Syvertsen Marte, Selmer Kaja, Enger Ulla, Nakken Karl O, Pal Deb K, Smith Anna, Koht Jeanette
Department of Neurology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway; National Center for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
Epilepsy Behav. 2019 Jan;90:122-128. doi: 10.1016/j.yebeh.2018.11.022. Epub 2019 Jan 22.
Juvenile myoclonic epilepsy (JME) constitutes about 10% of all epilepsies. Because of executive dysfunction, people with JME may be prone to impulsivity and risk-taking behavior. Our aim was to investigate whether psychosocial issues associated with impulsivity are more prominent in people with JME than in those with other types of genetic generalized epilepsy (GGE). Patients with GGE were recruited retrospectively through the Drammen Hospital records in Buskerud County, Norway, 1999-2013. They were invited to a semi-structured interview, either at the hospital or at home. Ninety-two patients with JME and 45 with other types of GGE were interviewed. Variables were evaluated in terms of their association with JME versus other GGE diagnosis using a logistic regression model. Juvenile myoclonic epilepsy was associated with use of illicit recreational drugs and police charges, although with borderline significance (odds ratio [OR] 3.4, p = 0.087 and OR 4.2, p = 0.095); JME was also associated with being examined for attention-deficit hyperactivity disorder (ADHD) in females (OR 15.5, p = 0.015), a biological parent with challenges like addiction or violent behavior (OR 3.5, p = 0.032), and use of levetiracetam (OR 5.1, p = 0.014). After controlling for group differences, we found psychosocial complications to be associated with JME, potentially influencing the lives of the individuals and their families to a greater extent than the seizures per se. Thus, JME should be considered a disorder of the brain in a broader sense than a condition with seizures only.
青少年肌阵挛性癫痫(JME)约占所有癫痫病例的10%。由于存在执行功能障碍,JME患者可能更容易出现冲动和冒险行为。我们的目的是调查与冲动相关的社会心理问题在JME患者中是否比在其他类型的遗传性全身性癫痫(GGE)患者中更为突出。通过回顾挪威布斯克吕德郡德拉门医院1999 - 2013年的记录,招募了GGE患者。他们被邀请到医院或家中接受半结构化访谈。对92例JME患者和45例其他类型GGE患者进行了访谈。使用逻辑回归模型评估变量与JME及其他GGE诊断之间的关联。青少年肌阵挛性癫痫与使用非法娱乐性药物及警方指控有关,尽管具有临界显著性(优势比[OR] 3.4,p = 0.087;OR 4.2,p = 0.095);JME还与女性接受注意力缺陷多动障碍(ADHD)检查有关(OR 15.5,p = 0.015),与有诸如成瘾或暴力行为等问题的亲生父母有关(OR 3.5,p = 0.032),以及与使用左乙拉西坦有关(OR 5.1,p = 0.014)。在控制组间差异后,我们发现社会心理并发症与JME相关,可能比癫痫发作本身对个体及其家庭生活的影响更大。因此,从更广泛的意义上讲,JME应被视为一种脑部疾病,而不仅仅是一种仅有癫痫发作的病症。