporal lobe epilepsy (TLE). The literature documents this association with case reports, patient series, and some larger controlled studies that reveal that almost a quarter of patients with TLE exhibit OCD features, which may go unrecognized. Obsession features with ordering, symmetry, exactness, handwashing, and religiosity occur more often in persons with right- or left-sided epileptic foci than in those with idiopathic generalized epilepsies or controls. Neurobiological and social factors suggest abnormalities of the frontal-thalamic-pallidal-striatal-anterior cingulate-frontal circuits stemming from the observation that certain diseases, damage, or surgery along these circuits may produce or, conversely, reduce OCD in TLE. This review explores the literature on case reports, case series, and larger retrospective controlled studies and looks at the associations of epilepsy with OCD. Contemporary speculation on the theoretical neurobiological underpinnings provides some basis on how and where to direct treatment. Invasive deep brain stimulation has triggered recent controversy on newer treatment modalities.
强迫症（OCD）与慢性癫痫之间存在长期公认的关联，尤其是难治性颞叶癫痫（TLE）。文献通过病例报告、患者系列和一些较大的对照研究记录了这种关联，这些研究表明，几乎四分之一的 TLE 患者表现出 OCD 特征，但这些特征可能未被识别。强迫症的特征包括强迫观念、对称、精确、洗手和宗教信仰，在右侧或左侧癫痫灶患者中比在特发性全面性癫痫或对照组中更为常见。神经生物学和社会因素表明，源自于这些电路中的某些疾病、损伤或手术可能会产生或相反地减少 TLE 中的 OCD，这些电路的额-丘脑-苍白球-纹状体-前扣带回-额回路的异常。本综述探讨了关于病例报告、病例系列和更大的回顾性对照研究的文献，并研究了癫痫与 OCD 的关联。关于理论神经生物学基础的当代推测为如何以及在何处提供了治疗的依据。侵入性深部脑刺激引发了关于新治疗方法的最新争议。
