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癫痫手术后快感缺失的管理。

Management of anhedonia after epilepsy surgery.

作者信息

Maria de Araujo Filho Gerardo, Teixeira Antonio L

机构信息

Department of Neurological Sciences, Psychiatry and Medical Psychology, Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), São Paulo, Brazil.

Faculdade Santa Casa BH, Belo Horizonte, Brazil.

出版信息

Epilepsy Behav Rep. 2024 Mar 7;26:100658. doi: 10.1016/j.ebr.2024.100658. eCollection 2024.

Abstract

Anhedonia is clinically defined as difficulty or inability to feel pleasure or to be motivated to perform activities that were previously pleasurable. Anhedonia is a core feature of depressive disorders but can be present in other conditions such as substance use and anxiety disorders. Herein we report the case of a 34-year-old female who developed marked anhedonia after left cortico-amygdalohippocampectomy. Despite optimal seizure control, the person struggled with anhedonia and other depressive symptoms. After ruling out medico-neurologic complications, she was prescribed with a selective serotonin reuptake inhibitor and cognitive-behavioral therapy. Anhedonia can be a challenging neuropsychiatric presentation that requires ruling out the effects of antiseizure medications, neurosurgery, and other drugs before prescribing antidepressants.

摘要

快感缺失在临床上被定义为难以或无法体验到愉悦感,或缺乏动力去从事之前能带来愉悦的活动。快感缺失是抑郁症的核心特征,但也可能出现在其他病症中,如物质使用障碍和焦虑症。在此,我们报告一例34岁女性患者,其在左侧大脑皮质-杏仁核-海马切除术之后出现了明显的快感缺失。尽管癫痫得到了最佳控制,但该患者仍饱受快感缺失及其他抑郁症状的困扰。在排除了医学-神经学并发症后,她开始服用选择性5-羟色胺再摄取抑制剂并接受认知行为疗法。快感缺失可能是一种具有挑战性的神经精神症状表现,在开抗抑郁药之前,需要排除抗癫痫药物、神经外科手术及其他药物的影响。

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