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治疗小儿癫痫中的神经精神疾病:实际考量

Treating Neuropsychiatric Conditions in Pediatric Epilepsy: Practical Considerations.

作者信息

Dilara Ertenu D, Salpekar Jay A

机构信息

Neuropsychiatry Program, Kennedy Krieger Institute, Baltimore, MD, USA.

Johns Hopkins University School of Medicine; Baltimore, MD, USA.

出版信息

Epilepsy Curr. 2025 Jun 16:15357597251350031. doi: 10.1177/15357597251350031.

Abstract

This review provides a practical, evidence-informed approach to initiating pharmacologic treatment for children and adolescents with epilepsy who present with comorbid neuropsychiatric symptoms including depression, behavioral dyscontrol, and attention-deficit/hyperactivity disorder. The paper addresses how to determine when medication is warranted, outlines considerations for medication selection, and offers general principles for medication initiation and monitoring. Although the discourse is aimed at a pediatric population, the concepts are applicable to other ages as well. The goal is to provide clinicians with a decision-making framework to optimize both neurological and psychiatric outcomes in this complex population.

摘要

本综述提供了一种基于证据的实用方法,用于对患有癫痫且伴有共病神经精神症状(包括抑郁、行为失控和注意力缺陷多动障碍)的儿童和青少年启动药物治疗。本文阐述了如何确定何时需要用药,概述了药物选择的注意事项,并提供了药物起始和监测的一般原则。尽管本文论述的对象是儿科人群,但这些概念也适用于其他年龄段。目标是为临床医生提供一个决策框架,以优化这一复杂人群的神经和精神治疗效果。

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本文引用的文献

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Anxiety and school avoidance in an 8-year-old child with epilepsy.一名8岁癫痫患儿的焦虑与厌学
Epilepsy Behav Rep. 2024 Mar 13;26:100659. doi: 10.1016/j.ebr.2024.100659. eCollection 2024.
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Treatment of Comorbid Anxiety and Epilepsy.共病焦虑和癫痫的治疗。
J Neuropsychiatry Clin Neurosci. 2023 Summer;35(3):218-227. doi: 10.1176/appi.neuropsych.20220116. Epub 2023 Feb 14.
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A review of cognitive and behavioral outcomes of Brivaracetam.布瓦西坦的认知和行为结果的综述。
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Effects of cenobamate on cognitive performance of epilepsy patients.cenobamate 对癫痫患者认知表现的影响。
Seizure. 2022 Nov;102:129-133. doi: 10.1016/j.seizure.2022.10.004. Epub 2022 Oct 4.

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