儿童神经系统疾病常常会合并一种甚至多种发育行为方面的问题(注意缺陷多动障碍、抽动障碍、睡眠障碍等),因此,临床工作中不但要注意区别疾病的不同,还要关注共患病的问题。在此过程中,诊疗思维应该从生物医学模式向生物-心理-社会模式转变,正确处理神经系统疾病的同时,关注发育行为方面的问题,使患儿的身心全面健康发展,获得长期良好的预后,减轻家庭和社会的负担。
Abstract
Children's neurological diseases are often associated with an elevated risk of one or more behavioral problems (attention deficit hyperactivity disorder,tic disorder,sleep disorder).Therefore,medical staff should not only pay attention to the differential diagnosis,but also focus more on comorbid disorders.In this process,the clinical thinking should be changed from biomedical model to bio-psycho-social model,in order to obtain healthy physical and mental development,and to reduce the burden of family and society.
关键词
神经系统疾病 /
注意缺陷多动障碍 /
抽动障碍 /
睡眠障碍 /
情绪障碍 /
诊治
Key words
neurological disease /
attention deficit hyperactivity disorder /
tic disorder /
sleep disorder /
mood disorder
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参考文献
[1] Tu YF,Lin CL,Lin CH,et al.Febrile convulsions increase risk of Tourette syndrome[J].Seizure,2014,23(8):651-656.
[2] Plioplys S,Siddarth P,Asato MR,et al.Clinicians’ views on antiepileptic medication management in nonepileptic seizures[J].J Child Neurol,2014,29(6):746-750.
[3] Yi YY,Kim HD,Lee JS,et al.Psychological problems and clinical outcomes of children with psychogenic non-epileptic seizures[J].Yonsei Med J,2014,55(6):1556-1561.
[4] Tsai FJ,Liu ST,Lee CM,et al.ADHD-related symptoms,emotional/behavioral problems,and physical conditions in Taiwanese children with epilepsy[J].J Formos Med Assoc,2013,112(7):396-405.
[5] Hu C,Chen W,Myers SJ,et al.Human GRIN2B variants in neurodevelopmental disorders[J].J Pharmacol Sci,2016,132(2):115-121.
[6] Xia SG,Li XB,Kimball AE,et al.Thalamic shape and connectivity abnormalities in children with attention- deficit/hyperactivity disorder[J].Psychiatry Res,2012,204(2-3):161-167.
[7] Cohen R,Senecky Y,Shuper A,et al.Prevalence of epilepsy and attention-deficit hyperactivity (ADHD) disorder:a population-based study[J].J Child Neurol,2013,28(1):120-123.
[8] Salpekar JA,Mishra G.Key issues in addressing the comorbidity of attention deficit hyperactivity disorder and pediatric epilepsy[J].Epilepsy Behav,2014,37(3):310-315.
[9] Weng WC,Huang HL,Wong LC,et al.Increased risks of tic disorders in children with epilepsy:a nation-wide population-based case-control study in Taiwan[J].Res Dev Disabil,2016,51-52:173-180.
[10] Tamara P.Tourette syndrome and other tic disorders of childhood[J].Handb Clin Neurol,2013,112:853-856.
[11] 吴兆芳,姜琨,刘文华,等。脑瘫儿童睡眠障碍及影响因素的Logistic回归分析[J].中国儿童保健杂志,2011,19(1):48-50.
[12] Uliel-Sibony S,Kramer U.Benign childhood epilepsy with centro-temporal spikes (BCECTSs),electrical status epilepticus in sleep (ESES),and academic decline--how aggressive should we be[J].Epilepsy Behav,2015,44(2):117-120.
[13] Camfield P,Camfield C.Idiopathic generalized epilepsy with generalized tonic-clonic seizures (IGE-GTC):a population-based cohort with >20 year follow up for medical and social outcome[J].Epilepsy Behav,2010,18(1-2):61-63.
[14] Goodwin SW,Wilk P,Karen Campbell M.Emotional well-being in children with epilepsy:family factors as mediators and moderators[J].Epilepsia,2017,58(11):1912-1919.
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