中国实用儿科杂志

中国实用儿科杂志 ›› 2023, Vol. 38 ›› Issue (1): 64-69.DOI: 10.19538/j.ek2023010612

• 综述 • 上一篇    下一篇

儿童癫痫共患抽动障碍的诊治与管理

  

  1. 广州市妇女儿童医疗中心神经内科，广东  广州  510120
  • 出版日期:2023-01-06 发布日期:2023-02-13
  • 通讯作者: 陈文雄，电子信箱：gzchcwx@126.com
  • 基金资助:
    广东省医学科学技术研究基金项目（B2019030）

Diagnosis, treatment and management of epilepsy comorbid with tic disorders in children

  1. Department of Neurology, Children’s Hospital, Guangzhou Women and Children’s Medical Center, Guangzhou  510120, China
  • Online:2023-01-06 Published:2023-02-13

摘要： 癫痫和抽动障碍（TD）皆为儿童常见的慢性疾病,但两者共患研究报道尚少,共患发病机制亦未明确。癫痫发作可能增加癫痫儿童共患抽动障碍的风险。儿童癫痫共患TD发病机制被认为可能与神经生物学因素、免疫因素等相关。目前未发现单一固定模式的癫痫合并抽动障碍的临床表现形式。治疗上选用主要提高颅内γ氨基丁酸神经功能的抗癫痫药物可能对儿童癫痫共患TD有效,另外需注意避免使用一些可能会加重TD发作的抗癫痫药物。临床上TD发作有时易与癫痫一些发作类型相混淆,需注意鉴别。

关键词: 癫痫, 抽动障碍, 共患, 诊治, 管理, 儿童

Abstract: Epilepsy and tic disorders（TD） are both common chronic diseases in children. However, there are few reports on the comorbidity of the two diseases and the pathogenesis of comorbidity is not clear. Epileptic seizures might increase the risk of comorbid tic disorders in children with epilepsy. The pathogenesis of TD in children with epilepsy is thought to be mostly related to neurobiological factors and immune factors. No single fixed clinical manifestation of tic disorder in children with epilepsy has been found. The antiepileptic drugs which mainly improve the GABA nerve function in the brain are possibly effective in the treatment of TD in children with epilepsy. In addition, attention should be paid to avoid the use of some antiepileptic drugs that may aggravate TD. In clinic, TD attack is easy to be confused with some seizure types of epilepsy, and need to be classified carefully. 

Key words: epilepsy, tic disorders, comorbid, diagnosis and treatment, management, child