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癫痫患者与精神性非癫痫发作患者认知障碍的比较。

Comparison of Cognitive Impairment between Patients having Epilepsy and Psychogenic Nonepileptic Seizures.

作者信息

Özer Çelik Ayşegül, Kurt Pınar, Yener Görsev, Alkin Tunç, Öztura İbrahim, Baklan Barış

机构信息

Clinic of Neurology, Kanuni Training and Research Hospital, Trabzon, Turkey.

Department of Psychology, İstanbul Arel University, İstanbul, Turkey.

出版信息

Noro Psikiyatr Ars. 2015 Jun;52(2):163-168. doi: 10.5152/npa.2015.7290. Epub 2015 Jun 1.

Abstract

INTRODUCTION

The aim of this study was to evaluate cognitive impairment in patients having epilepsy or psychogenic nonepileptic seizures (PNESs) using selected neuropsychological tests at different time periods related to the seizure.

METHODS

In this study, selected neurocognitive tests were administered to the patients. Within 24 h, the previously applied neurocognitive tests were repeated within 24 h following the observation of typical seizures when monitoring and normalizing electroencephalography (EEG) activity. Basal neurocognitive tests were also administered to the healthy control group, and repeat neurocognitive evaluation was performed within 24-96 h.

RESULTS

The basal neurocognitive evaluation revealed that verbal learning and memory scores as well as Stroop test interference time were significantly lower in the PNES group compared with those in the controls. In the basal cognitive tests administered to the patients with epilepsy, verbal learning and memory scores, long-term memory, and total recognition test scores were significantly lower than those of the controls. Following the repeat cognitive tests, significant progress was found in the verbal categorical fluency score of the PNES group. No significant difference was determined in the epilepsy group. Significant contraction was determined in the Stroop interference time in the control group, but no similar change was recorded in the epilepsy or PNES groups.

CONCLUSION

While memory problems seemed to be most prominent in the assessed patients with epilepsy, attention and executive function problems were more dominant in the patients with PNESs. These findings are probably related to numerous factors such duration of disease, mood disorders, and specific drug use. No deterioration in attention and executive functions was reported in the early post-seizure period in either patient group.

摘要

引言

本研究的目的是通过在与癫痫发作相关的不同时间段使用选定的神经心理学测试,评估癫痫患者或精神性非癫痫发作(PNES)患者的认知障碍。

方法

在本研究中,对患者进行了选定的神经认知测试。在24小时内,当监测和使脑电图(EEG)活动正常化时,在观察到典型发作后的24小时内重复之前应用的神经认知测试。也对健康对照组进行了基础神经认知测试,并在24 - 96小时内进行了重复神经认知评估。

结果

基础神经认知评估显示,与对照组相比,PNES组的言语学习和记忆分数以及斯特鲁普测试干扰时间显著更低。在对癫痫患者进行的基础认知测试中,言语学习和记忆分数、长期记忆以及总识别测试分数显著低于对照组。重复认知测试后,PNES组的言语分类流畅性分数有显著进步。癫痫组未发现显著差异。对照组的斯特鲁普干扰时间有显著缩短,但癫痫组或PNES组未记录到类似变化。

结论

虽然在评估的癫痫患者中记忆问题似乎最为突出,但注意力和执行功能问题在PNES患者中更为明显。这些发现可能与多种因素有关,如疾病持续时间、情绪障碍和特定药物使用。在任何一个患者组的癫痫发作后早期,均未报告注意力和执行功能恶化。

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Psychogenic nonepileptic seizures.心因性非癲癇性發作。
Epilepsy Behav. 2011 Sep;22(1):85-93. doi: 10.1016/j.yebeh.2011.02.016. Epub 2011 Mar 29.
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The effect of seizures on working memory and executive functioning performance.癫痫对工作记忆和执行功能表现的影响。
Epilepsy Behav. 2010 Mar;17(3):412-9. doi: 10.1016/j.yebeh.2010.01.006. Epub 2010 Feb 13.
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The differential diagnosis of epilepsy: a critical review.癫痫的鉴别诊断:一项批判性综述。
Epilepsy Behav. 2009 May;15(1):15-21. doi: 10.1016/j.yebeh.2009.02.024. Epub 2009 Feb 21.

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