创伤后癫痫(PTE)与颅脑损伤后的生活质量

V. Garg, Seema Singh, Dharambir, Kashyap
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引用次数: 1

摘要

创伤性脑损伤(TBI)是世界范围内一种复杂的神经损伤,常见于社会生活中,表现出多种症状,长期神经心理残疾,还会导致死亡[1]。TBI的患病率为每年1000万人,是年轻人死亡的主要原因之一[2,3]。TBI通过两种方式损害大脑:10种大脑损伤,发生在侮辱时的损伤,20种脑损伤,在损伤后很少发生[4]。根据格拉斯哥昏迷15分量表(GCS),TBI分为3类,即轻度、中度和重度,该量表通常用于评定脑损伤的严重程度[5]。TBI过程中常见的损伤区域包括挫伤、局灶性剪切损伤、水肿、血管损害、弥漫性轴索损伤(DAI)和兴奋性毒性反应,以及弥漫性脑损伤(DBI)[6]。创伤后癫痫(PTE)是TBI的常见预后之一,但其机制尚不清楚,其次是PTE。癫痫发生是指脑损伤后的潜伏期,在这段时间内,大脑经历分子和细胞修饰,引起其兴奋性,然后导致反复自发癫痫发作。与严重TBI相关的创伤后致痫成分会增强癫痫发作的易感性并导致PTE。与TBI有关的癫痫类型包括症状性癫痫、有意识和无意识的部分癫痫发作以及全身性癫痫发作。失神发作与头部创伤无关[7]。TBI被认为是一种“无声的流行病”,因为个人大多没有意识到这个问题[8]。它还降低了受影响患者的生活质量。患者变得不被社会接受,这导致了他们的社会抵制,有时甚至导致自杀企图。它也会干扰正常的大脑功能[9]。影响生活质量的重要因素是记忆障碍[10]、疲劳[11]、自我意识缺陷、感觉、情绪等[12]。
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Post-Traumatic Epilepsy (PTE) and Quality of Life after Traumatic Brain Injury (TBI)
Traumatic Brain Injury (TBI), a complex neurotrauma worldwide, commonly occurs in social life and shows several symptoms, longterm neuropsychological disability, and also causes mortality [1]. The prevalence of TBI is 10 million individuals per year and is one of the major causes of death amid young adults [2,3]. TBI damages brain in two ways: 10 brain damage, the damage which occurs at the time of insult, and 20 brain damage, the damage that develops few time after the injury [4]. TBI is classified into 3 categories i.e. mild, moderate, and severe based on the 15-point Glasgow Coma Scale (GCS), commonly used for rating the severity of brain insult [5]. The common areas which are injured during TBI are contusion, focal shear injury, edema, vascular compromise, Diffuse Axonal Injury (DAI), and excitotoxic reaction, along with diffuse brain injury (DBI) [6]. PostTraumatic Epilepsy (PTE) is one of the common prognosis of TBI but the mechanisms are not known and followed by PTE. Epileptogenesis refers to the latent period followed by brain damaging injury in which the brain experiences molecular and cellular modifications, causes its excitability then leads to the occurrence of repeated spontaneous seizures. Post-traumatic epileptogenic components linked with severe TBI, enhance seizure susceptibility and lead to PTE. The categories of epilepsy which are associated with TBI are symptomatic, partial seizure with consciousness and without consciousness and generalized seizures. Absence seizures are not associated with head trauma [7]. TBI is believed to be a ‘silent epidemic,’ as individuals are mostly unaware of this problem [8]. It also decreases the quality of life (QoL) of the affected patients. Patients become unacceptable to the society which leads to their social boycott, sometimes leads to suicidal attempt. It interferes with the normal brain function also [9]. The important factors which affect QoL are memory disorders [10], fatigue [11], self-awareness deficits, feeling, emotions etc [12].
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