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小儿癫痫手术:中枢神经系统合并症对患者及其家庭的预后价值

Pediatric Epilepsy Surgery: The Prognostic Value of Central Nervous System Comorbidities in Patients and their Families.

作者信息

Qualmann Krista J, Spaeth Christine G, Myers Melanie F, Horn Paul S, Holland Katherine, Mangano Francesco T, Greiner Hansel M

机构信息

1 Division of Human Genetics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

2 Division of Pediatric Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

出版信息

J Child Neurol. 2017 Apr;32(5):467-474. doi: 10.1177/0883073816685653. Epub 2017 Jan 6.

Abstract

Central nervous system comorbidities have been identified in patients with epilepsy. Several of these comorbidities have been correlated with poor surgery outcomes in patient cohorts. The authors sought to determine if prevalence of comorbidities in pediatric epilepsy surgery patients and their families correlate with long-term seizure outcome in a cross-sectional analysis. Three-generation pedigrees were elicited to compare family history of epilepsy, ADHD, anxiety, autism, bipolar disorder, cognitive disability, depression, migraine, and motor disability to surgery outcomes in 52 patients. Proportions of affected patients and relatives were compared to general population comorbidity rates and the patients' most recent seizure outcome classification. Patients and families had significantly higher rates of comorbidities than the general population. Poorer long-term seizure outcomes following resective surgery were associated with autism or cognitive disability in patients. Together these data support evidence for a common pathophysiological mechanism between epilepsy and central nervous system comorbidities.

摘要

癫痫患者中已发现存在中枢神经系统合并症。在一些患者队列中,其中几种合并症与手术效果不佳相关。作者试图通过横断面分析来确定小儿癫痫手术患者及其家属中合并症的患病率是否与长期癫痫发作结果相关。绘制三代家系图,以比较52例患者的癫痫、注意力缺陷多动障碍(ADHD)、焦虑症、自闭症、双相情感障碍、认知障碍、抑郁症、偏头痛和运动障碍家族史与手术结果。将受影响患者和亲属的比例与一般人群合并症发生率以及患者最近的癫痫发作结果分类进行比较。患者及其家属的合并症发生率显著高于一般人群。切除性手术后较差的长期癫痫发作结果与患者的自闭症或认知障碍有关。这些数据共同支持了癫痫与中枢神经系统合并症之间存在共同病理生理机制的证据。

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