The impact of childhood epilepsy on neurocognitive and behavioral performance: A prospective longitudinal study
The impact of childhood epilepsy on neurocognitive and behavioral performance: A prospective longitudinal study
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DOI：
10.1111/j.1528-1157.2000.tb00184.x
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发表时间：
2000-04-01
期刊：
影响因子：
5.6
通讯作者：
Turk, WR
中科院分区：
文献类型：
--
作者：
Bailet, LL;Turk, WR
目的：评估特发性癫痫儿童的神经认知和行为表现（CWE，n = 74），他们的兄弟姐妹没有癫痫（对照组，n = 23），偏头痛儿童（CWM，n = 13），并确定与CWE中的学习或行为问题相关的医学因素。受试者年龄为8-13岁，智商大于或等于80，每年完成一次神经认知成套测试，持续时间小于或等于3年。对于CWE，癫痫发作时的年龄，最近的脑电图结果，癫痫发作类型，癫痫发作频率，目前的抗癫痫药物（AED），最近的AED血清水平记录在每次visit.Results：CWE和CWM有较高的年级保留率和安置在特殊教育与兄弟姐妹对照。CWE在许多神经认知变量上的表现比对照组差。这些差异随着时间的推移持续存在。脑电图异常的CWE在阅读和拼写方面的得分低于脑电图正常的CWE，即使智商相当。癫痫发作时的年龄、癫痫发作类型和癫痫发作频率与神经认知或行为测试评分无关。服用卡马西平（CBZ）的CWE在学业成绩指标方面的表现优于服用丙戊酸盐（VPA）的CWE，尽管该研究缺乏必要的对照以彻底评估该结果。CWM没有不同的CWE或控制在认知或学术成就skills.Conclusions：长期的学习问题的风险存在于CWE与对照组相比，即使智商正常和控制良好的癫痫发作。根据医学因素预测CWE的学习问题仍然是难以捉摸的。监测教育进度和神经认知筛查可能是最有效的评估CWE的学术风险。
Purpose: To assess neurocognitive and behavioral performance in children with idiopathic epilepsy (CWE, n = 74), their siblings without epilepsy (control, n = 23), and children with migraine (CWM, n = 13), and to identify medical factors related to learning or behavioral problems in CWE.Methods: Subjects, ages 8-13 years with IQs of greater than or equal to 80, completed a neurocognitive test battery annually for less than or equal to 3 years. For CWE, age at seizure onset, most recent EEG results, seizure type, seizure frequency, current antiepileptic drug (AED), and most recent AED serum levels were documented at each visit.Results: CWE and CWM had high rates of grade retention and placement in special education compared with sibling controls. CWE performed worse than controls on numerous neurocognitive variables. These differences persisted over time. CWE with abnormal EEGs scored lower than CWE with normal EEGs on reading and spelling measures, even with com-parable IQs. Age at seizure onset, seizure type, and seizure frequency were not related to neurocognitive or behavioral test scores. CWE taking carbamazepine (CBZ) performed better than CWE taking valproate (VPA) on academic achievement measures, although the study lacked controls necessary to assess this finding thoroughly. CWM did not differ from CWE or controls in cognitive or academic achievement skills.Conclusions: Long-term risk of learning problems exists among CWE as compared with controls, even with normal IQs and well-controlled seizures. Predicting learning problems in CWE based on medical factors remains elusive. Monitoring of educational progress and neurocognitive screening may be most effective in assessing academic risk for CWE.