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颞叶癫痫患儿及青少年的精神障碍:一项叙述性综述。

Psychiatric disorders in children and adolescents with temporal lobe epilepsy: A narrative review.

作者信息

Cappelletto Pietro, Accolla Claudia, Preti Martina, Pisano Tiziana, Barba Carmen, Guerrini Renzo

机构信息

University of Florence, Florence, Italy.

Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS, Florence, Italy.

出版信息

Epilepsia Open. 2025 Feb;10(1):74-84. doi: 10.1002/epi4.13122. Epub 2024 Dec 27.

Abstract

People with epilepsy (PWE) are at higher risk of psychiatric disorders (PD), disability, and reduced quality of life than the general population, especially in childhood and adolescence and when seizures originate from the temporal lobe. Temporal Lobe Epilepsy (TLE) is the most common type of focal epilepsy and can be due to structural abnormalities, or non-lesional causes, such as genetic variants. The prevalence of PD is approximately 20%-30% in people with epilepsy in general, and from 40% up to 80% in people with TLE. A higher rate of anxiety and depression disorders has been observed in association with TLE than with extra-temporal epilepsy, or idiopathic generalized epilepsy, or other chronic diseases such as diabetes. However, while the association between psychopathology and TLE has been extensively assessed in adults, only a few studies have focused on its expression in children and adolescents. In this review, we describe the prevalence, characteristics, and risk factors for PD in people with epilepsy in general and with TLE, with a specific focus on the pediatric age. In addition, we provide insights into the current knowledge of the pathophysiological bases of psychiatric symptoms in children and adolescents with TLE. PLAIN LANGUAGE SUMMARY: This review examines the frequency and characteristics of psychiatric disorders in people with temporal lobe epilepsy, with a focus on children and adolescents. Similarly to adults, younger people with epilepsy have higher rates of psychiatric disorders, such as depression and anxiety, than healthy peers or children with other chronic illnesses such as diabetes and asthma. Contributing risk factors include epilepsy duration and severity, and the effects of antiseizure medications, as well as psychological challenges, sociocultural influences, and family dynamics. Psychiatric disorders associated with temporal lobe epilepsy are relatively frequent, probably in relation to the critical role that some limbic structures in the temporal lobe, such as the amygdala and hippocampus, play in regulating emotions and behavior.

摘要

与普通人群相比,癫痫患者(PWE)患精神障碍(PD)、残疾和生活质量下降的风险更高,尤其是在儿童期和青少年期,以及癫痫发作起源于颞叶时。颞叶癫痫(TLE)是最常见的局灶性癫痫类型,可能由结构异常或非病变原因引起,如基因变异。一般癫痫患者中精神障碍的患病率约为20%-30%,而颞叶癫痫患者中这一比例为40%至80%。与颞叶外癫痫、特发性全身性癫痫或糖尿病等其他慢性疾病相比,与颞叶癫痫相关的焦虑和抑郁障碍发生率更高。然而,虽然精神病理学与颞叶癫痫之间的关联在成年人中已得到广泛评估,但只有少数研究关注其在儿童和青少年中的表现。在本综述中,我们描述了一般癫痫患者和颞叶癫痫患者中精神障碍的患病率、特征和危险因素,特别关注儿童期。此外,我们还深入探讨了目前关于儿童和青少年颞叶癫痫患者精神症状病理生理基础的知识。通俗易懂的总结:本综述研究了颞叶癫痫患者精神障碍的频率和特征,重点关注儿童和青少年。与成年人一样,癫痫患儿患抑郁症和焦虑症等精神障碍的比例高于健康同龄人或患有糖尿病和哮喘等其他慢性疾病的儿童。促成风险因素包括癫痫持续时间和严重程度、抗癫痫药物的影响,以及心理挑战、社会文化影响和家庭动态。与颞叶癫痫相关的精神障碍相对常见,这可能与颞叶中的一些边缘结构(如杏仁核和海马体)在调节情绪和行为中所起的关键作用有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0a6/11803279/7bfcf620d01f/EPI4-10-74-g002.jpg

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