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非惊厥性癫痫持续状态的认知和运动康复效果:一例报告

Effects of cognitive and motor rehabilitation in non-convulsive status epilepticus: A case report.

作者信息

Corallo Francesco, Lo Buono Viviana, Di Cara Marcella, De Salvo Simona, Vermiglio Giuliana, Pollicino Patrizia, Bramanti Placido, Marino Silvia, Rifici Carmela

机构信息

IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.

IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.

出版信息

J Clin Neurosci. 2018 Aug;54:137-139. doi: 10.1016/j.jocn.2018.06.024. Epub 2018 Jun 13.

DOI:10.1016/j.jocn.2018.06.024
PMID:29908718
Abstract

Epilepsy is a neurological disorder characterized by recurrent and unpredictable interruptions of normal brain function, that implies neurobiologic, psychological, and social consequences. Non-convulsive status epilepticus (NCSE) is an electro-clinical state associated to altered level of consciousness. In NCSE could occur the behavioural and emotional disorder, cognitive impairment and psychiatric disorder with a negative impact on quality of life and adaptive social behaviours. Cognitive rehabilitation for epileptic patients may include internal compensation strategies, external memory aids, psychoeducation, verbal and visual memory training, attention exercise and executive functions. We described the cognitive rehabilitation in a patient with NCSE characterized by an unusual cognitive impairment. A 55-year-old female patient, with epileptic seizures presented a severe impairment in cognitive function and focal neurological deficit. The cognitive treatment was designed as a combination of direct training of the impaired functions and metacognitive training to facilitate the development of compensatory strategies and it was divided into three methods. Neuropsychological evaluation showed a progressive deficit of high cognitive functions. The patient after cognitive rehabilitation, demonstrated a significant recovery of motor abilities, despite the neuro-cognitive profile was abnormal. Several advances have been made in this field but few studies on neuropsychological rehabilitation in adult patients with NCSE have been conducted and no standardized protocol or clinical guidelines are still available.

摘要

癫痫是一种神经系统疾病,其特征是正常脑功能反复出现且不可预测的中断,这意味着会产生神经生物学、心理和社会后果。非惊厥性癫痫持续状态(NCSE)是一种与意识水平改变相关的电临床状态。在NCSE中,可能会出现行为和情绪障碍、认知障碍及精神障碍,对生活质量和适应性社会行为产生负面影响。癫痫患者的认知康复可能包括内部补偿策略、外部记忆辅助工具、心理教育、言语和视觉记忆训练、注意力训练及执行功能训练。我们描述了一名以异常认知障碍为特征的NCSE患者的认知康复情况。一名55岁女性患者,伴有癫痫发作,存在严重的认知功能障碍和局灶性神经功能缺损。认知治疗设计为受损功能的直接训练与元认知训练相结合,以促进补偿策略的发展,并分为三种方法。神经心理学评估显示高级认知功能逐渐衰退。尽管神经认知特征仍异常,但该患者经过认知康复后,运动能力有显著恢复。该领域已取得了一些进展,但针对成年NCSE患者的神经心理学康复研究较少,目前仍没有标准化方案或临床指南。

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