Campanille Verónica, Sierra Natalia, Calle Analía, Bernater Ricardo, Thomson Alejandro, O'Neill Santiago
Instituto de Neurociencias, Centro de Epilepsia, Hospital Universitario Fundación Favaloro, Argentina. E-mail:
Neurología Cognitiva, Hospital Universitario Fundación Favaloro, Argentina.
Medicina (B Aires). 2021;81(6):965-971.
Juvenile myoclonic epilepsy (JME) is a benign disorder with a good response to antiepileptic drugs. Neuropsychological evaluations revealed mild cognitive deficits. The objective of this study is to determine the cognitive profile and mood symptoms in JME compared to normal controls. 30 patients with JME and 29 controls matched for age, gender, and education level were prospectively evaluated. The clinical characteristics were analysed. They were given a complete cognitive battery, a self-administered questionnaire of executive difficulties (DEX), the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Beck Depression Inventory (BDI), Generalized Anxiety Disorder Scale (GAD-7) and suicide risk scale (MINI). No significant differences in age and education were observed between JME and controls. Average time of evolution of the disease 18 years, 53% have three types of seizures: myoclonic, absence seizures and tonic-clonic seizures. Significant differences were found with greater failures in attention, executive function, a significantly higher score values in DEX in JME subjects. A higher score was found in the NDDI-E; BDI and GAD-7. No differences were found in the risk of suicide with respect to controls. The study confirms that JME presents greater failures in attentional functioning and executive skills related to flexibility and inhibition, with patients being aware of their difficulties in most cases. Knowing these difficulties would allow a better therapeutic approach to improve symptoms usually dismissed.
青少年肌阵挛性癫痫(JME)是一种对抗癫痫药物反应良好的良性疾病。神经心理学评估显示存在轻度认知缺陷。本研究的目的是确定与正常对照组相比,JME患者的认知特征和情绪症状。对30例JME患者和29名年龄、性别及教育水平相匹配的对照组进行前瞻性评估。分析了临床特征。对他们进行了全面的认知测试、一份关于执行功能困难的自填问卷(DEX)、癫痫神经疾病抑郁量表(NDDI-E)、贝克抑郁量表(BDI)、广泛性焦虑障碍量表(GAD-7)和自杀风险量表(MINI)。JME患者和对照组在年龄和教育程度上未观察到显著差异。疾病平均病程18年,53%的患者有三种发作类型:肌阵挛发作、失神发作和强直阵挛发作。在注意力、执行功能方面存在显著差异,JME患者在DEX中的得分值显著更高。在NDDI-E、BDI和GAD-7中得分更高。在自杀风险方面与对照组未发现差异。该研究证实,JME患者在注意力功能以及与灵活性和抑制相关的执行技能方面存在更大缺陷,大多数情况下患者意识到自己的困难。了解这些困难将有助于采取更好的治疗方法来改善通常被忽视的症状。