Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Epilepsy Behav. 2013 Oct;29(1):166-71. doi: 10.1016/j.yebeh.2013.07.010. Epub 2013 Aug 22.
The purpose of this study was to quantify the intelligence of children with epilepsy and to determine the clinical factors associated with intellectual impairment. The medical records of patients diagnosed with childhood-onset epilepsy at a single tertiary medical center in Korea between 2006 and 2011 were retrospectively reviewed. The Korean Education Development Institute-Wechsler Intelligence Scale for Children or Korean Wechsler Intelligence Scale for adults was used to quantify the level of intelligence. Age at seizure onset, etiology, epilepsy duration, number of seizures in the last year, use of antiepileptic drugs, EEG/MRI findings, and epilepsy classification were recorded. The association between clinical factors and the intelligence was determined using logistic regression. Three hundred and twenty-two patients were included in the analysis. One hundred and seventy-six (54.7%) patients had low intelligence (intelligence quotient [IQ]<80) with 18 (5.6%) defined as borderline mental retardation (IQ 70-79), 47 (14.6%) as mild mental retardation (IQ 60-69), and 111 (34.5%) as moderate-to-severe mental retardation (IQ<60). Epilepsy duration, number of seizures in the last year, and epilepsy classification were significantly associated with low intelligence in multivariate logistic regression (p<0.05). However, when analyzed according to etiology, these factors were not associated with low intelligence in children with idiopathic epilepsy. The most important factors associated with low intelligence in childhood-onset epilepsy are the underlying etiology and, in cryptogenic and symptomatic epilepsy, seizure burden. The results of this study underscore the importance of seizure control to alleviate the harmful impact of epilepsy on cognition.
本研究旨在量化癫痫儿童的智力，并确定与智力障碍相关的临床因素。回顾性分析了 2006 年至 2011 年期间在韩国一家三级医疗中心确诊为儿童期起病癫痫的患者的病历。采用韩国教育发展研究所-韦氏儿童智力量表或韩国韦氏成人智力量表来量化智力水平。记录发病年龄、病因、癫痫持续时间、过去一年的发作次数、抗癫痫药物的使用、脑电图/磁共振成像结果和癫痫分类。使用逻辑回归确定临床因素与智力之间的关联。共纳入 322 例患者进行分析。176 例（54.7%）患者存在智力低下（智商[IQ]＜80），其中 18 例（5.6%）为边缘智力障碍（IQ 70-79），47 例（14.6%）为轻度智力障碍（IQ 60-69），111 例（34.5%）为中重度智力障碍（IQ＜60）。多变量逻辑回归显示，癫痫持续时间、过去一年的发作次数和癫痫分类与智力低下显著相关（p＜0.05）。然而，根据病因进行分析时，这些因素与特发性癫痫患儿的智力低下无关。与儿童期起病癫痫智力低下相关的最重要因素是潜在病因，而在隐源性和症状性癫痫中，是发作负荷。本研究结果强调了控制癫痫发作以减轻癫痫对认知的有害影响的重要性。
