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目的探讨临床下癇样放电对青少年癫癇患者认知功能的影响。方法以全身强直阵挛性发作(GTCS)为临床表现的特发性癫癇患者65例,无临床发作均超过3个月,其中35例动态脑电图或普通脑电图显示有癇样放电,30例患者动态脑电图均正常。65例患者均服用左乙拉西坦治疗,随访6个月,服药前后分别进行基本认知能力测试,分析两组患者6个月前后认知功能的变化。结果 63例完成本实验,两组实验前后IQ均在正常范围且差异不明显。但6个月后有癇样放电组认知功能明显下降(P<0.01),具体表现在数字鉴别(P<0.01)、汉字快速比较(P<0.01)、汉字旋转(P<0.01)、图形再认(P<0.01)等方面,而脑电图正常组认知功能无明显变化(P>0.05)。结论临床下癇样放电可损害患者的认知能力,应受到重视,采取适当的干预措施。
Objective To investigate the effect of clinical epileptiform discharge on cognitive function in adolescent with epilepsy. Methods Sixty-five patients with idiopathic epilepsy with global tonic-clonic seizure (GTCS) as the clinical manifestations were followed up for more than 3 months without clinical attack. Among them, 35 cases of EEG or general EEG showed epileptiform discharge, Thirty patients had normal EEG. Sixty-five patients were treated with levetiracetam, followed up for 6 months. Before and after treatment, their basic cognitive ability tests were performed respectively. The changes of cognitive function in both groups after 6 months were analyzed. Results 63 cases completed this experiment, IQ before and after the two groups were in the normal range and the difference was not obvious. However, after 6 months, the cognitive function of epileptiform discharge group was significantly decreased (P <0.01), especially in digital identification (P <0.01), rapid comparison of Chinese characters (P <0.01), rotation of Chinese characters (P <0.01), while there was no significant change in cognitive function in normal group (P> 0.05). Conclusions Clinical epileptiform discharge can impair the cognitive ability of patients and should be taken seriously and appropriate intervention measures taken.