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青少年肌阵挛性癫痫:精神共病及其对结局的影响。

Juvenile myoclonic epilepsy: psychiatric comorbidity and impact on outcome.

机构信息

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.

出版信息

Epilepsy Behav. 2013 Jul;28 Suppl 1:S74-80. doi: 10.1016/j.yebeh.2013.03.026.

Abstract

Juvenile myoclonic epilepsy (JME) is a well-defined age-related idiopathic epilepsy syndrome. Past studies have emphasized the difficulties in the treatment of patients with JME, which have been attributed to some specific psychiatric, psychological, and psychosocial characteristics. These aspects have aroused a significant amount of interest in the last two decades. In this article, the available studies that investigated the prevalence of psychiatric disorders (PDs) in JME and its impact on seizure outcome were reviewed in order to provide an update to clinicians about these two important aspects associated with this common epilepsy syndrome. The review disclosed a high prevalence of PDs in patients with JME, particularly mood, anxiety, and personality disorders. In addition, most recent studies have also observed that overall prevalence of PDs in JME has not shown statistically significant differences when compared with TLE, an epilepsy syndrome where the psychiatric aspects are most frequently studied. Taken together, data regarding the prevalence of PDs and their possible consequences on seizure outcome on JME indicate that special attention should be directed to psychological disturbances and psychiatric symptoms in this epilepsy syndrome. The early recognition and treatment of psychiatric symptoms, as well as psychological disturbances and psychosocial difficulties, should be considered fundamental to JME prognosis.

摘要

青少年肌阵挛癫痫(JME)是一种明确的与年龄相关的特发性癫痫综合征。过去的研究强调了 JME 患者治疗的困难,这归因于一些特定的精神、心理和社会心理特征。在过去的二十年中,这些方面引起了极大的关注。在本文中,回顾了研究 JME 中精神障碍(PD)的患病率及其对癫痫发作结局影响的现有研究,以便向临床医生提供有关与这种常见癫痫综合征相关的这两个重要方面的最新信息。该综述显示 JME 患者的 PD 患病率很高,尤其是情绪、焦虑和人格障碍。此外,最近的大多数研究还观察到,与 TLE 相比,JME 中 PD 的总体患病率没有统计学上的显著差异,TLE 是最常研究精神方面的癫痫综合征。综上所述,关于 JME 中 PD 的患病率及其对癫痫发作结局可能产生的影响的数据表明,在这种癫痫综合征中,应特别注意心理障碍和精神症状。早期识别和治疗精神症状以及心理障碍和社会心理困难应被视为 JME 预后的基础。

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