Tuchman Roberto
Department of Neurology, Nicklaus Children's Hospital, Miami Children's Health System, Weston, FL.
Epilepsy Curr. 2015 Jul-Aug;15(4):202-5. doi: 10.5698/1535-7511-15.4.202.
The association of epilepsy, autism spectrum disorders (ASD), and intellectual disability (ID) is well recognized. There is a wide range of social-cognitive deficits that can be identified in epilepsy over the life-span, from ASD in infants with an epileptic encephalopathy, to social-cognitive impairments affecting social interaction and comprehension in those with normal nonsocial cognitive function. Identifying ASD and social-cognitive deficits is an important aspect of comprehensive epilepsy care. There are behavioral and educational interventions that exist to treat ASD and social-cognitive deficits. These behavioral, communication, and educational interventions, in conjunction with medications to treat the seizures, should be considered an integral part of the comprehensive management of epilepsy throughout the life-span. The following are the key points of this review: Autism spectrum disorders and social-cognitive deficits are associated with epilepsy throughout the life-span, and identification of these deficits is an important part of epilepsy care.Children with an epileptic encephalopathy such as infantile spasms are at high risk for developing ASD, and the social-cognitive deficits that precede ASD may be recognized in the first year of life.In epilepsy, the likelihood of developing autism spectrum disorders is highest in those with ID, but there is a wide spectrum of manifestations, from ASD in children with epilepsy and ID, to social-cognitive impairments affecting social interaction and comprehension in those with normal nonsocial cognitive function.Implementation of behavioral, communication, and educational interventions that exist to treat ASD and social-cognitive deficits, along with medications to treat the seizures, should be considered an important part of the comprehensive management of epilepsy throughout the life-span.
癫痫、自闭症谱系障碍(ASD)和智力残疾(ID)之间的关联已得到广泛认可。在癫痫患者的一生中,可以发现一系列社会认知缺陷,从患有癫痫性脑病的婴儿出现的ASD,到正常非社会认知功能者中影响社会互动和理解的社会认知障碍。识别ASD和社会认知缺陷是全面癫痫护理的一个重要方面。存在治疗ASD和社会认知缺陷的行为和教育干预措施。这些行为、沟通和教育干预措施,与治疗癫痫发作的药物相结合,应被视为癫痫患者一生综合管理的一个组成部分。以下是本综述的要点:自闭症谱系障碍和社会认知缺陷在癫痫患者一生中都与之相关,识别这些缺陷是癫痫护理的重要组成部分。患有癫痫性脑病(如婴儿痉挛症)的儿童患ASD的风险很高,ASD之前的社会认知缺陷可能在生命的第一年就被识别出来。在癫痫患者中,ID患者患自闭症谱系障碍的可能性最高,但表现形式多种多样,从患有癫痫和ID的儿童的ASD,到正常非社会认知功能者中影响社会互动和理解的社会认知障碍。实施现有的治疗ASD和社会认知缺陷的行为、沟通和教育干预措施,以及治疗癫痫发作的药物,应被视为癫痫患者一生综合管理的重要组成部分。