Epilepsy, cognition, and behavior: The clinical picture.
Epilepsy, cognition, and behavior: The clinical picture.
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DOI：
10.1111/j.1528-1167.2010.02905.x
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发表时间：
2011-01
期刊：
影响因子：
5.6
通讯作者：
Berg AT
中科院分区：
文献类型：
--
作者：
Berg AT
虽然癫痫的定义是自发癫痫发作的发生，但大量证据表明，癫痫与一系列行为、精神和认知障碍以及猝死有关。对这些关联的解释包括：(1)结构性病变的影响，它可能损害参与病变的大脑区域所支持的功能。(2)发作活动的影响可能在临床发作发生之前很久就开始，并可能在发作结束后很长一段时间内持续存在，这引发了关于什么是真正构成“发作间歇”的问题。此外，在发育的关键时期，婴儿期癫痫的脑病影响可能特别严重，可能是不可逆的。(3)在没有中枢神经系统结构损害或单独疾病的情况下，癫痫发作以及这些其他障碍的共同机制。流行病学和临床研究表明，不仅在癫痫发作期间，而且在癫痫发作之前，认知、精神和行为障碍的风险都会增加。这也可能比癫痫的活动期持续时间更长。越来越多的证据有力地支持承认癫痫是一系列疾病的一部分，并反对即使是简单的癫痫也可以先验被认为是良性的概念。
Although epilepsy is defined by the occurrence of spontaneous epileptic seizures, a large body of evidence indicates that epilepsy is linked to a spectrum behavioral, psychiatric, and cognitive disorders as well as to sudden death. Explanations for these associations include: (1) The effects of structural lesions which may impair the functions subserved by the regions of the brain involved in the lesion. (2) The effects of seizure activity which may begin well before a clinical seizure occurs and may persist long after it is over raising questions about what truly constitutes “interictal.” In addition, encephalopathic effects of epilepsy in infancy during critical periods in development may be particularly severe and potentially irreversible. (3) Shared mechanisms underlying seizures as well as these other disorders in the absence of structural lesions or separate diseases of the CNS. Epidemiological and clinical studies demonstrate the elevated risk of cognitive, psychiatric, and behavioral disorders not just during but also prior to the onset of epilepsy (seizures) itself. These may outlast the active phase of epilepsy as well. The mounting evidence argues strongly for the recognition of epilepsy as part of a spectrum of disorders and against the notion that even uncomplicated epilepsy can a priori be considered benign.