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德拉韦特综合征:特征、合并症及照料者关切问题

Dravet syndrome: Characteristics, comorbidities, and caregiver concerns.

作者信息

Villas Nicole, Meskis Mary Anne, Goodliffe Sue

机构信息

Dravet Syndrome Foundation, PO Box 3026, Cherry Hill, NJ 08034, USA.

出版信息

Epilepsy Behav. 2017 Sep;74:81-86. doi: 10.1016/j.yebeh.2017.06.031. Epub 2017 Jul 18.

DOI:10.1016/j.yebeh.2017.06.031
PMID:28732259
Abstract

The Dravet Syndrome Foundation (DSF) conducted the largest in-depth survey of parents and caregivers of patients with Dravet syndrome (DS) to date, in order to (1) identify top concerns among caregivers, (2) establish an approximate frequency of characteristics and comorbidities of DS beyond seizures, and (3) provide direction for clinicians and researchers looking to study the effects of DS on the patient and family unit. Two hundred fifty-six responses were received representing a patient age range of 9months to 32years with a median age group of 7-10years (IQR=8). In an open response, caregivers ranked speech/communication, impacts on siblings, and cognitive impairment as their top concerns after seizure control, and nearly two-thirds of caregivers reported having suffered from depression. Some characteristics of DS such as gait issues increased with patient age, while others, including photosensitivity, hypotonia, and ataxia, were present from a young age. Comorbidities such as sleep disturbances and cardiac abnormalities were more frequently reported than in previous studies and some (including bradycardia) were correlated with SCN1A mutation status. This survey supports the concept of Dravet syndrome as a disease of the central nervous system with far-reaching effects and highlights the importance of the patient voice in determining appropriate research objectives. While seizure frequency is a relatively well-understood objective, seizures represent only a portion of parent and caregiver concerns. Studying the characteristics of DS described herein may identify additional outcomes significant for research.

摘要

德雷维特综合征基金会(DSF)开展了迄今为止针对德雷维特综合征(DS)患者家长及照料者的规模最大的深度调查,目的是:(1)确定照料者最为关切的问题;(2)确定DS除癫痫发作外各种特征及共病的大致出现频率;(3)为希望研究DS对患者及其家庭影响的临床医生和研究人员提供指导。共收到256份回复,代表患者年龄范围为9个月至32岁,年龄中位数组为7至10岁(四分位距=8)。在开放性回答中,照料者将言语/沟通、对兄弟姐妹的影响以及认知障碍列为癫痫得到控制后的首要关切问题,近三分之二的照料者报告称曾患有抑郁症。DS的一些特征,如步态问题会随着患者年龄增长而增多,而其他一些特征,包括光敏性、肌张力减退和共济失调在患者幼年时就已存在。与之前的研究相比,睡眠障碍和心脏异常等共病的报告更为频繁,其中一些(包括心动过缓)与SCN1A突变状态相关。这项调查支持了德雷维特综合征是一种具有深远影响的中枢神经系统疾病的概念,并突出了患者的意见对于确定合适研究目标的重要性。虽然癫痫发作频率是一个相对容易理解的指标,但癫痫发作只是家长和照料者所关切问题的一部分。研究本文所述的DS特征可能会确定对研究具有重要意义的其他结果。

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