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德拉韦特综合征——波兰家庭视角研究

Dravet Syndrome-The Polish Family's Perspective Study.

作者信息

Paprocka Justyna, Lewandowska Anita, Zieliński Piotr, Kurczab Bartłomiej, Emich-Widera Ewa, Mazurczak Tomasz

机构信息

Department of Pediatric Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.

Students' Scientific Society, Department of Pediatric Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.

出版信息

J Clin Med. 2021 Apr 28;10(9):1903. doi: 10.3390/jcm10091903.

Abstract

AIM

The aim of the paper is to study the prevalence of Dravet Syndrome (DS) in the Polish population and indicate different factors other than seizures reducing the quality of life in such patients.

METHOD

A survey was conducted among caregivers of patients with DS by the members of the Polish support group of the Association for People with Severe Refractory Epilepsy DRAVET.PL. It included their experience of the diagnosis, seizures, and treatment-related adverse effects. The caregivers also completed the PedsQL survey, which showed the most important problems. The survey received 55 responses from caregivers of patients with DS (aged 2-25 years).

RESULTS

Prior to the diagnosis of DS, 85% of patients presented with status epilepticus lasting more than 30 min, and the frequency of seizures (mostly tonic-clonic or hemiconvulsions) ranged from 2 per week to hundreds per day. After the diagnosis of DS, patients remained on polytherapy (drugs recommended in DS). Before diagnosis, some of them had been on sodium channel blockers. Most patients experienced many adverse effects, including aggression and loss of appetite. The frequency of adverse effects was related to the number of drugs used in this therapy, which had an impact on the results of the PedsQL form, particularly in terms of the physical and social spheres. Intensive care unit stays due to severe status epilepticus also had an influence on the results of the PedsQL form.

CONCLUSIONS

Families must be counseled on non-pharmacologic strategies to reduce seizure risk, including avoidance of triggers that commonly induce seizures (including hyperthermia, flashing lights and patterns, sleep abnormalities). In addition to addressing seizures, holistic care for a patient with Dravet syndrome must involve a multidisciplinary team that includes specialists in physical, occupational and speech therapy, neuropsychology, social work.

摘要

目的

本文旨在研究波兰人群中德雷维特综合征(DS)的患病率,并指出除癫痫发作外影响此类患者生活质量的其他不同因素。

方法

重度难治性癫痫患者协会波兰支持小组DRAVET.PL的成员对DS患者的照料者进行了一项调查。调查内容包括他们对诊断、癫痫发作及治疗相关不良反应的经历。照料者还完成了儿童生活质量量表(PedsQL)调查,该调查显示了最重要的问题。此次调查共收到55名DS患者(年龄在2至25岁之间)照料者的回复。

结果

在DS确诊前,85%的患者出现持续超过30分钟的癫痫持续状态,癫痫发作频率(主要为强直阵挛发作或半侧惊厥)从每周2次到每天数百次不等。DS确诊后,患者继续接受联合治疗(DS推荐使用的药物)。在确诊前,他们中的一些人曾使用过钠通道阻滞剂。大多数患者经历了许多不良反应,包括攻击行为和食欲不振。不良反应的频率与该治疗中使用的药物数量有关,这对儿童生活质量量表的结果产生了影响,尤其是在身体和社会领域。因严重癫痫持续状态入住重症监护病房也对儿童生活质量量表的结果产生了影响。

结论

必须向家庭提供有关降低癫痫发作风险的非药物策略的咨询,包括避免常见的诱发癫痫发作的诱因(包括高热、闪烁灯光和图案、睡眠异常)。除了应对癫痫发作外,对德雷维特综合征患者的整体护理必须由多学科团队参与,该团队包括物理治疗、职业治疗和言语治疗、神经心理学、社会工作方面的专家。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da6d/8125154/6e3e81149577/jcm-10-01903-g001.jpg

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