Kerr M P
Welsh Centre for Learning Disabilities, Cardiff University, Cardiff, Wales, UK.
Acta Neurol Scand Suppl. 2012(194):1-9. doi: 10.1111/ane.12014.
The impact of epilepsy is multifaceted and extensive on its effects. The occurrence of seizures is unpredictable and often dangerous, increasing the risk of injury, hospitalization and mortality, and adversely affecting a patient's mental health, often resulting in anxiety, depression or cognitive impairment. Seizures can also result in stigmatization and social exclusion, with detrimental effects on an individual's confidence and self-esteem. However, the burden of epilepsy extends beyond the effects of seizures themselves. In particular, individuals with epilepsy are significantly more likely to have medical or psychiatric comorbidities than those without epilepsy, and comorbidity in patients with epilepsy has been shown to be strongly correlated with negative impacts on subjective health status and quality of life (QoL). In addition, antiepileptic drug (AED) treatment is commonly associated with side effects, which further impair patients' QoL. Patient surveys provide valuable insights into what matters to patients in their daily lives and highlight important discrepancies between the perceptions of patients and their physicians. For example, survey data show that physicians underestimate the number of patients experiencing AED side effects and the impact of these on patients. Screening questionnaires can help physicians to quickly identify problems with treatment side effects; also, to recognize comorbidities such as depression that are otherwise difficult to identify in a time-limited consultation. Ultimately, successful management of epilepsy requires a holistic approach to care, with treatment tailored to the individual patient's needs; this can only be achieved through effective doctor-patient communication and the full involvement of a multidisciplinary care team.
癫痫的影响是多方面且广泛的。癫痫发作的发生不可预测且往往危险，会增加受伤、住院和死亡的风险，并对患者的心理健康产生不利影响，常导致焦虑、抑郁或认知障碍。癫痫发作还可能导致污名化和社会排斥，对个人的信心和自尊产生不利影响。然而，癫痫的负担不仅限于发作本身的影响。特别是，癫痫患者比非癫痫患者更有可能患有医学或精神疾病合并症，并且已表明癫痫患者的合并症与对主观健康状况和生活质量（QoL）的负面影响密切相关。此外，抗癫痫药物（AED）治疗通常伴有副作用，这进一步损害了患者的生活质量。患者调查为了解患者日常生活中的重要事项提供了有价值的见解，并突出了患者与医生认知之间的重要差异。例如，调查数据显示，医生低估了经历AED副作用的患者数量以及这些副作用对患者的影响。筛查问卷可以帮助医生快速识别治疗副作用问题；还可以识别抑郁症等合并症，否则在有限的咨询时间内很难识别这些合并症。最终，成功管理癫痫需要采取整体护理方法，根据个体患者的需求进行治疗；这只能通过有效的医患沟通和多学科护理团队的全面参与来实现。
