Rogač Željka, Stevanović Dejan, Bečanović Sara, Božić Ljubica, Dimitrijević Aleksandar, Bogićević Dragana, Bosiočić Ivana, Jovanović Kristina, Nikolić Dimitrije
Institute for Children's Diseases, Clinical Centre of Montenegro, Podgorica 81000, Montenegro.
Clinic for Neurology and Psychiatry for Children and Youth, Belgrade 11000, Serbia.
Epilepsy Res. 2022 Jan;179:106844. doi: 10.1016/j.eplepsyres.2021.106844. Epub 2021 Dec 18.
Long-term studies indicated changes in aspects of cognition, psychopathology, and quality of life (QOL) in children and adolescents followed up after the diagnosis of epilepsy. However, evidence is limited regarding what happens during the first few months after epilepsy is diagnosed because at this phase is possible to adjust and/or change an AED regimen or add other treatment interventions, if needed. This is a naturalistic, six months follow-up study that evaluated changes in overall cognitive profiles, levels of psychopathological symptoms, and quality of life (QOL) in newly diagnosed, uncomplicated pediatric epilepsy. In total, 61 (35 [57.4%] males) children and adolescents aged 7-18 years were assessed at the time of diagnosis and the initiation of antiepileptic drug (AED) treatment and six months afterward. The Revised Wechsler Intelligence Scale for Children, the Revised Child Anxiety and Depression Scale (RCADS), Nisonger Child Behavior Rating Form for typically developing children and adolescents (NCBRF), KIDSCREEN-10 Quality of Life Measure, and Adverse Event Profile (AEP) were used. The RCADS and NCBRF scores significantly increased over time, while the KIDSCREEN-10 scores significantly decreased. The most significant increases were observed in scores measuring social phobia and depressive symptoms and inattentiveness. Verbal cognitive abilities and full-scale intelligence scores changed slightly, while more changes were found in aspects of non-verbal cognitive abilities. This study showed that six months after epilepsy diagnosis and AED initiation, there were marked increases in anxiety levels, depressive symptoms, and behavioral problems, with deteriorations in QOL, while cognitive changes were relatively minimal. Therefore, monitoring levels of psychopathological symptoms and QOL in newly diagnosed epilepsy is highly recommended.
长期研究表明，癫痫诊断后接受随访的儿童和青少年在认知、精神病理学和生活质量（QOL）方面发生了变化。然而，关于癫痫诊断后头几个月的情况，证据有限，因为在此阶段，如果需要，可以调整和/或改变抗癫痫药物（AED）治疗方案或添加其他治疗干预措施。这是一项自然主义的六个月随访研究，评估了新诊断的、无并发症的小儿癫痫患者在总体认知概况、精神病理症状水平和生活质量（QOL）方面的变化。总共61名（35名[57.4%]男性）7至18岁的儿童和青少年在诊断和开始抗癫痫药物（AED）治疗时以及六个月后接受了评估。使用了修订版韦氏儿童智力量表、修订版儿童焦虑和抑郁量表（RCADS）、针对正常发育儿童和青少年的尼森格儿童行为评定表（NCBRF）、儿童生活质量量表KIDSCREEN - 10以及不良事件概况（AEP）。随着时间的推移，RCADS和NCBRF评分显著增加，而KIDSCREEN - 10评分显著下降。在测量社交恐惧症、抑郁症状和注意力不集中的评分中观察到最显著的增加。言语认知能力和全量表智力评分变化较小，而非言语认知能力方面的变化更多。这项研究表明，癫痫诊断和开始使用AED六个月后，焦虑水平、抑郁症状和行为问题显著增加，生活质量下降，而认知变化相对较小。因此强烈建议监测新诊断癫痫患者的精神病理症状水平和生活质量。
