儿童癫痫的精神和行为合并症患病率

Rana Elkarray, R. Mohamed, Rania A. Hamed
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摘要

背景:癫痫是儿童时期最常见的神经系统疾病之一,有大量证据表明其与精神病理有关。目的了解癫痫患儿行为问题的患病率及其危险因素。患者与方法选取50例5 ~ 16岁的癫痫患者和50例同龄的对照组儿童。除了儿童行为检查表外,还使用了经过验证的阿拉伯语版《儿童和青少年迷你国际神经精神病学访谈》来评估样本。结果应用迷你国际儿童青少年神经精神病学访谈发现,癫痫组与对照组在行为障碍和焦虑方面的差异均有统计学意义。根据儿童行为检查表,癫痫组与非癫痫组相比存在临床注意问题、违反规则行为、攻击行为和社会问题。在平均值方面,癫痫患者除违反规则投诉和思维问题外,其他各领域的行为得分均显著高于对照组。一些因素与癫痫儿童的神经精神合并症显著相关,如癫痫发作持续时间超过或等于5年、多药治疗和癫痫发作状态不受控制的癫痫类型(原发性全身性癫痫)。结论癫痫患儿更易出现神经精神问题。神经精神合并症的早期发现、诊断和治疗可提高其长期预后。
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Prevalence of psychiatric and behavioral comorbidities in pediatric epilepsy
Background Epilepsy is among the most common neurological disorder in childhood for which there is substantial evidence of the associated psychopathology. Objective To assess the prevalence of behavioral problems in children with epilepsy and its risk factors. Patients and methods Fifty patients aged 5–16 years with a diagnosis of epilepsy and 50 control children of the same age range were recruited. A validated Arabic version of the Mini International Neuropsychiatric Interview for Children and Adolescents in addition to the Child Behavior Check List was applied to evaluate the sample. Results By using Mini International Neuropsychiatric Interview for Children and Adolescents, it was found that both conduct disorder and anxiety show a statistically significant difference between the epileptic and control groups. According to Child Behavior Check List, it was found that the epileptic group had clinically attention problems, rule-breaking behavior, aggressive behavior, and social problems compared with the nonepileptic group. Regarding the mean values, behavioral scores in patients with epilepsy were significantly higher as compared with control in all the domains, except rule-breaking complaints and thought problems. Some factors were significantly associated with neuropsychiatric comorbidities in children with epilepsy as seizure duration more than or equal to 5 years, polytherapy, and uncontrolled seizure-status epilepsy type (primary generalized epilepsy). Conclusion Children with epilepsy are more likely to develop neuropsychiatric problems. Early detection, diagnosis, and treatment of neuropsychiatric comorbidities may enhance their long-term prognosis.
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