Assistance Publique-Hôpitaux de Paris, Service de Neurologie Pédiatrique, Hôpital Robert Debré, Paris, France.
Université Paris-Cité, Institut National de la Santé et de la Recherche Médicale NeuroDiderot, Paris, France.
Dev Med Child Neurol. 2022 Dec;64(12):1444-1452. doi: 10.1111/dmcn.15337. Epub 2022 Jul 8.
Cognitive comorbidities are more frequent in children with epilepsy than in the general population. The cognitive function of children with epilepsy should be appropriately screened, and when there is an impairment, it must be diagnosed and managed. Several factors contribute to the occurrence of this comorbidity. The underlying aetiology and epilepsy syndrome are the major risk factors. Other factors also play a role, such as seizure recurrence, antiseizure medication, and interictal abnormalities. Recent evidence also suggested that cognitive involvement is an ongoing process that interacts with the normal maturation of cognitive function in children with epilepsy. Furthermore, some patients experience rapid cognitive deterioration related to epileptic activity, resulting in epileptic encephalopathy. Further research is needed to better understand how to prevent or modify factors that affect cognitive function in children with epilepsy. WHAT THIS PAPER ADDS: Cognitive comorbidities are more frequent in children with epilepsy than in the general population. The risk factors for cognitive impairment are the underlying aetiology/syndrome, seizure recurrence, antiseizure medication, and interictal abnormalities. Advanced genetic and neuroimaging studies are useful tools to better understand cognitive impairment in children with epilepsy.
认知共病在癫痫儿童中比在普通人群中更为常见。癫痫儿童的认知功能应进行适当筛查,当存在损害时,必须进行诊断和治疗。有几个因素促成了这种共病的发生。潜在病因和癫痫综合征是主要的危险因素。其他因素也起作用,如发作复发、抗癫痫药物和发作间期异常。最近的证据还表明,认知受累是一个持续的过程,与癫痫儿童认知功能的正常成熟相互作用。此外,一些患者经历与癫痫活动相关的认知迅速恶化,导致癫痫性脑病。需要进一步研究以更好地了解如何预防或改变影响癫痫儿童认知功能的因素。本文的贡献在于:认知共病在癫痫儿童中比在普通人群中更为常见。认知障碍的危险因素是潜在病因/综合征、发作复发、抗癫痫药物和发作间期异常。高级遗传和神经影像学研究是更好地理解癫痫儿童认知障碍的有用工具。