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了解伦诺克斯-加斯东综合征的负担:对高资源和低资源环境下患者、护理人员及社会的影响:一项叙述性综述

Understanding the Burden of Lennox-Gastaut Syndrome: Implications for Patients, Caregivers, and Society in High and Low Resource Settings: A Narrative Review.

作者信息

Mourid Marina Ramzy, Oduoye Malik Olatunde

机构信息

Faculty of Medicine Alexandria University Alexandria Egypt.

Department of Research The Medical Research Circle Goma Congo.

出版信息

Health Sci Rep. 2024 Dec 12;7(12):e70169. doi: 10.1002/hsr2.70169. eCollection 2024 Dec.

Abstract

BACKGROUND

Lennox-Gastaut syndrome (LGS) poses significant challenges in diagnosis, management, and treatment due to its rare nature, diverse presentation, and drug-resistant seizures. While classical features aid diagnosis, challenges persist, impacting patient care and outcomes. Understanding the syndrome's burden is essential for improving healthcare policies and interventions.

AIM

This literature review aimed to comprehensively analyze clinical symptom burden, comorbidities, care requirements, quality of life (QoL), economic burden, caregiver burden, and treatment burden to pinpoint knowledge gaps for future research and intervention development, ultimately aiming to enhance the well-being of patients and caregivers.

METHODS

A comprehensive literature review was conducted using electronic databases and manual searches to analyze clinical symptom burden, comorbidities, care requirements, QoL, economic burden, caregiver burden, and treatment burden associated with LGS.

RESULTS

LGS significantly impacts the QoL for patients, with seizures, cognitive impairment, and social challenges affecting various aspects of daily living. Caregivers, particularly mothers, face significant stress and exhaustion, impacting their own health and well-being. Healthcare resource utilization is substantial, with elevated costs for LGS patients compared to controls. Cognitive impairment is prevalent and worsens over time, influencing educational and social outcomes. Prognosis varies based on factors like age of onset, underlying cause, and genetic factors, with limited treatment options available.

CONCLUSION

Managing LGS requires tailored approaches addressing seizures, comorbidities, and caregiver needs. While advancements in treatments and surgical techniques offer hope, challenges persist in achieving optimal outcomes and reducing the societal burden. The management of LGS involves a combination of pharmacological and nonpharmacological therapies, tailored to the individual patient's needs and response to treatment. Regular follow-up with a neurologist specialized in epilepsy is crucial for ongoing management, including annual reassessment of the diagnosis and treatment plan. The primary focus should always be on optimizing the patient's QoL, including learning and behavioral management, as complete seizure remission is rare.

摘要

背景

伦诺克斯 - 加斯托综合征(LGS)因其罕见性、多样的表现形式和耐药性癫痫发作,在诊断、管理和治疗方面带来了重大挑战。虽然典型特征有助于诊断,但挑战依然存在,影响着患者护理和治疗结果。了解该综合征的负担对于改善医疗政策和干预措施至关重要。

目的

本综述旨在全面分析临床症状负担、合并症、护理需求、生活质量(QoL)、经济负担、照料者负担和治疗负担,以确定未来研究和干预措施开发的知识空白,最终目标是提高患者和照料者的福祉。

方法

通过电子数据库和手工检索进行全面的文献综述,以分析与LGS相关的临床症状负担、合并症、护理需求、QoL、经济负担、照料者负担和治疗负担。

结果

LGS对患者的生活质量有显著影响,癫痫发作、认知障碍和社交挑战影响着日常生活的各个方面。照料者,尤其是母亲,面临着巨大的压力和疲惫,影响着她们自身的健康和福祉。医疗资源利用大量增加,与对照组相比,LGS患者的成本更高。认知障碍普遍存在且随时间恶化,影响教育和社会成果。预后因发病年龄、潜在病因和遗传因素等而异,可用的治疗选择有限。

结论

管理LGS需要针对癫痫发作、合并症和照料者需求采取量身定制的方法。虽然治疗和手术技术的进步带来了希望,但在实现最佳治疗效果和减轻社会负担方面仍存在挑战。LGS的管理涉及药物治疗和非药物治疗的结合,根据个体患者的需求和对治疗的反应进行调整。定期由癫痫专科神经科医生进行随访对于持续管理至关重要,包括每年对诊断和治疗计划进行重新评估。首要重点应始终是优化患者的生活质量,包括学习和行为管理,因为完全缓解癫痫发作很少见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2607/11635840/91afe493e001/HSR2-7-e70169-g002.jpg

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