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癫痫与暴力:关于癫痫患者子女遭受身体创伤的病例系列研究。

Epilepsy and violence: case series concerning physical trauma in children of persons with epilepsy.

机构信息

Department of Neurology, Linköping University, Linköping, Sweden ; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.

Department of Neurology, Linköping University, Linköping, Sweden ; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden ; Neurology Unit, Department of Medical Specialist, General Hospital, Department of Medicine and Health Sciences, IMM, County Council, Linköping University, Motala, Sweden ; Department of Neuroscience, Uppsala University, Uppsala, Sweden.

出版信息

Neuropsychiatr Dis Treat. 2014 Nov 14;10:2183-9. doi: 10.2147/NDT.S68438. eCollection 2014.

Abstract

Historically, epilepsy has been associated with violence, but more recent studies have emphasized genetic and psychosocial factors as more important. The case series presented here aim to highlight the difficult situation the affected children are in. We report on three cases when children have been traumatized and, in one case, even been killed by their parent who was diagnosed with epilepsy. In the first case, we describe a woman with juvenile myoclonic epilepsy who was sentenced to forensic psychiatry care for killing her child. She lived under difficult psychosocial circumstances and a suicide attempt contributed to what happened. The second case describes a man with post-traumatic seizures who was sentenced for child abuse. Ictal or postictal violence was considered in these two cases but a causal link between the violence and epilepsy has not been established. In the third case, we describe a woman with focal epilepsy and psychogenic non-epileptic seizures (PNESs). Her child was hurt and frightened in relation to violent seizures, which were regarded as PNESs. This case series demonstrates that children of parents with epilepsy can be in a vulnerable situation. No causality has been established between the seizures and these events, so consequently other factors such as psychosocial stress, low cognitive function, and a suicide attempt must also be considered as important. When a child is hurt by a parent with epilepsy the patient must be closely examined to determine the role of the seizures. Children can also be affected by PNESs. It is essential to notice especially those children of parents with epilepsy who live under difficult psychosocial circumstances and offer extra support when necessary.

摘要

从历史上看,癫痫与暴力有关,但最近的研究强调遗传和社会心理因素更为重要。这里呈现的病例系列旨在强调受影响儿童的困境。我们报告了三个案例,当孩子受到父母患有癫痫的创伤,在一个案例中,甚至被父母杀害。在第一个案例中,我们描述了一位患有青少年肌阵挛性癫痫的女性,她因杀害孩子而被判处法医精神病学治疗。她生活在困难的社会心理环境中,自杀未遂促成了这一事件的发生。第二个案例描述了一位患有创伤后癫痫发作的男性,他因虐待儿童而被判刑。在这两个案例中都考虑了癫痫发作或发作后暴力行为,但暴力行为与癫痫之间的因果关系尚未建立。在第三个案例中,我们描述了一位患有局灶性癫痫和心因性非癫痫性发作(PNESs)的女性。她的孩子因暴力发作而受伤和惊吓,这些发作被认为是 PNESs。这个病例系列表明,癫痫父母的孩子可能处于弱势地位。癫痫发作与这些事件之间没有建立因果关系,因此还必须考虑其他因素,如社会心理压力、认知功能低下和自杀未遂,这些因素也很重要。当孩子被患有癫痫的父母伤害时,必须对患者进行仔细检查,以确定癫痫发作的作用。儿童也可能受到 PNESs 的影响。重要的是要注意到那些生活在困难的社会心理环境中的父母患有癫痫的孩子,并在必要时提供额外的支持。

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