Mizobuchi Masahiro
Department of Neurology, Nakamura Memorial Hospital.
Brain Nerve. 2013 Sep;65(9):1031-40.
Epilepsy is one of the most common neurological disorders. Global neurological knowledge is essential for differential diagnosis of epileptic syndromes due to the diversity of ictal semiology, causes and syndromes. Neurologists play an important role in planning the medical care for patients with epilepsy, as medication is the most fundamental therapeutic strategy. Some patients with early-onset epilepsy require joint care by pediatric neurologists, those with intractable epilepsy by neurosurgeons, and those with psychological comorbidity by psychiatrists, and neurologists should play a coordinating role. While there is a great need for neurologists to participate in epilepsy care, neurologists in Japan currently do not participate substantially in the epilepsy management system. It is necessary to train more neurologists who can provide epilepsy care and conduct basic and clinical research on epilepsy by providing continuous education on epilepsy for general neurologists as well as pre- and post-graduate medical students. Most of the patients who require long-term treatment experience many medical problems and social handicaps, such as adverse effects of medication, social stigma, educational disadvantages and difficulties in obtaining driver's license. To improve the quality of life of patients with epilepsy, it is desirable to build broad medical-social networks participated by patients, doctors, neurological nurses, psychologists, social workers, school teachers, managers of employment support facilities and care givers.
癫痫是最常见的神经系统疾病之一。由于发作期症状学、病因和综合征的多样性,全球神经学知识对于癫痫综合征的鉴别诊断至关重要。神经科医生在为癫痫患者规划医疗护理方面发挥着重要作用,因为药物治疗是最基本的治疗策略。一些早发性癫痫患者需要儿科神经科医生的联合护理,难治性癫痫患者需要神经外科医生的护理,有心理合并症的患者需要精神科医生的护理,而神经科医生应发挥协调作用。虽然非常需要神经科医生参与癫痫护理,但日本的神经科医生目前并未大量参与癫痫管理系统。有必要通过为普通神经科医生以及医学专业的研究生和本科生提供癫痫方面的持续教育,培养更多能够提供癫痫护理并开展癫痫基础和临床研究的神经科医生。大多数需要长期治疗的患者会经历许多医疗问题和社会障碍,如药物不良反应、社会污名、教育劣势以及获取驾照困难等。为提高癫痫患者的生活质量,建立由患者、医生、神经科护士、心理学家、社会工作者、学校教师、就业支持设施管理人员和护理人员参与的广泛医疗 - 社会网络是可取的。