Conde-Guzon P A, Cancho-Candela R
Área de Personalidad, Evaluación y Tratamiento Psicológicos, Campus de Vegazana, Universidad de León, E-24071 León.
Rev Neurol. 2012 Jul 16;55(2):65-73.
To analyze the neuropsychological profile of children with absence seizures treated with valproate.
Sample of 34 children from 7 to 12 years with absence seizures treated with valproate (median dose: 30 mg/kg/day) and 28 controls. We get the neuropsychological profile by applying the Wechsler Intelligence Scale for Children-Revised (WISC-R) and Luria-DNI Battery.
Children with absence seizures manifest verbal IQ significantly lower (p < 0.05) than the control group but within normal. The neuropsychological profile Luria-DNI is significantly lower (p < 0.05) than the control group in all areas except in regulation verbal, kinesthetic, visual perception, comprehension and understanding simple grammar. This is a serious deterioration profile in the areas of logical memory, short-term memory, arithmetic, numerical structure, reading, writing, naming, and articulation. Children with absence seizures have a significant memory deficit. Memory profile measured with the Luria-DNI Battery and the WISC-R appears generally deteriorated when compared with the control group (p < 0.001) although there is a paradoxical preservation of shape memory. The short-term auditory and visual memory and logical memory are particularly affected. In the epileptic group, the attentional profile (estimated by the 'third factor of the WISC-R') is generally deteriorated when compared with the control group.
We consider in children with this diagnosis and treatment, the neuropsychological profile described to strengthen deficient neuropsychological and psychoeducational areas. Above, we claim the need, in the consultations of neuropediatrics, the neuropsychlogists to ensure the systematic analysis of neuropsychological and cognitive difficulties both at the time of the diagnosis and follow-up of epilepsy.
分析丙戊酸盐治疗失神发作儿童的神经心理学特征。
选取34名7至12岁接受丙戊酸盐治疗（中位剂量：30mg/kg/天）的失神发作儿童作为样本，以及28名对照儿童。通过应用韦氏儿童智力量表修订版（WISC-R）和鲁利亚-神经心理成套测验获取神经心理学特征。
失神发作儿童的言语智商显著低于对照组（p<0.05），但仍在正常范围内。除言语调节、动觉、视觉感知、理解和简单语法理解外，鲁利亚-神经心理成套测验的神经心理学特征在所有领域均显著低于对照组（p<0.05）。在逻辑记忆、短期记忆、算术、数字结构、阅读、写作、命名和发音等领域，这是一种严重的衰退特征。失神发作儿童存在明显的记忆缺陷。与对照组相比，用鲁利亚-神经心理成套测验和WISC-R测量的记忆特征总体上有所衰退（p<0.001），尽管形状记忆存在矛盾性保留。短期听觉和视觉记忆以及逻辑记忆受到的影响尤为明显。在癫痫组中，与对照组相比，注意力特征（由WISC-R的“第三个因素”估计）总体上有所衰退。
对于患有这种诊断和接受该治疗的儿童，我们认为所描述的神经心理学特征可用于加强存在缺陷的神经心理学和心理教育领域。在此，我们主张在神经儿科会诊中，神经心理学家有必要在癫痫诊断和随访时确保对神经心理学和认知困难进行系统分析。
