癫癎共患病研究进展

Common comorbidity of epilepsy:a review of new progress

癫癎是多种原因导致的脑神经元高度同步化异常放电的临床综合征,某些疾病易与癫癎共存于同一个体中,不同疾病之间难分主次、相互影响,称为癫癎共患病。其中以偏头痛、焦虑、抑郁、精神分裂症、注意力缺陷多动障碍、睡眠障碍、认知损害、心理障碍、线粒体脑肌病等较为常见,癫癎患者年龄、性别、发病年龄、病程、家族史、抗癫癎药物数量、发作控制情况等与共患病种类、数量,以及严重程度密切相关。癫癎共患病在临床上较易误诊,可影响抗癫癎药物的治疗效果与患者预后,降低患者生活质量。因此,积极探讨癫癎与共患病的内在关系、充分认识癫癎共患病的临床特点,探索对癫癎与共患病协同治疗的适宜原则与措施,才能够最大程度地提高抗癫癎药物的治疗效果,改善预后,提高患者生活质量。

A range of medical and neurologic disorders occurs more frequently in people with epilepsy than in the general population and constitutes somatic comorbidity. Common examples include migraine, depression, schizophrenia, attention- deficit hyperactivity disorder （ADHD）, sleep disorder, cognitive damage, developmental abnormality and so on. There are more interesting clinical features in some special types of patients with benign epilepsy of childhood with centrotemporal spikes （BECT）, temporal epilepsy and mitochondrial encephalomyopathy. The association between epilepsy and other conditions can be due to a variety of interacting genetic, biologic structural, functional, pharmacological and environmental factors. Co-existence of other disorders in a person with epilepsy can complicate diagnosis, induce adverse prognostic implications and attenuate health-related quality of life. Therefore, recognition and management of comorbidity of epilepsy may facilitate the treatment of epilepsy. In this article, we review recent pathophysiologic and clinical studies to elucidate the etiology, mechanisms, clinical characteristics, differential diagnosis and treatment of common comorbidity of epilepsy.