Oldrati Viola, Minghetti Sara, Zanotta Nicoletta, Bardoni Alessandra, Zucca Claudio
Scientific Institute IRCCS Eugenio Medea, 23842 Bosisio Parini, Lecco, Italy.
Heliyon. 2023 Feb 25;9(3):e14085. doi: 10.1016/j.heliyon.2023.e14085. eCollection 2023 Mar.
Childhood epilepsy can be frequently associated with impaired cognitive functioning. Previous research has suggested an increased risk of cognitive impairment that may be related to the etiology, the electro-clinical pattern and the load of anti-seizure medications (ASMs). The aim of this study was to evaluate the impact of different clinical features on the global intellectual functioning in a cohort of children and adolescents with epilepsy. We studied eighty patients diagnosed and followed in a tertiary care center. These factors were examined: 1. Etiology of epileptic syndrome; 2. Type of seizure; 3. Number of ASMs; 4. Seizure frequency; 5. Age at seizure onset; 6. Total duration of epilepsy; and 7. Active duration of epilepsy. Multiple regression analysis showed that the etiology and the total duration of epilepsy were the best indicators of intellectual functioning. The present data indicate that children with symptomatic epilepsy (SE) have lower IQ scores (M = 63.5), while children with self-limited focal epilepsy and generalized idiopathic epilepsy, i.e. age-related epileptic syndromes (ARES), have a higher IQ (M = 100.0; p < 0.01). Children with epilepsy of unknown etiology (UEE) (M = 75.1; p < 0.05) are positioned at an intermediate level between the SE and the ARES group (p < 0.01). Increased duration of epilepsy was associated with decreased intellectual functioning. In conclusion, knowledge about the risks associated with etiologic factors and the duration of the disease may guide the definition of optimal neuropsychological rehabilitation strategies.
儿童癫痫常与认知功能受损相关。先前的研究表明，认知障碍风险增加可能与病因、电临床模式及抗癫痫药物（ASM）负荷有关。本研究旨在评估不同临床特征对一组癫痫儿童和青少年整体智力功能的影响。我们对在一家三级护理中心确诊并接受随访的80名患者进行了研究。研究了以下因素：1. 癫痫综合征的病因；2. 癫痫发作类型；3. ASM数量；4. 癫痫发作频率；5. 癫痫发作起始年龄；6. 癫痫总病程；7. 癫痫活动期病程。多元回归分析表明，癫痫病因和总病程是智力功能的最佳指标。目前的数据表明，症状性癫痫（SE）患儿的智商得分较低（M = 63.5），而自限性局灶性癫痫和全身性特发性癫痫患儿，即年龄相关性癫痫综合征（ARES）患儿的智商较高（M = 100.0；p < 0.01）。病因不明的癫痫（UEE）患儿（M = 75.1；p < 0.05）处于SE组和ARES组之间的中间水平（p < 0.01）。癫痫病程延长与智力功能下降相关。总之，了解与病因因素和疾病病程相关的风险可能有助于指导最佳神经心理康复策略的制定。
