Epilepsi Tanılı Çocuk ve Ergenlerde Konsültasyon-Liyezon Psikiyatrisi
Özet
Epilepsi tanılı çocuklarda genel popülasyona kıyasla daha fazla psikiyatrik sorun görülebilmektedir. Anti-nöbet ilaç tedavilerinin nörobilişsel ve nörodavranışsal yan etkileri de bu sorunlara katkıda bulunmaktadır. Epilepsinin bazı türlerinde ise güç fark edilen bilişsel ya da davranışsal klinik görünümler nedeniyle ilk olarak çocuk ve ergen psikiyatristlerine başvurabilmektedir. Doğru tanı ve güvenli tedavi sıklıkla çocuk nörologları ile işbirliği yapmayı gerektirmektedir. Kitabın bu bölümünde Çocukluk Çağı Nöbetleri ve Epilepsilerinde Nöropsikiyatrik Etkilenme, Epilepsi Tanılı Çocuk ve Ergenlerde Psikiyatrik Değerlendirme ve Tedavi İlkeleri ile Epilepsi Tanılı Çocuk ve Ergenlerde Sık Görülen Psikiyatrik Bozukluklar şeklinde üç başlık altında epilepsi tanılı çocuklarda konsültasyon-liyezon psikiyatrisiyle ilişkili en temel bilgilere değinilmiştir. İlk başlıkta febril nöbetler, absans nöbetleri, jüvenil myoklonik epilepsi, benign rölandik epilepsi, Landau-Kleffner sendromu, ESES/CSWS sendromu, West sendromu, Lennox-Gestaut sendromu ve Dravet sendromu gibi çocukluk çağında gelişimin sosyal, dil/iletişim, biliş/zeka ve davranış alanlarında farklı düzeylerde etkilenmeler görülen özel klinik tablolardan bahsedilmektedir. Ardından ikinci başlık altında KLP kapsamında çocuk ve ergen psikiyatristlerinin epilepsi tanılı çocuk ve ergenlerde değerlendirme ve tedavide genel yaklaşımları için yararlı olabilecek noktalara yer verilmiştir. Üçüncü başlıkta ise epilepsiye eşlik eden DEHB, zihinsel yetersizlik, otizm spektrum bozukluğu, duygudurum ve anksiyete bozuklukları ile psikozun klinik görünümü ile tedavi şekli ele alınmaktadır.
Children diagnosed with epilepsy are more likely to experience psychiatric problems compared to the general population. The neurocognitive and neurobehavioral side effects of anti-seizure medications also contribute to these issues. In some types of epilepsy, subtle cognitive or behavioral clinical presentations may lead families to seek help from child and adolescent psychiatrists initially. Accurate diagnosis and safe treatment often require collaboration with pediatric neurologists. This chapter covers the fundamental aspects of consultation-liaison psychiatry in children with epilepsy under three main headings: Neuropsychiatric Impact of Childhood Seizures and Epilepsies, Psychiatric Evaluation and Treatment Principles in Children and Adolescents with Epilepsy, and Common Psychiatric Disorders in Children and Adolescents with Epilepsy. The first section discusses specific clinical conditions observed in childhood epilepsy that affect social, language/communication, cognitive/intellectual, and behavioral development at varying levels. These include febrile seizures, absence seizures, juvenile myoclonic epilepsy, benign Rolandic epilepsy, Landau-Kleffner syndrome, ESES/CSWS syndrome, West syndrome, Lennox-Gastaut syndrome, and Dravet syndrome. The second section highlights key points that may be beneficial for child and adolescent psychiatrists in evaluating and treating children and adolescents with epilepsy within the scope of consultation-liaison psychiatry. The third section examines the clinical presentation and treatment approaches for common psychiatric disorders accompanying epilepsy, including ADHD, intellectual disability, autism spectrum disorder, mood and anxiety disorders, and psychosis.
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