Antonio-Cruz A, Prieto-Corona B, Yáñez-Téllez M G, Amaya-Hernández A, García-Méndez A, Sánchez-Rodríguez G, Ramírez-Reyes A G
Universidad Nacional Autónoma de México, Tlalnepantla de Baz, México.
Hospital General. Centro Médico Nacional La Raza, La Raza, México.
Rev Neurol. 2024 Jun 16;78(12):343-354. doi: 10.33588/rn.7812.2024096.
At least 20% of paediatric patients with epilepsy present resistance to multiple anti-crisis drugs in trials, which has a negative impact on their neuropsychological state, quality of life and prognosis; it is therefore necessary to document their neuropsychological profile in order to improve the clinical approach to them.
To describe the neuropsychological profile (cognitive, academic, behavioural, emotional, adaptive, sleep disturbances and quality of life) of paediatric patients with drug-resistant focal epilepsy in the frontal, temporal and occipital lobes, and to compare performance between patients with frontal and temporal foci, and to assess the link between the duration of the condition, the frequency of seizures and the amount of anti-crisis drugs and the neuropsychological profile.
The neuropsychological profile of 19 paediatric patients with a diagnosis of pharmacoresistant epilepsy with a mean age of 10.89 years was evaluated.
57.9% of the 19 patients were men. 63.2% presented frontal focus; 26.3% presented temporal focus; and 10.5% presented occipital focus. Deficiencies in attention, comprehension, verbal memory, working memory and processing speed, in addition to adaptive difficulties were observed. When the patients with frontal and temporal focus were compared, the former were found to present greater deficits in planning, while the patients with temporal focus presented more severe symptoms of anxiety. Patients with a longer disease duration were found to present greater impairment to their intelligence quotient and adaptive behavioural skills.
Pharmacoresistant epilepsy in paediatric patients affects intelligence quotient and adaptive skills, as well as attention, memory and executive functions, and neuropsychological intervention programmes must therefore be implemented to improve these patients' quality of life.
在试验中，至少20%的小儿癫痫患者对多种抗癫痫药物产生耐药性，这对他们的神经心理状态、生活质量和预后产生负面影响；因此，有必要记录他们的神经心理特征，以改善对他们的临床治疗方法。
描述额叶、颞叶和枕叶耐药性局灶性癫痫小儿患者的神经心理特征（认知、学业、行为、情绪、适应性、睡眠障碍和生活质量），比较额叶和颞叶病灶患者的表现，并评估病情持续时间、癫痫发作频率、抗癫痫药物用量与神经心理特征之间的联系。
评估了19例诊断为药物性耐药癫痫的小儿患者的神经心理特征，这些患者的平均年龄为10.89岁。
19例患者中57.9%为男性。63.2%为额叶病灶；26.3%为颞叶病灶；10.5%为枕叶病灶。观察到注意力、理解力、言语记忆、工作记忆和处理速度存在缺陷，以及适应性困难。比较额叶和颞叶病灶患者时，发现前者在计划方面存在更大缺陷，而颞叶病灶患者表现出更严重的焦虑症状。发现病程较长的患者其智商和适应性行为技能受损更严重。
小儿患者的药物性耐药癫痫会影响智商和适应性技能，以及注意力、记忆力和执行功能，因此必须实施神经心理干预计划以改善这些患者的生活质量。
