Helmstaedter Christoph, Witt Juri-Alexander
University of Bonn, Department of Epileptology, Germany.
University of Bonn, Department of Epileptology, Germany.
Seizure. 2017 Jan;44:113-120. doi: 10.1016/j.seizure.2016.09.010. Epub 2016 Oct 13.
Some of the roots of current clinical neuropsychology go back to the early days of epilepsy surgery. Looking back a huge number of publications have dealt with cognition in epilepsy. The major factors driving this work were questions relating to surgery, antiepileptic drugs and, more recently, also to underlying pathology. However, most factors affecting cognition in epilepsy have been discerned many years ago. The body of neuropsychological literature in this field has accumulated much knowledge, raising the question why, apart from epilepsy surgery settings, neuropsychology has still not been fully integrated in the routine care of patients with epilepsy. This review on the occasion of Seizure's 25th anniversary attempts to summarize clinically relevant diagnostic advances following a question guided, modular, and evidence-based approach. In doing so, we hope to attract the interest of readers to an exciting mode of assessment which does not only have theoretical but also practical relevance. The comorbidities of epilepsy are becoming an increasingly relevant topic. It is now widely accepted that, while epilepsy may be defined by the occurrence of epileptic seizures, these seizures represent only one of several possible sources of cognitive impairment. It is well-established that there are complex interactions between epilepsy, cognition and behavior, and that both seizures and problems with cognition or behavior may result from a common underlying pathology requiring treatment. With this review we aim to demonstrate that neuropsychology can make a highly valuable contribution to the care of individual patients by contributing to the diagnostic process and by serving as a tool for the monitoring of disease and treatment, thereby improving the quality and safety of patient care. On a national, European, and international level, first efforts are being made to homogenize diagnostics across epilepsy centers and countries in order to achieve a common language and core standards. This should improve communication within and outside the speciality, and help to generate the data required to allow the field to make further progress.
当前临床神经心理学的一些根源可追溯到癫痫手术的早期。回顾过去，大量出版物都涉及癫痫中的认知问题。推动这项工作的主要因素是与手术、抗癫痫药物相关的问题，以及最近与潜在病理学相关的问题。然而，影响癫痫认知的大多数因素早在许多年前就已被发现。该领域的神经心理学文献积累了大量知识，这就提出了一个问题：为什么除了癫痫手术环境外，神经心理学仍未完全融入癫痫患者的常规护理中。在《癫痫发作》创刊25周年之际，本综述试图采用问题导向、模块化和循证的方法总结临床相关的诊断进展。在此过程中，我们希望吸引读者关注一种令人兴奋的评估方式，它不仅具有理论意义，而且具有实际意义。癫痫的合并症正成为一个越来越重要的话题。现在人们普遍认为，虽然癫痫可能由癫痫发作的发生来定义，但这些发作只是认知障碍的几种可能来源之一。众所周知，癫痫、认知和行为之间存在复杂的相互作用，癫痫发作以及认知或行为问题可能都源于需要治疗的共同潜在病理学。通过本综述，我们旨在证明神经心理学可以通过促进诊断过程以及作为疾病和治疗监测工具，为个体患者的护理做出非常有价值的贡献，从而提高患者护理的质量和安全性。在国家、欧洲和国际层面，人们正在首次努力使癫痫中心和各国之间的诊断同质化，以实现共同的语言和核心标准。这将改善该专业内部和外部的沟通，并有助于生成使该领域取得进一步进展所需的数据。
