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Neuropsychologie bei Temporallappenepilepsien

Neuropsychology in temporal lobe epilepsy

  • Leitthema
  • Published:
Zeitschrift für Epileptologie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Temporallappenepilepsien sind die häufigste Form der fokalen strukturellen Epilepsien und charakteristisch begleitet von neuropsychologischen Beeinträchtigungen v. a. im Bereich des Gedächtnisses, aber auch in weiteren Teilleistungsbereichen wie der Aufmerksamkeit und der Sprache. Sensitive Diagnostikinstrumente können dazu beitragen, Ätiologien aufzuklären, den weiteren Verlauf abzuschätzen und die Epilepsiebehandlung hinsichtlich der individuellen Lebensqualität sowie kognitiver und affektiver Aspekte zu evaluieren.

Fragestellung

Darstellung aktueller Fragestellungen und Standards der neuropsychologischen Diagnostik bei Temporallappenepilepsien zur Detektion, Objektivierung, Prädiktion und zum Monitoring neuropsychologischer Beeinträchtigungen.

Material und Methode

Diskussion von Original- und Übersichtsarbeiten sowie von Expertenempfehlungen.

Ergebnisse

In den vergangenen Dekaden hat sich der Erkenntnisgewinn verdichtet, welche neuropsychologischen Funktionsbereiche häufig bei Temporallappenepilepsien beeinträchtigt sind. Es fehlt jedoch aktuell an verbindlichen methodischen Leitlinien zum Vorgehen in der Praxis. Neuentwicklungen zeigen sich hinsichtlich unterschiedlicher Ätiologien, die statisch oder dynamisch sein können, des Einsatzes der funktionellen Bildgebung, der Prädiktion kognitiver Veränderungen und hinsichtlich kognitionsschonender Behandlungsansätze.

Schlussfolgerungen

Evidenzbasierte neuropsychologische Diagnostik kann einen entscheidenden Beitrag zur Diagnosestellung, Therapie und Prognose bei Temporallappenepilepsien leisten.

Abstract

Background

Temporal lobe epilepsies (TLE) are the most frequent form of focal structural epilepsy and are often accompanied by neuropsychological deficits, mainly impairments of memory but also of attention and speech functions. Sensitive diagnostic tools can help to elucidate the etiology and further course of TLE, especially after resective surgery and to monitor therapeutic interventions with respect to the individual quality of life as well as cognitive and affective aspects.

Objective

Description of current indications and standards of neuropsychological diagnostics in TLE for detection, objectification, prediction and monitoring of neuropsychological deficits.

Material and methods

Discussion of original articles and reviews as well as expert opinions.

Results

In the past decades, knowledge has been accumulated on which neuropsychological functions can be impaired under which circumstances in TLE; however, methodological guidelines for assessments are still missing. New fields of research have emerged with imaging methods as diagnostic tools and the application of minimally invasive surgery in order to reduce cognitive deficits. Aside from presurgical issues, the topic of late onset, autoimmune TLE becomes more relevant.

Conclusion

Evidence-based neuropsychological assessment can significantly contribute to the diagnostics, therapy and prognosis in TLE.

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Authors and Affiliations

  1. Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland

    Viola von Podewils

  2. Klinik für Epileptologie, Universitätsklinikum Bonn (UKB), Venusberg-Campus 1, 53127, Bonn, Deutschland

    Christoph Helmstaedter &  Juri-Alexander Witt

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  1. Viola von Podewils
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Correspondence to Viola von Podewils.

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Interessenkonflikt

V. von Podewils und J.-A. Witt geben an, dass kein Interessenkonflikt besteht. C. Helmstaedter erhielt Honorare durch UCB Pharma, EISAI und GW-Pharma sowie über Versicherungsgesellschaften, öffentliche Gerichte, und EU Fördermittel (EpiCare), die jedoch nicht mit dieser Arbeit assoziiert sind.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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von Podewils, V., Helmstaedter, C. & Witt, JA. Neuropsychologie bei Temporallappenepilepsien. Z. Epileptol. 33, 22–29 (2020). https://doi.org/10.1007/s10309-019-00295-7

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