Neuropsychiatric Aspects of Epilepsy.
Neuropsychiatric Aspects of Epilepsy.
复制标题
癫痫的神经精神方面。
DOI：
10.1016/j.psc.2020.02.002
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
LaFranceJr,WilliamCurt
中科院分区：
文献类型：
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作者：
Tolchin,Benjamin;Hirsch,LawrenceJ;LaFranceJr,WilliamCurt
在这篇文章中，我们回顾了癫痫的常见和临床重要的神经精神方面，包括合并症，如抑郁、焦虑、精神病、认知障碍、自闭症和心因性非癫痫性发作，以及它们对癫痫患者的影响。这些合并症在PWE中很常见，但诊断不足，并严重影响临床结果，如癫痫发作控制和生活质量。多种生物、心理和社会因素导致癫痫和神经精神疾病之间的关联。流行病学研究指出癫痫与神经精神疾病（包括抑郁、焦虑、精神病和自闭症）之间存在双向关系：PWE更有可能患上这些神经精神疾病，而患有这些疾病的人更有可能患上癫痫。这种关系表明可能存在共同的潜在病理生理。最后，我们回顾了抗癫痫药物（asm）的神经精神影响，以及治疗癫痫的神经精神合并症的治疗选择。理想情况下，诊断和治疗需要多学科团队的密切合作，包括神经科医生、精神病学家、心理学家、社会工作者和神经外科医生。
In this article, we review common and clinically important neuropsychiatric aspects of epilepsy, including comorbidities such as depression, anxiety, psychosis, cognitive impairment, autism, and psychogenic nonepileptic seizures, and their impact on people with epilepsy (PWE). These comorbidities are common and underdiagnosed among PWE, and powerfully impact clinical outcomes, such as seizure control and quality of life. Multiple biological, psychological, and social factors contribute to the associations between epilepsy and neuropsychiatric disorders. Epidemiological studies point to a bidirectional relationships between epilepsy and neuropsychiatric disorders, including depression, anxiety, psychosis, and autism: PWE are more likely to develop these neuropsychiatric disorders, and those with these disorders are more likely to develop epilepsy. This relationship suggests the possibility of shared underlying pathophysiologies. Finally, we review the neuropsychiatric impact of antiseizure medications (ASMs), and therapeutic options for the treatment of neuropsychiatric comorbidities of epilepsy. Diagnosis and treatment ideally involve close collaboration among a multidisciplinary team including neurologists, psychiatrists, psychologists, social workers, and neurosurgeons.