중심-측두엽 극파 동반 양성 간질에서의 인지 행동 관찰 및 topiramate 1일 1회 투약 효과
Cognitive and Behavioral Problems and the Effectiveness of Topiramate Once per Day in the Control of Benign Childhood Epilepsy with Centrotemporal Spikes
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참고문헌
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초록
목 적:본 연구는 객관적인 검사 도구를 이용하여 BECTS 환자의 인지 기능 및 행동을 평가하고 장애 여부를 판단하고자 하였다. 또한 본 연구는 예비 연구로서 BECTS 환자의 topiramate 1일 1회 투약의 항경련 효과 및 인지 기능 및 행동에 미치는 영향을 분석할 예정이다. 방 법:세브란스 어린이 병원에서 임상 증상 및 뇌파 검사 상 BECTS로 진단 받은 7명을 대상으로 전향적 연구를 시행하였다. 대상 환자들을 기본 소아 간질 인지 검사를 시행하여 인지 기능 및 행동을 평가 하였고, topiramate 단일 요법으로 치료하면서 경련의 횟수와 양상, 약물의 부작용, 환자가 호소하는 인지 기능 및 행동 장애를 추적 관찰하였다. 결 과:대상 환자들의 지능 지수, 기억 지수, 사회성 지수는 일반 인구군과 비교하였을 때 차이가 없었으나, 행동 평가에서 주의력결핍/과잉행동장애를 보인 환자가 3명(43%) 있었다. 평균 6개월 간 추적 관찰하였고 topiramate 투약 후에 간질 관해율은 100%이며 투약과 관련해서 새롭게 발생한 인지-행동 장애를 호소한 환자는 없었다. 결 론:BECTS 환자들은 인지-행동 장애를 보일 수 있으므로 면밀한 면담과 객관적인 검사가 필요하며 topiramate 1일 1회 투약으로 간질이 충분히 조절될 수 있는 가능성을 확인하였다.
Abstract
Purpose:This study was aimed to evaluate cognitive and behavioral problems in benign childhood epilepsy with centrotemporal spikes (BECTS) using objective scales. In addition, we investigated the efficacy and cognitive effects of topiramate by introducing it once a day as a pilot study. Methods:Seven patients were evaluated. They were diagnosed as BECTS based on clinical features and electroencephalography findings. We assessed cognitive and behavioral functions with several neuropsychological tests and followed up the seizure frequency, side effects, and cognitive dysfunction for six months after introducing topiramate once per day. Results:The mean intelligence quotient, memory quotient, and social quotient of patients show the difference as compared to the general population. However, three patients showed attention deficit/hyperactivity disorder. Further, the seizure reduction rate was 100% after receiving topiramate once a day and there were no newly reported neuropsychological problems on questionnaires. Conclusion:This study demonstrated that a significant number of children with BECTS have behavioral problems and that topiramate monotherapy once a day is effective.
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