Belousova E D, Zavadenko N N
N. I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow.
Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(5. Vyp. 2):80-85. doi: 10.17116/jnevro20181185280.
The problem of epilepsy comorbidity with autism spectrum disorders in children is discussed. The incidence data of autism spectrum disorders in epilepsy, epileptiform discharges on the EEG in autism spectrum disorders and epilepsy in autism spectrum disorders are reviewed. The following types of epilepsy and autism co-occurrence are discussed: both conditions are independent, have different causes and may co-occur by chance; epilepsy and autism are associated, both being independent consequences of the same genetic disorder or early cerebral damage; autism is caused by the epileptic process which interferes with the function of specific brain networks involved in the development of communication and social behavior; autism is a result of the withdrawal reaction in the epileptic child. The known genetic causes of epilepsy and autism spectrum disorders comorbidity are provided. The practical issues are discussed, in particular the rational indication of antiepileptic drugs to the children suffering autism spectrum disorders.
本文讨论了儿童癫痫与自闭症谱系障碍共病的问题。回顾了癫痫中自闭症谱系障碍的发病率数据、自闭症谱系障碍患者脑电图上的癫痫样放电以及自闭症谱系障碍中的癫痫情况。文中讨论了以下几种癫痫与自闭症共病的类型:两者均为独立病症,病因不同,可能偶然同时出现;癫痫与自闭症相关联,二者均是同一遗传疾病或早期脑损伤的独立后果;自闭症由癫痫过程引起,该过程干扰了参与沟通和社会行为发展的特定脑网络功能;自闭症是癫痫儿童退缩反应的结果。文中还介绍了癫痫与自闭症谱系障碍共病已知的遗传原因。此外,还讨论了实际问题,特别是针对患有自闭症谱系障碍儿童的抗癫痫药物合理用药指征。