Lenci Giovanna, Calevo Maria Grazia, Gaggero Roberto, Prato Giulia, Pisciotta Livia, De Grandis Elisa, Mancardi Maria Margherita, Baglietto Maria Giuseppina, Vigano' Monica, Veneselli Edvige
Unit of Child Neuropsychiatry, Dept of Clinical and Surgical Neurosciences and Rehabilitation, IRCCS Istituto Giannina Gaslini, Genoa 16147, Italy.
Epidemiology and Biostatistics Section, Scientific Directorate, IRCCS Istituto Giannina Gaslini, Genoa 16147, Italy.
Brain Dev. 2019 Jun;41(6):522-530. doi: 10.1016/j.braindev.2019.02.004. Epub 2019 Feb 20.
Epilepsy with continuous spike-waves during slow sleep syndrome (CSWSS) is characterized by various seizure types, a characteristic EEG pattern and neuropsychological disorders. The main purpose of this study was to evaluate the long-term outcome of CSWSS occurred in childhood and to evaluate the variables that could influence the quality of social adaptation and the personality profile.
This is a prospective study on 24 young adults with previous CSWSS (median age 24.5 yrs) who were enrolled between January and July 2011 at the G. Gaslini Children's Hospital, Genoa, Italy. Patients were divided into two groups: twelve with previous spike-wave index (SWI > 85%) defined as typical CSWSS (T-CSWSS) and twelve with previous SWI = 50-85% defined as atypical CSWSS (A-CSWSS). All the subjects were submitted to Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Psychological General Well-Being Index (PGWBI), and to a structured interview.
A correlation was observed with the severity of EEG abnormalities expressed by the SWI and outcome. The T-CSWSS group showed a significantly lower perceived well-being. Similarly in the T-CSWSS group the percentage of MMPI-2 clinical scales with T-scores ≥65 was higher than in the A-CSWSS group. Finally, a significant lower schooling in the T-CSWSS group was observed.
There seem to be two forms of the same disease, with similar onset and clinical evolution but a different outcome regarding the social and psychological conditions. The outcome of the social adaptation and of the personality consciousness was related with the severity of the EEG abnormalities: more favorable in patients with less intense SWI activity (A-CSWSS) compared those with a more severe EEG impairment (T-CSWSS).
慢波睡眠期持续棘慢波癫痫综合征(CSWSS)的特征为多种发作类型、特征性脑电图模式和神经心理障碍。本研究的主要目的是评估儿童期发生的CSWSS的长期预后,并评估可能影响社会适应质量和人格特征的变量。
这是一项对24例曾患CSWSS的年轻成年人(中位年龄24.5岁)进行的前瞻性研究,他们于2011年1月至7月在意大利热那亚的G. Gaslini儿童医院入组。患者分为两组:12例既往棘慢波指数(SWI>85%)定义为典型CSWSS(T-CSWSS),12例既往SWI=50-85%定义为非典型CSWSS(A-CSWSS)。所有受试者均接受明尼苏达多相人格调查表-2(MMPI-2)、心理总体幸福感指数(PGWBI)评估,并进行结构化访谈。
观察到SWI所表达的脑电图异常严重程度与预后之间存在相关性。T-CSWSS组的主观幸福感显著较低。同样,在T-CSWSS组中,T分数≥65的MMPI-2临床量表百分比高于A-CSWSS组。最后,观察到T-CSWSS组的受教育程度显著较低。
似乎存在同一种疾病的两种形式,其起病和临床演变相似,但在社会和心理状况方面预后不同。社会适应和人格意识的预后与脑电图异常的严重程度相关:与脑电图损害更严重的患者(T-CSWSS)相比,SWI活动强度较小的患者(A-CSWSS)预后更有利。