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目的分析注意缺陷多动障碍(ADHD)对局灶性发作癫痫(FEP)患儿生活质量的影响。方法按照《精神障碍诊断与统计手册(第Ⅳ版)》诊断标准对2009年5月至2010年10月首都儿科研究所附属儿童医院神经科门诊及病房120例确诊为FEP患儿进行ADHD临床诊断及临床亚型分型,采用整合视听持续执行测试进行注意力及反应控制能力评估,采用癫痫患者生活质量量表(QOlIE-31),对112例患儿的生活质量进行评估。结果 120例FEP患儿中共患ADHD者21例(17.5%),其中ADHD-I型17例(81.0%),ADHD-C型4例(19.0%),无ADHD-HI型患儿。不同治疗阶段癫痫患儿其共患率差异无统计学意义(P>0.05)。120例FEP患儿综合尺度注意力及综合尺度反应控制商数在不同治疗阶段的3组间差异均无统计学意义(P>0.05),其中的60例良性儿童癫痫伴中央颞区棘波(BECTs)患儿上述指标在不同治疗阶段的3组间差异均无统计学意义(P>0.05)。共患ADHD的FEP患儿生活质量及认知功能的分项值均明显低于无共患组,差异有统计学意义(P<0.05)。结论 FEP患儿ADHD的共患率颇高,其临床亚型呈现注意力缺陷型占优的特点,ADHD导致癫痫患儿生活质量明显降低,对认知方面的负面影响尤为突出,故在治疗癫痫的过程中,应重视共患疾病的存在,并给予适当治疗。
Objective To analyze the effect of attention deficit hyperactivity disorder (ADHD) on quality of life in children with focal seizure (FEP). Methods According to the Diagnostic and Statistical Handbook of Mental Disorders (Ⅳ) diagnostic criteria, 120 children diagnosed with FEP at the department of neurology of the Children’s Hospital Affiliated to Capital Institute of Pediatrics from May 2009 to October 2010 were diagnosed as ADHD And subtypes of clinical subtypes. Consciousness and response control ability were assessed by integrated audio-visual continuous test, and QOlIE-31 was used to assess the quality of life of 112 children. Results Among the 120 children with FEP, 21 (17.5%) were suffering from ADHD. Among them, 17 (81.0%) were ADHD-I and 4 (19.0%) were ADHD-C without ADHD-HI. There was no significant difference in the comorbidity between children with epilepsy at different stages of treatment (P> 0.05). There was no significant difference between the three groups in the comprehensive scale of attention and comprehensive scale reaction control in 120 cases of FEP (P> 0.05), of which 60 cases of benign childhood epilepsy with central temporal spikes ( There was no significant difference in the above indexes between the three groups in different stages of treatment (P> 0.05). The sub-items of quality of life and cognitive function in FEP children with comorbid ADHD were significantly lower than those without comorbid comorbidity, the difference was statistically significant (P <0.05). Conclusions The prevalence of ADHD in children with FEP is quite high. The clinical subtypes are characterized by attention deficit hyperactivity disorder. The quality of life of children with epilepsy is significantly lower and the negative impact on cognition is more prominent in ADHD. Therefore, in the treatment of epilepsy In the process, should pay attention to the existence of comorbid diseases, and give appropriate treatment.