Drug Treatment of Epilepsy Neuropsychiatric Comorbidities in Children.
Drug Treatment of Epilepsy Neuropsychiatric Comorbidities in Children.
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DOI：
10.1007/s40272-020-00428-w
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Holmes GL
中科院分区：
文献类型：
--
作者：
Holmes GL
越来越多的人认识到癫痫可能与广泛的合并症有关。虽然癫痫发作是儿童癫痫的一个基本要素，但有一系列神经，心理健康和认知障碍增加了儿童癫痫的疾病负担，导致生活质量下降。儿童癫痫最常见的共病包括抑郁症、焦虑症、自闭症谱系障碍、睡眠障碍、注意力缺陷、认知障碍和偏头痛。虽然癫痫可导致合并症，但许多儿童合并症具有双向关联，合并症增加癫痫风险，癫痫增加合并症风险。癫痫的双向特征和共病提示癫痫发作和共病有共同的病理基础。虽然对儿童癫痫的共病状况的认识正在增加，但有效疗法的开发一直滞后，部分原因是担心用于治疗共病状况的药物可能会增加癫痫发作的易感性。现在有一些证据表明，大多数用于共病的药物是安全的，不会降低癫痫发作阈值。不幸的是，显示药物对治疗许多儿童癫痫合并症有效的证据非常有限。非常需要随机、安慰剂对照的药物试验来评估儿童癫痫合并症治疗的有效性和安全性。
There is increasing recognition that epilepsy can be associated with a broad spectrum of comorbidities. While epileptic seizures are an essential element of epilepsy in children, there is a spectrum of neurological, mental health and cognitive disorders that add to the disease burden of childhood epilepsy resulting in a decreased quality of life. The most common comorbid conditions in childhood epilepsy include depression, anxiety, autism spectrum disorders, sleep disorders, attention deficits, cognitive impairment and migraine. While epilepsy can result in comorbidities, many of the comorbidities of childhood have a bi-directional association, with the comorbid condition increasing risk for epilepsy and epilepsy increasing the risk for the comorbid condition. The bidirectional feature of epilepsy and the comorbidities suggest a common underlying pathological basis for both the seizures and comorbid condition. While recognition of the comorbid conditions of pediatric epilepsies is increasing, there has been a lag in the development of effective therapies partly out of concern that drugs used to treat the comorbid conditions could increase seizure susceptibility. There is now some evidence that most drugs used for comorbid conditions are safe and do not lower seizure threshold. Unfortunately, the evidence showing drugs are effective in treating many of the childhood comorbidities of epilepsy is quite limited. There is a great need for randomized, placebo-controlled drug trials for efficacy and safety in the treatment of comorbidities of childhood epilepsy.
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