Kasradze Sofia, Lomidze Giorgi, Cross J Helen, Kvernadze David, Alkhidze Maia, Gagoshidze Tamar
Institute of Neurology and Neuropsychology, 83/11, Vaja-Pshavela Ave., 0186 Tbilisi, Georgia; Caucasus International University, 73, Chargali Str., 0141 Tbilisi, Georgia.
UCL Great Ormond Street Institute of Child Health, 30, Guilford Street, London WC1N 1EH, UK.
Brain Dev. 2021 Sep;43(8):833-842. doi: 10.1016/j.braindev.2021.03.007. Epub 2021 Apr 21.
This study describes the specific neuropsychological abnormalities among children with epilepsy (CH-E) living in Georgia.
A cohort of CH-E and children without epilepsy (CH-NoE), aged 6-13 years, admitted to the epilepsy center of the Institute of Neurology and Neuropsychology from 1st January 2010 to 31st December 2015, was selected and investigated with a structured protocol. Neurological/epileptological assessments were made and neuropsychological testing was done on all study subjects.
Abnormalities in praxis, verbal functions, verbal learning, visual-spatial matching, visual-motor ability, and fine motor skills, working memory, and phonological memory span were often revealed in CH-E as compared to CH-NoE. Early age of seizure onset, epilepsy duration, and anti-seizure medication (ASM) use, in combination with brain structural abnormalities on neuroimaging, and structural etiology were independent predictors of impaired functioning in various neuropsychological domains.
More than half of children with epilepsy have a variety of cognitive impairments, which may increase with ASM therapy, especially when the cause of seizures is structural damage to the brain. Therefore, in the process of diagnosing epilepsy, evaluation of cognitive functions should become an integral part to ensure effective management of the disorder.
本研究描述了居住在格鲁吉亚的癫痫患儿(CH-E)的特定神经心理学异常情况。
选取2010年1月1日至2015年12月31日期间入住神经病学与神经心理学研究所癫痫中心的6至13岁癫痫患儿队列和无癫痫患儿(CH-NoE),采用结构化方案进行调查。对所有研究对象进行神经学/癫痫学评估及神经心理学测试。
与CH-NoE相比,CH-E常出现实践、言语功能、言语学习、视觉空间匹配、视觉运动能力、精细运动技能、工作记忆和语音记忆广度方面的异常。癫痫发作起始年龄早、癫痫病程、抗癫痫药物(ASM)使用情况,以及神经影像学上的脑结构异常和结构病因是各神经心理学领域功能受损的独立预测因素。
超过半数的癫痫患儿存在多种认知障碍,这些障碍可能会因ASM治疗而加重,尤其是当癫痫病因是脑结构损伤时。因此,在癫痫诊断过程中,认知功能评估应成为确保有效管理该疾病的一个组成部分。