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常规癫痫护理中神经心理学评估的适应症与期望:国际抗癫痫联盟神经心理学特别工作组报告,诊断方法委员会,2013 - 2017年

Indications and expectations for neuropsychological assessment in routine epilepsy care: Report of the ILAE Neuropsychology Task Force, Diagnostic Methods Commission, 2013-2017.

作者信息

Wilson Sarah J, Baxendale Sallie, Barr William, Hamed Sherifa, Langfitt John, Samson Séverine, Watanabe Masako, Baker Gus A, Helmstaedter Christoph, Hermann Bruce P, Smith Mary-Lou

机构信息

Melbourne School of Psychological Sciences, The University of Melbourne, Austin Health, Melbourne, Australia.

Comprehensive Epilepsy Program, Austin Health, Melbourne, Australia.

出版信息

Epilepsia. 2015 May;56(5):674-81. doi: 10.1111/epi.12962. Epub 2015 Mar 16.

Abstract

The International League Against Epilepsy (ILAE) Diagnostic Methods Commission charged the Neuropsychology Task Force with the job of developing a set of recommendations to address the following questions: (1) What is the role of a neuropsychological assessment? (2) Who should do a neuropsychological assessment? (3) When should people with epilepsy be referred for a neuropsychological assessment? and (4) What should be expected from a neuropsychological assessment? The recommendations have been broadly written for health care clinicians in established epilepsy settings as well as those setting up new services. They are based on a detailed survey of neuropsychological assessment practices across international epilepsy centers, and formal ranking of specific recommendations for advancing clinical epilepsy care generated by specialist epilepsy neuropsychologists from around the world. They also incorporate the latest research findings to establish minimum standards for training and practice, reflecting the many roles of neuropsychological assessment in the routine care of children and adults with epilepsy. The recommendations endorse routine screening of cognition, mood, and behavior in new-onset epilepsy, and describe the range of situations when more detailed, formal neuropsychological assessment is indicated. They identify a core set of cognitive and psychological domains that should be assessed to provide an objective account of an individual's cognitive, emotional, and psychosocial functioning, including factors likely contributing to deficits identified on qualitative and quantitative examination. The recommendations also endorse routine provision of feedback to patients, families, and clinicians about the implications of the assessment results, including specific clinical recommendations of what can be done to improve a patient's cognitive or psychosocial functioning and alleviate the distress of any difficulties identified. By canvassing the breadth and depth of scope of neuropsychological assessment, this report demonstrates the pivotal role played by this noninvasive and minimally resource intensive investigation in the care of people with epilepsy.

摘要

国际抗癫痫联盟(ILAE)诊断方法委员会责成神经心理学特别工作组开展一项工作,即制定一套建议,以解决以下问题:(1)神经心理学评估的作用是什么?(2)谁应该进行神经心理学评估?(3)癫痫患者应在何时被转介进行神经心理学评估?以及(4)对神经心理学评估应抱有怎样的期望?这些建议是为癫痫诊疗机构的医疗保健临床医生以及那些建立新服务的人员广泛编写的。它们基于对国际癫痫中心神经心理学评估实践的详细调查,以及由来自世界各地的癫痫专科神经心理学家针对推进临床癫痫护理提出的具体建议的正式排名。它们还纳入了最新研究成果,以确立培训和实践的最低标准,反映神经心理学评估在癫痫儿童和成人常规护理中的多种作用。这些建议支持对新发癫痫患者进行认知、情绪和行为的常规筛查,并描述了需要进行更详细、正式神经心理学评估的一系列情况。它们确定了一组核心认知和心理领域,应予以评估,以便客观描述个体的认知、情感和社会心理功能,包括在定性和定量检查中可能导致缺陷的因素。这些建议还支持向患者、家属和临床医生常规反馈评估结果的影响,包括关于如何改善患者认知或社会心理功能以及缓解所发现的任何困难带来的痛苦的具体临床建议。通过探讨神经心理学评估范围的广度和深度,本报告展示了这项无创且资源消耗极少的检查在癫痫患者护理中所起的关键作用。

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