Department of Pediatrics, HeBei General Hospital, No.348 of Heping West Road, Xinhua District, Shijiazhuang, 050051, China.
Eur J Med Res. 2024 Mar 12;29(1):168. doi: 10.1186/s40001-024-01751-5.
To analyze the risk factors affecting psychiatric behavior and study the psychobehavioral conditions of children with epilepsy.
We randomly selected and enrolled 294 children with epilepsy who visited and were hospitalized in the pediatric clinic of Hebei General Hospital between January 2017 and January 2022, as the study participants. We comprehensively assessed their cognitive functions using the Gesell development schedule or Wechsler Intelligence Scales. The participants were divided into the study group (n = 123) with cognitive impairment and the control group (n = 171) with normal cognitive functions, for analysis.
There were statistically significant differences between the two groups in disease course, frequency of epilepsy, status epilepticus, and the number of antiseizure medications (ASMs) used (P < 0.05), while there were no statistically significant differences in age, gender, age of onset, form of onset, interictal epileptiform discharge, history of febrile convulsion, and the time from onset to initial visit (P > 0.05). Based on multivariate logistic regression analysis, the course of disease, frequency of onset, status epilepticus and number of ASMs used were identified as high-risk factors for cognitive impairment in children with epilepsy. Similarly, early onset, long course of disease, known etiology, and combination of multiple drugs have a negative impact on behavioral problems, school education, and social adaptability.
The course of disease, the frequency of onset, status epilepticus, and the number of ASMs used are high-risk factors for cognitive impairment in children with epilepsy, which can be prevented and controlled early. When selecting ASMs, their advantages and disadvantages should be weighed. Moreover, the availability of alternative treatment options must be considered. With the help of genomic technology, the causes of epilepsy should be identified as early as possible, and precision medicine and gene therapy for children with epilepsy should be actively developed.
分析影响精神行为的危险因素，并研究癫痫患儿的精神行为状况。
随机选取 2017 年 1 月至 2022 年 1 月在河北医科大学第一医院儿科门诊就诊并住院的 294 例癫痫患儿作为研究对象，采用盖塞尔发育量表或韦氏智力量表对其认知功能进行全面评估。根据认知功能将患儿分为研究组（n=123，认知功能障碍）和对照组（n=171，认知功能正常）。
两组患儿的病程、癫痫发作频率、癫痫持续状态及抗癫痫药物（AEDs）使用种类数比较，差异均有统计学意义（P<0.05）；而两组患儿的年龄、性别、起病年龄、起病形式、发作间期痫样放电、热性惊厥史及起病至初诊时间比较，差异均无统计学意义（P>0.05）。多因素 logistic 回归分析显示，病程、发作频率、癫痫持续状态、AEDs 使用种类数是癫痫患儿发生认知功能障碍的高危因素。同样，早发、病程长、已知病因、多种药物合用对患儿的行为问题、学校教育、社会适应能力有负面影响。
癫痫患儿认知功能障碍的高危因素为病程、发作频率、癫痫持续状态、AEDs 使用种类数，可早期进行预防和控制。在选择 AEDs 时，应权衡其利弊，同时考虑是否有替代治疗方案。借助基因组技术，尽早明确癫痫的病因，积极开展癫痫患儿的精准医学和基因治疗。
